Fentanyl is one of the world’s most deadly opioid drugs. It’s been around for more than six decades, and although it’s a prescription drug, it’s also illegally manufactured and distributed. It’s particularly dangerous because it’s often mixed with other street drugs, which the user may not realize.
Fentanyl is widely discussed in the news and media because it’s part of the opioid crisis that involves more than half of all overdose deaths. As a synthetic opioid, it’s 100 times stronger than morphine and 50 times stronger than heroin.
Fentanyl awareness is key for parents, teens, and college students because open and honest discussions are the best way to understand the implications of fentanyl use and avoid fentanyl overdose.
What is Fentanyl?
Fentanyl was developed around 1959-60 and was celebrated as a miracle drug by pain specialists for its potency. In recent years, the skyrocketing overdose rate has led to a re-evaluation of prescription use. Fentanyl was first prescribed in 1968, and it’s been prescribed to treat pain in children two years and older.
Types of Fentanyl
There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl. Both are considered synthetic opioids.
- Pharmaceutical Fentanyl: Doctors prescribe pharmaceutical fentanyl to treat severe pain, especially after surgery and for advanced-stage cancer.
- Illicitly Manufactured Fentanyl: Most fentanyl-related overdoses involve manufactured fentanyl, sold illegally to mimic the effects of heroin. A drug’s potency makes it more powerful, dangerous, and more addictive. This form of fentanyl is also inexpensive, which is why it’s mixed with heroin and other drugs.
Fentanyl is a semi-synthetic opioid, which means manufacturers use natural opium as part of its synthesis in a laboratory. Other examples of semi-synthetics include morphine, codeine, and heroin.
What Does Fentanyl Look Like?
Fentanyl is available in many forms. It was only available as an injection when it was first developed, but now doctors also prescribe it as a transdermal patch. In its illegal form, it can be found as a pill, film, tablet, or even blotter paper. It can also be smoked, sniffed, or snorted.
Why Do Doctors Prescribe Fentanyl?
Doctors and other medical professionals still prescribe fentanyl for pain. They might prescribe fentanyl with other analgesics to reduce and eliminate pain for cancer patients. Or they might prescribe transdermal patches to manage severe and/or chronic pain. Fentanyl effectively reduces and eliminates severe pain and offers relaxation and a euphoric high (but also confusion in some cases).
The statistics involving opioid and, by extension, fentanyl use and abuse are staggering. Fentanyl awareness means you can and should examine the stark reality of these statistics. Here’s a quick overview of the fentanyl usage statistics (how many people are using it).
Pharmacies sold some 4 million prescriptions in 2018, down from 6.5 million in 2015. Even if that gives us a sense of how many prescriptions were written, there’s still the fact that 5% of urine specimens tested positive for fentanyl in U.S. clinics. DEA agents confiscated 239 kilograms or 59.75 million lethal doses of fentanyl from 2013 to 2015.
How Does Fentanyl Work?
As a short-acting opioid, fentanyl works faster than morphine but doesn’t last as long. In the body, the drug remains for more than a day, impacting various organs and systems. It can take 2 to 16 hours for fentanyl’s narcotic effects to wear off. It can take 6 to 32 hours for fentanyl to leave the body, although it may show up in drug tests longer.
A person’s body distributes the fentanyl molecules in fat and attaches them to human plasma proteins. When fentanyl is absorbed from the bloodstream into the brain, it acts preferentially on the μ-opioid peptide receptors. The molecules also interact with κ-opioid and delta opioid receptors to produce the euphoric high.
What are the Side Effects?
The typical side effects of fentanyl include drowsiness, nausea, and vomiting. Seek medical assistance if you experience, or you see someone else experience, a severe or prolonged reaction to fentanyl.
How Does Fentanyl Affect the Brain?
Fentanyl affects the brain by binding to opioid receptors, which control pain and emotions. As you take the drug, your brain adapts, reducing the efficacy of the drug. Over some time, the body develops tolerance, and higher doses are needed to reduce pain and produce relaxation or euphoric effects.
Is Fentanyl Addictive?
Fentanyl is addictive because the body adapts to it, and when it’s no longer present, withdrawal symptoms occur. If a doctor prescribes this drug for you, they should always caution you about the side effects and withdrawal symptoms. You could become physically dependent on fentanyl or any other drug without becoming addicted. However, if you become dependent, it could lead to being addicted.
The U.S. Drug Enforcement Agency (DEA) classifies fentanyl as a Schedule II controlled substance because it can create psychological and physiological dependence and has a high risk of abuse.
What Happens When You Stop Taking Fentanyl?
People addicted to fentanyl experience withdrawal symptoms as the effects of the drug wear off. They might experience sleep problems, cold flashes, muscle and bone pain, strong cravings for the drug, diarrhea and vomiting, and other side effects. These symptoms can be extremely uncomfortable.
How Do You Treat Fentanyl Withdrawal?
The FDA approved lofexidine, a non-opioid medicine, to reduce opioid withdrawal symptoms. Also, the NSS-2 Bridge device is a small electrical nerve stimulator placed behind the person’s ear that can ease symptoms for up to five days during the acute withdrawal phase. The FDA also approved reSET®, a mobile application to treat opioid use disorders through cognitive behavioral therapy.
What Makes Fentanyl so Dangerous?
Illegal forms of fentanyl are more prevalent and dangerous than many people realize. One of the dangers is that, without lab testing, there’s no way to confirm the dose or whether fentanyl is even in the drug. Some 42% of pills tested for fentanyl contained at least 2 mg of fentanyl, considered a potentially lethal dose.
How Much Fentanyl is Fatal
Manufacturers probably began developing and distributing illegal fentanyl around 1979, but it’s not an exact process or science. Even the smallest amounts (2 milligrams) of fentanyl can be dangerous and deadly depending on a person’s tolerance, body size, and concurrent drug use.
Sold by weight in kilograms by many illegal distributors, one kilogram of fentanyl could kill up to 500,000 people. A person might take fentanyl without knowing it or consume a dose without knowing the concentration is lethal.
Drug dealers sometimes mix fentanyl with cocaine, heroin, methamphetamine, and MDMA to increase profits. So a person may not know exactly what they’re taking, what concentration of fentanyl it contains, and whether it’s a dangerous combination.
What Are Signs of a Fentanyl Overdose?
If you recognize the signs of opioid overdose, you might be able to save a life. Here are some symptoms to look for:
- Clammy or cold to the touch
- Discolored skin (bluish lips and nails)
- Gurgling or choking noises
- Loss of consciousness (they might not be able to stay awake)
- Shallow or weak breathing (they may have stopped breathing altogether)
- An unresponsive, limp body
Since fentanyl is often combined with other drugs, the overdose may look or sound different. Whenever you see a person in obvious distress, call 911 and get medical assistance immediately.
How Can You Treat Fentanyl Overdose?
You may not know whether they’ve taken fentanyl. Even the overdosing person may think they took a different drug. The first step is always to call 911 and ask for immediate assistance. Follow the directions of the 911 operator until the paramedics arrive and assess the person’s condition.
If it’s a fentanyl overdose, they will likely administer an injectable naloxone solution (common brands include Narcan and Kloxxado) to treat the opioid overdose. It blocks the effects of opioid drugs like fentanyl, which is why they must administer it immediately.
Since naloxone is not as strong as fentanyl, they may have to administer multiple doses to counteract the overdose effects. Even after the paramedic administers the naloxone, they still need to monitor the person, so they’ll typically transport them to the hospital.
Depending on where you’re located, you may get naloxone from a pharmacy without a prescription. You can also use or keep the naloxone nasal spray for emergencies that might come up.
How to Speak to Your Friends or Loved Ones About Fentanyl Awareness
Fentanyl awareness is important, but it’s not always easy to start conversations about it. Here are a few tips that should help you talk about it, including simple suggestions for what you should cover.
Talk About the Stats
While the number of overdoses and deaths may vary in your area, the bleak reality is difficult to ignore. So, talk about what’s happening. Mention the national numbers, but also talk about what’s happening in your area.
Let Them Know the Risks
Talk about what fentanyl does, what the side effects are, and what withdrawal symptoms look like. Be honest and upfront about what could happen with an overdose. This discussion is not only about what could happen to your kids, friends, or other loved ones. It’s also to raise their fentanyl awareness and let them know what to look for if someone they know goes through withdrawal or overdose.
Help Them Get Naloxone
Depending on where you’re located, you might get naloxone injections over the counter at a pharmacy. You may get the nasal spray. Find out what form you have access to, and then help your friends and family know how to get it in case of emergencies.
National Fentanyl Awareness Day
National Fentanyl Prevention and Awareness Day is a way to remember loved ones affected by and who have died from fentanyl poisoning. It’s a way to raise fentanyl awareness to help your community better understand how it has affected families and friends.
- 10 Strategies to Prevent Your Young Person from Using Drugs
- Buying Drugs Online – What You Should Know & How to Protect Your Kids
- Growing Up Drug Free – a Parent’s Guide to Prevention
- How Teens Misuse Medicine
- Is naloxone accessible? from National Institute on Drug Abuse (NIDA)
- Medications to Treat Opioid Disorder from National Institute on Drug Abuse (NIDA)
- Naloxone Drug Facts from National Institute on Drug Abuse (NIDA)
- Naloxone for Opioid Overdose: Life-Saving Science from National Institute on Drug Abuse (NIDA)
- Opioid Overdose Toolkit from SAMHSA
- The Helping to End Addiction Long-term Initiative from NIH HEAL Initiative