As recently as three years ago, not many people outside the medical profession or law enforcement had heard of fentanyl. Public awareness of the dangers of fentanyl increased exponentially when Prince died from an apparently self-administered dose of fentanyl in April 2016. The drug is so powerful that law enforcement officers must wear protective gear when searching for it because skin exposure/absorption or inhalation can be fatal. Agents are trained in how to give themselves the antidote drug naloxone (Narcan) in case of accidental exposure to fentanyl. The following fentanyl facts shed light on the dangers of this incredibly powerful opioid drug:1
Is Fentanyl an Opiate?
Yes, fentanyl is a synthetically made opiate or opioid medication. The terminology opiate versus opioid is a matter of semantics rather than the inherent characteristics of the drugs in this category. Opiate is generally an older term used for drugs derived from opium, although the word is still used in clinical context with withdrawal. The term opioid encompasses the entire family of opiate drugs including illicit drugs like heroin, semi-synthetic prescription drugs like hydrocodone and synthetic prescription drugs like fentanyl.2,3
What Is Illicit Fentanyl?
Unlike controlled, FDA-approved fentanyl, the ingredients in illicit fentanyl are often unknown. Fentanyl derivatives such as acetyl fentanyl, furanyl fentanyl and carfentanil have been detected in drug seizures and overdose toxicology. Moreover, illicit fentanyl is often laced with cocaine and heroin or made to look like oxycodone or other opioid painkillers. Experts compare this deception to ordering a glass of wine and drinking a lethal dose of pure ethanol. Pure fentanyl is inexpensive and a 3 mg dose is enough to kill an average-size adult male. Clandestine labs and drug dealers have no hesitation when it comes to producing and peddling fentanyl in its pure and most lethal form to unsuspecting individuals looking for a high, or adding it to heroin, which often results in fatal overdoses.4,5,6
What Is Fentanyl Used For?
It is typically prescribed for the treatment of severe post-surgery pain and sometimes for chronic pain that does not respond to other medications in adults and even critically ill newborn infants. The transdermal patch is indicated for the management of persistent, moderate to severe chronic pain in opioid-tolerant individuals when a continuous, around-the-clock opioid analgesic is needed for an extended period of time. It is considered the go-to drug for crippling, otherwise intractable pain experienced by many individuals with advanced cancer. Illicit fentanyl is readily available, relatively inexpensive and abused for its powerful high.3,7
Are Fentanyl and Heroin Similar?
In powder form, fentanyl and heroin look identical and both are opioids. Heroin is illegal whereas fentanyl is available as both an FDA-approved prescription drug and as an illicit street drug. Fentanyl is 30 to 50 times more potent than heroin. It takes less than 3 mg to die from fentanyl versus 30 mg of heroin. The chemicals in both drugs bind to opioid receptors in the brain, although fentanyl gets there faster than morphine because it passes more easily through plentiful fat in the brain. Morphine is the nearly instantaneous byproduct of heroin broken down by the body. Fentanyl also hugs the receptor so tightly that just a tiny amount is enough to start the molecular chain of events that trigger opioid effects in the body. While naloxone (Narcan) is highly effective at reversing heroin overdoses, it takes far more to combat a fentanyl overdose.4
- Fentanyl worries changing way narcotics officers operate. The Big Story/Associated Press website. http://bigstory.ap.org/article/3fc71c46fdb74280a14663fa65b626e2/fentanyl-worries-changing-way-narcotics-officers-operate Published June 26, 2016. Accessed February 11, 2017
- Opiates/Opioids. The National Alliance of Advocates for Buprenorphine Treatment website. https://www.naabt.org/education/opiates_opioids.cfm Accessed February 11, 2017.
- What Is Fentanyl? The Drug That Killed Prince Has Killed Thousands of Others. NBC News website. http://www.nbcnews.com/news/us-news/what-fentanyl-drug-killed-prince-has-killed-thousands-others-n584961 Published June 3, 2016. Accessed February 11, 2017.
- This photo shows exactly why Fentanyl is deadlier than heroin. PBS News Hour website. http://www.pbs.org/newshour/rundown/fentanyl-deadlier-heroin-single-photo/ Published September 30, 2016. Accessed February 11, 2017.
- Kerensky T, Walley AY. Opioid overdose prevention and naloxone rescue kits: what we know and what we don’t know. Addict Sci Clin Pract. 2017;12:4. doi:10.1186/s13722-016-0068-3.
- Fentanyl: The dangers of this potent “man-made” opioid. Harvard Health Blog website. http://www.health.harvard.edu/blog/fentanyl-dangers-potent-man-made-opioid-2016080510141 Published August 5, 2016. Accessed February 11, 2017.
- Fentanyl Injection. Drugs website. https://www.drugs.com/fentanyl.html Updated September 30, 2016. Accessed February 11, 2017.