Fentanyl is a powerful synthetic opioid.
Opioids are medications that reduce pain by targeting opioid receptors in the brain. Most of them are produced using the poppy plant, but synthetic opioids such as fentanyl are manufactured in the lab. According to the National Institute on Drug Abuse, fentanyl is 50-100 times more powerful than morphine, another powerful (natural) opioid from which heroin is derived. So what is fentanyl made from that makes it so powerful?
In the United States, the Drug Enforcement Administration classifies fentanyl as a Schedule II substance, meaning it has a high potential for abuse and physical dependence but has a recognized medical use as a prescription drug. Fentanyl is so potent that it is now competing with heroin as the most dangerous opioid on the market.
Fentanyl is also commonly abused alongside other substances. Since it is so potent and powerful, it is often used as a cheap way of cutting more expensive drugs. However, the consequences of consuming fentanyl unwittingly can be catastrophic. Additionally, combining it with other substances often affects the brain in surprising and unpredictable ways. Using fentanyl irresponsibly in this fashion can often be fatal.
According to the Centers for Disease Control and Prevention, overdoses due to fentanyl are on the rise. This is in part due to the increased availability of illegally-made non-pharmaceutical fentanyl. From 2012 to 2015, the number of deaths due to overdoses from synthetic opioids such as fentanyl almost tripled. Because fentanyl is so easy to produce in large quantities, and because even a pinch of it is so powerful, drug dealers are turning more and more often to selling fentanyl, which in many areas is now more accessible than heroin. Additionally, among abused substances, fentanyl is particularly easy to ship undetected. This has contributed to a large extent toward the spread of the substance.
Due to its affordability and potency, fentanyl is commonly used by drug dealers to cut or lace other drugs, particularly opioids such as heroin. As a result, many drug addicts who are trying to buy heroin are often consuming fentanyl as well. Unfortunately, while heroin is obviously dangerous in and of itself, consuming both drugs simultaneously exposes addicts to increased risks. Because both opioids are central nervous system depressants, the chances of respiratory depression increase.
When respiratory depression occurs, breathing slows or comes to a stop entirely. Additionally, the chances of overdoses skyrocket. This is particularly true because heroin users are consuming fentanyl accidentally, and when using opiates it is important to match potency and dose to the individual user’s tolerance and sensitivity levels.
It is also common for fentanyl to be mixed with cocaine and pressed into pill form. These substances, which are sold on the street under many names, are often sold without any mention of the fentanyl contained within. Combining opioids with stimulants such as cocaine is known as speedballing.
These substances, which have opposite effects, are used together because they both provide powerful and euphoric “highs” and tend to nullify the other drug’s negative effects. However, the risk of overdose increases alongside the high. Stimulants such as cocaine overwork the heart and cause the body to use more oxygen.
On the other hand, fentanyl and other depressants cause users to breathe more slowly and can even slow the rhythm of the heart itself. These contradictory effects can be life threatening.
Unfortunately for many addicts, it is often unclear what they are getting when they choose to purchase an illicit drug. Fentanyl can be added to many drugs, including heroin and cocaine. Drug dealers who are trying to profit may not mention this, which adds an additional risk factor. These shady practices can occur when fentanyl is purchased on the street, but it is becoming more and more common with drugs purchased on the Internet’s “dark web” as well.
For this reason, it is crucial to use fentanyl only under strict medical supervision. However, even when fentanyl is taken for its legitimate purpose of treating severe and chronic pain, it can cause serious health problems. Even at a reasonable and non-abusive dose, fentanyl can cause confusion, nausea, and constipation, drowsiness and sedation, problems breathing, and sometimes unconsciousness.
Physicians often find that even patients who take fentanyl responsibly develop a tolerance and dependence on the substance. At this point, a prudent physician will often work with the patient to taper off the opioid and thereby avoid the most severe withdrawal symptoms.
For addicts who purchase fentanyl illegally or who have accidentally ingested fentanyl via an adulterant found in another substance, it is often a good idea to seek substance abuse treatment. Recovery programs such as sober living homes, rehabs, and medical detox centers can provide the support and supervision necessary to become drug-free.