What Is Fentanyl? Forms & Risk

Fentanyl is a synthetic opioid 80 to 100 times stronger than morphine.

Experts once worried about people stealing and abusing fentanyl recreationally. Now, they worry about people buying drugs tainted with fentanyl and overdosing. 

3 Forms of Fentanyl You Should Know About

Doctors asked for a drug that was strong enough to help people with significant cancer pain. They wanted a medication that worked quickly, lasted a long time, and would be effective even in people who had taken painkillers before.

Fentanyl was the result.

Synthetic drugs like fentanyl are flexible. Chemists can transform them into almost any shape and size a consumer might want. But in general, there are three classifications of fentanyl drugs every consumer should be aware of. 

Fentanyl can appear in these forms:

• Illicit street drugs: A dealer could sell fentanyl pills, nasal sprays, candies, or eye drops. Some make fentanyl-infused papers users can put on their tongues.
  
  Some dealers tell their customers that the products they’re purchasing contain fentanyl. Others stamp or label their products with the word “fentanyl” or some abbreviation.
  
• Prescription medications: Shots, patches, and lozenges with fentanyl are available from doctors and pharmacies. These products should be clearly marked with a manufacturer’s name, and some have dosing information stamped on them.
  
• Tainted street products: Powdered fentanyl made in a lab is pressed into pill shapes, and dealers could mark these products with words like “Vicodin” or “ecstasy.” Dealers can also substitute fentanyl for powdered heroin.
  
  Drug users generally don’t know when their products are contaminated in this way. They think they are taking something else entirely, not fentanyl.

Unless you’re buying medication from a reputable pharmacy, or your dose is delivered by a doctor in a medical setting (like a hospital), you may not know if the product you’re about to use contains fentanyl, has no fentanyl, or something in between. 

Dangers of Fentanyl-Laced Drugs

Do you know what’s inside the pill you’re about to take? Are you sure your heroin dose only contains heroin? There is a decent chance the next hit you buy from a dealer will contain fentanyl, and its power could kill you.

Fentanyl contamination is dangerous for many reasons.

 

• It is easy to hide. Fentanyl is colorless, tasteless, and impossible to spot on sight. Only a lab can verify its presence and the strength of the dose you’re about to take.
  
• It is strong. Fentanyl is up to 100 times stronger than morphine. You may know just how much morphine, heroin, or Vicodin to take to get high. But use that same amount of fentanyl, and you could overdose.
  
• It is deadly. Overdose deaths involving synthetic opioids like fentanyl rose 16 percent between 2018 and 2019. Far too many people lose their lives by taking contaminated drugs. 

Fentanyl is so powerful that experts say people abusing it regularly would have a very high tolerance for opioids and might need a tailored treatment plan. But so few people survive fentanyl doses that there aren’t enough of them to study. 

Signs of Fentanyl Overdose & What to Do

Bystanders are present in most opioid overdose cases. If you suspect someone has taken too much of any opioid, or you think someone has taken a drug tainted by fentanyl, you must act quickly. Overdose is very likely with fentanyl use.

An overdosing person may exhibit strange symptoms. Look for the following:

• Collapse: No matter how hard you shake, you can’t wake the person up. They seem completely unresponsive.
• Strange breathing: Slow, shallow breaths accompanied by gurgling sounds are common in a fentanyl overdose. 
• Changing colors: A blue tinge creeps over the person’s lips and fingernails. Their face may take on an ashen appearance.
• Stiffness: Curled hands, clenched jaws, open eyes, and a statue-like appearance could all indicate a fentanyl overdose. 

Pick up your phone and call 911 immediately. While you wait for emergency response teams, administer naloxone. This prescription opioid agonist knocks active fentanyl from receptors and can reverse an overdose quickly.

Give one dose of naloxone, and if the person doesn’t wake up, give another dose. Repeat this process until the person wakes up or the emergency teams arrive. 

If you use drugs or know someone who does, always keep naloxone with you. Use a site like this to find places that will dispense naloxone. Some community organizations and pharmacists will give you the medication without a prescription, and they’ll show you how to administer the drug to someone overdosing. 

A Risky Substance

Fentanyl is an incredibly risky substance that can quickly lead to death. If you suspect an overdose, fast action is imperative to save a life.

References

Fentanyl. United States Drug Enforcement Administration. 

Fentanyl Facts. (February 2022). Centers for Disease Control and Prevention. 

Fentanyl Drug Facts. (June 2021). National Institute on Drug Abuse. 

Why Fentanyl Is Deadlier Than Heroin in a Single Photo. (September 2016). Stat. 

Fentanyl Warning for Parents and Students. Seattle and King County Public Health. 

Fentanyl. (February 2021). Centers for Disease Control and Prevention. 

Research on the Use and Misuse of Fentanyl and Other Synthetic Opioids. (June 2017). National Institute on Drug Abuse. 

Fentanyl: The 411. (July 2021). New York State Department of Health. 

Lifesaving Naloxone. (February 2022). Centers for Disease Control and Prevention. 

State Finder. Next Harm Reduction.

The Fentanyl Story. (December 2014). The Journal of Pain.

Fentanyl Kills So Fast That Aid Groups Are Rethinking How to Fight Overdoses. (April 2022). The Wall Street Journal.

Addressing the Fentanyl Threat to Public Health. (February 2017). The New England Journal of Medicine.

Fentanyl Invades More Illicit Pills, With Deadly Consequences. (December 2021). The Wall Street Journal.

The Rising Crisis of Illicit Fentanyl Use, Overdose, and Potential Therapeutic Strategies. (November 2019). Translational Psychiatry.