Substance Abuse
Substance Abuse: Fentanyl

Why Is Fentanyl So Dangerous?

What Is Fentanyl?

Fentanyl is a synthetic opioid drug similar to morphine but as much as 100 times stronger.  Fentanyl is a medicine developed for cancer pain and is commonly used to treat severe pain, particularly after surgery. The drug is also used to treat chronic pain in patients who have developed a tolerance to other opioids. T

How Is Fentanyl Used

When used with a prescription, fentanyl is an injection, a patch, or even lozenges sucked like cough drops.  Most illegal fentanyl is made in illicit labs and sold as a powder, on blotter paper, or in pills similar to other prescription opioids.  It is even made into illegal eye drops and nasal sprays.  

Fentanyl Facts

Commercial fentanyl is known as Actig®, Duragesic®, and Sublimaze®.  

The primary source of illegal fentanyl is Mexico.  

Street names include Apache, China Girl, China Town, China White, Dance Fever, Goodfellas, Great Bear, He-Man, Poison, and Tango & Cash.  

Synthetic opioids, including fentanyl, are currently the most common cause of drug overdose deaths in the United States.  

Measured from September 2020 to September 2021, says the CDC, the death toll tops 100,000, being the highest among Black and Native American men, with more than 50 deaths per 100,000 persons.   

How Dangerous Is Fentanyl

Fentanyl is at least 80 times stronger than morphine and hundreds of times more potent than heroin.  It has an extremely high potential for abuse and addiction.  Even the first dose can produce cravings for more.  Its side effects are physically dangerous.  Overdose is common due to depression of the central nervous system resulting from taking increasingly large doses.  The DEA says that 2 milligrams of pure fentanyl are a lethal dose.  Nearly half of the illegal pills seized include at least this dose.

Effects of Fentanyl Use

Like all opioids, fentanyl binds to the body's opioid receptors in the regions of the brain controlling pain and emotions.  The brain gradually adapts to the drug, making it harder to feel pleasure in any other way.  


Fentanyl produces an intense short-term high with feelings of euphoria.  It can relax the user, provide sedation and pain relief, and cause confusion, drowsiness, dizziness, vomiting, and pupillary constriction.  It slows respiration and reduces blood pressure.  Side effects include nausea, fainting, seizures, constipation, urine retention, and death.  


Long-term effects of fentanyl include chronic, severe constipation and bowel obstruction, breathing problems, heart failure, immune system suppression, and reproductive issues in both sexes. 

Dangers of Combining with Other Drugs

Some users mix fentanyl with heroin, cocaine, methamphetamine, and MDMA (a synthetic stimulant hallucinogen).  Fentanyl is relatively cheap because it takes so little to affect the user.  Combining it with more expensive drugs reduces the overall cost of the high.  However, it also increases the risk, especially if the user is not aware there is fentanyl in the mix.  These combined drugs are more likely to lead to overdose because of the strength of the fentanyl.  

Addiction and Treatment Options

Fentanyl is highly addictive because of its potency.  Even those taking the drug under a prescription can become addicted or dependent.  


Addiction is the most extreme form of compulsive and uncontrolled drug-taking.  Addicts take drugs despite adverse consequences. Fentanyl withdrawal symptoms include:

  • Bone and muscle pain
  • Sleep problems
  • Diahhea and emesis
  • Cold flashes
  • Leg spasms

Drugs and medical devices are now available to ease withdrawal.


Like all opioids, fentanyl addiction is best treated with medication and behavioral therapy.  Methadone and buprenorphine bind to opioid receptors, reducing cravings and withdrawal symptoms.  Naltrexone, in contrast, blocks the receptors and prevents fentanyl from having any effect.  

Various therapies have been used to treat addiction:

  • Cognitive behavioral therapy
  • Contingency management therapy
  • Motivational interviewing therapy

Overdosing and Treatment

Because of the potency of fentanyl and because it is mixed with other drugs, overdoses are common.  The overdose can be treated with Naloxone, a drug that blocks opioid receptors.  Because of fentanyl's strength, several doses may be required.  


What Makes Fentanyl So Dangerous? | October Road (

It only takes a small amount of fentanyl to cause an overdose. (

Fentanyl: Incapacitating Agent | NIOSH | CDC

Fentanyl DrugFacts | National Institute on Drug Abuse (NIDA) (

Fentanyl: What You Need To Know - National Coalition Against Prescription Drug Abuse (

Methylenedioxymethamphetamine (MDMA or 'Ecstasy') drug profile |

Black men hit hardest by drug overdose deaths in recent years | Pew Research Center

Drug Overdose Deaths in the U.S. Top 100,000 Annually (


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