How to Identify Fentanyl

What Is Fentanyl?

A synthetic opioid drug that is extremely potent, fentanyl is a Schedule II controlled substance by the Drug Enforcement Administration (DEA) due to its high potential for diversion, misuse, overdose, and addiction. 

Fentanyl is produced pharmaceutically in lozenge, buccal and sublingual tablets, patch, and injectable formulations. It is most commonly used to treat breakthrough cancer pain in people who are tolerant to opioids. 

Fentanyl is also commonly illegally manufactured into illicit fentanyl, which can be made into powder or liquid form. It is also pressed into counterfeit pills and laced into other drugs such as heroin. 

Fentanyl is commonly found in street drugs without the user’s knowledge. This can be especially dangerous, as it can be lethal in very small doses (as small as the size of the head of a pin). Synthetic opioids, which mainly means fentanyl, were involved in more than 70,000 overdose deaths in 2020.

Key Facts About Identifying Fentanyl

What Does Pharmaceutical Fentanyl Look Like?

Pharmaceutical fentanyl is administered in several different ways to treat breakthrough cancer pain in patients who are tolerant to opioids and for whom other methods of pain management are not working. This can include the following:

• Transmucosal sublingual tablet (Abstral): The 100 mcg dose can be in a blue or white round tablet; the 200 mcg dose is commonly white or orange and oval-shaped; the 300 mcg dose is brown or white and three-sided (triangle shaped); the 400 mcg dose is purple or white and diamond shaped; the 600 mcg dose is U- or D-shaped and blue or white; and the 800 mcg dose is white or purple and capsule-shaped.
• Buccal tablet (Fentora): This tablet is usually white or yellow and imprinted with the dosage amount on one side (“8” for 800 mcg, for instance) and the logo (“C” for Cephalon, the manufacturer) on the other.
• Lozenges (Actiq): Often called the fentanyl “lollipop,” Actiq is a lozenge on the end of a stick that is generally a white or off-white solid formulation imprinted with ACTIQ and the number indicating dosage, such as “800.”
• Transdermal patch (Duragesic): The fentanyl patch is translucent, small, and thin. It is packaged individually to keep patches from sticking together. The fentanyl patch is sticky on one side and smooth on the other. It is a rectangular patch with rounded corners, often marked with orange ink indicating the brand name DURAGESIC and the dosage amount.
• Injectable solution (Sublimaze): This is a liquid solution that is contained in 2 mL ampules. It is generally dispensed in a hospital setting by a trained medical professional.
• Nasal spray (Lazanda): This product is a nasal spray that comes in a clearly labeled applicator with the name of the medication (Lazanda) and dosage amount printed on the label.

What Does Illicit Fentanyl Look Like?

Illicit fentanyl is made in clandestine laboratories and can be made into a powder, pill, chalk-like block, or liquid form. It can be made in a variety of colors, shapes, and sizes. 

Fentanyl is lethal in very small doses. Typically, a dose as small as 2 mg is enough to cause a fatal overdose. 

Fentanyl is very commonly mixed in with other illicit drugs, such as heroin in both powder and liquid form, and it is hard to tell it apart from these drugs. It is also pressed into pills of various shapes and colors, and it can be made to look like many other licit drugs.

Rainbow fentanyl is a fairly new trend of making fentanyl in bright colors to appeal to a younger audience. This bright fentanyl is made into powder and pills as well as blocks that look like sidewalk chalk. 

Illicit fentanyl can be made to look a variety of different ways and can therefore be easy to mix into other drugs or substances. It is very hard to detect with the naked eye, making it extremely dangerous.

What Does Fentanyl Taste Like?

Fentanyl has no specific taste, and it is not detectable with a “taste test.” With the exception of Actiq, which has berry flavor added to it, fentanyl has no discernable taste. 

It can also be absorbed through the skin, but it is a common misperception that you can overdose on fentanyl quickly by touching it. It takes hours to absorb the drug via skin, such as with fentanyl patches.

What Does Fentanyl Smell Like?

Fentanyl does not have a particular smell, and it is impossible to detect by trying to smell it. Fentanyl can often be unknowingly mixed into other substances and drugs. Other than testing the drug, there is generally no other way to detect its presence.

What Does Fentanyl Feel Like?

Physically, fentanyl can feel like a grainy or chalky powder or liquid. 

When taken, the user will experience a fentanyl “high,” which is euphoric and mellow as well as intense. The high starts almost immediately upon taking it. 

Fentanyl blocks pain sensations and floods the brain with pleasure. It also slows down the central nervous system, which can make you feel heavy, drowsy, and relaxed. It can also cause dizziness, nausea and vomiting, confusion, and breathing issues. 

Fentanyl is highly addictive. After initial use, people often want to continue using it.

How Is Fentanyl Taken?

Fentanyl is taken both pharmaceutically and recreationally, and it can be administered in a variety of different ways. Pharmaceutically, fentanyl is taken in the following ways:

• Ingested: Fentanyl is commonly distributed through a transmucosal delivery system, which involves a dissolvable tablet (either sublingual that is placed under the tongue or buccal, which is placed in the cheek cavity) or as a lozenge.
• Injected: Injectable fentanyl is commonly given through an IV (intravenously) or directly into the body via injection by a trained medical professional in a hospital setting.
• Transdermal: The fentanyl patch is placed on the skin to deliver fentanyl through the skin in a controlled fashion over a period of 72 hours.

Illicit fentanyl can be taken in the following ways:

• Orally: Pills or tablets can be swallowed or chewed and then swallowed.
• Intranasally: Powder can be inhaled through the nose, or tablets can be crushed and then snorted.
• Injected: Fentanyl can be injected as a liquid solution, or the powder can be dissolved and then injected.

Tips to Avoid Taking Illicit Fentanyl

Fentanyl can be very dangerous to take, especially if you do not realize you are taking it. Here are some tips to help you avoid taking illicit fentanyl:

• Look at how the substance appears. It can be hard to detect fentanyl in powder form, but counterfeit pills and tablets often have “tells” showing that they are fake. They may be the wrong color, have the wrong logos imprinted on them, or be in strange shapes. Many counterfeit pills are difficult to tell from the real ones, however.
• Use a drug test. There are several technologies that can detect fentanyl, including a gas chromatograph/mass spectrometer, but you likely will not have access to these types of testing. Fortunately, fentanyl test strips can be just as effective at detecting fentanyl in illicit drugs. These strips are a cheap and easy method with lifesaving potential.
• Go to a harm reduction location to test your drugs. Many of these locations now offer methods or test strips for detecting fentanyl to help protect you from accidental overdose.

Overdose Prevention Tips

To minimize the chance for overdose, the best method is to ensure that you are not accidentally taking fentanyl without knowing it. Tips for preventing overdose include the following:

• Avoid mixing fentanyl with other drugs or medications.
• Take pharmaceutical fentanyl exactly as directed.
• Use a fentanyl test strip to detect fentanyl before using illicit drugs.
• Take the least amount possible and wait to take extra doses.
• There is safety in numbers. Always have someone with you if you are going to use drugs.
• Injecting drugs carries the highest risk, so consider other administration methods.
• Always have naloxone on hand to reverse an overdose. It should be promptly administered if overdose is suspected.
• Call 911 if an overdose is suspected even if naloxone is administered. Medical attention is still needed.

The Bottom Line

The best way to identify fentanyl is with testing strips that can detect the drug or its analogues. It is very difficult to identify fentanyl by look, feel, or smell.

Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More