5 Things You Probably Didn’t Know About Fentanyl

The Drug Enforcement Agency’s (DEA) Campaign, “One Pill Can Kill” has swept through Facebook, Instagram, and Twitter warning teens, parents, and young adults everywhere of the dangers of illicit fentanyl. Billboards with victims of the fentanyl crisis and strong warnings like, “Don’t die to get high” and “Don’t let it happen to you” are in major cities across the United States. Fentanyl is one of the world’s strongest synthetic opioids and fentanyl poisoning is the leading cause of death for young adults in the United States. Let’s take a few minutes to talk about some things that most people don’t know about fentanyl. Here are five facts about fentanyl that will increase your awareness and ability to educate others about the risks of illicit fentanyl, fentanyl poisoning, and what to do if you were to encounter an overdose

#1 – First Thing You Probably Didn’t Know About Fentanyl

In most 2023 households the word “fentanyl” has parents turning their heads and paying closer attention to everything around them and this is a good thing. I had only heard of the drug from my adult child who was battling addiction until fentanyl poisoning took his life. At the time, I didn’t understand that there are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl (IMF)

Pharmaceutical fentanyl is prescribed by a doctor and is very closely monitored. The drug is often used for patients after surgery of for those in end-of-life care. When caregivers are administering fentanyl to patients, they wear gloves and use extreme caution to avoid accidental fentanyl poisoning. In its prescription form fentanyl can be given as a shot, a patch that is put on a person’s skin, or in the form lozenges.

IMF is not monitored by the FDA and is completely unregulated. Because it is not regulated, IMF is responsible for the most fentanyl overdoses and poisonings. IMF has inconsistent amounts of the drug in each dose and is often pressed with a combination of other illicit substances. Adding fentanyl to other drugs makes them cheaper, more powerful, more addictive, and dangerous. IMF is intentionally being brought across the boarders of the United States and it is being used to take American lives everyday.

#2 – Second Thing You Probably Didn’t Know About Fentanyl

Mexican drug cartels are responsible for most of the IMF in the United States. It can be bought on the streets, online, and even in schools and shopping malls. As parents, we work to educate our children and to limit their access to exposure that is counterproductive to dangerous and unhealthy living. Unfortunately, The belief that our children and families are not being impacted by drug culture is dangerous. Having a strong understanding of the many ways that IMF is accessed arms us all with the information that we need to educate our children and combat the fentanyl epidemic.  IMF has several street names including Fetty, Apache, Dance Fever, Friend, Goodfellas, Jackpot, Murder 8, Tango & Cash. Knowing the street names and the context which these names are often used is helpful for parents and caregivers of adolescents and teens.

#3 – Third Thing You Probably Didn’t Know About Fentanyl

According to the DEA 7 of every 10 fake pills have enough fentanyl to take a life. The lethal dose of fentanyl is just two milligrams, to put that into perspective: roughly two grains of salt are enough to kill a person. Because of the number of people being poisoned by fentanyl, many states invest time and resources into harm reduction kits. Harm reduction kits have both Naloxone, also known as Narcan, and Fentanyl Testing Strips (FTS). Narcan is used to reverse the effects of an overdose and FTS detect the presence of fentanyl in the sampled portion of a drug. While access to harm reduction kits is one step in the direction of overdose prevention. Please note that an FTS can detect fentanyl in the portion of the drug being tested, fentanyl is not evenly distributed. Relying on an FTS is extremely risky because there is no way to know if the untested portion of a drug contains fentanyl.

Until recently, Narcan has not been treated like an item that should be in every first aid kit or floating around in the bottom of purses and make up bags. The truth is though that access to Narcan is crucial in reversing the effects of fentanyl poisoning. There are many non-profit harm reduction organizations that distribute Narcan for free. The resources and points of contact do vary from one state to the next, but NEXT Distro provides free Narcan by mail regardless of which state you live in. Another way to access both Narcan and Fentanyl Testing Strips is to check out the National Harm Reduction Coalition Website. You use the websites prompts to see if there are any resources in your local area, this can be faster than waiting for Narcan in the mail.

#4 – Fourth Thing You Probably Didn’t Know About Fentanyl

According to the Centers for Disease Control and Prevention, it is estimated that 187 people in the U.S. die every day of opioid poisoning or overdoses. Of these fatalities the most common drug identified through autopsy is IMF.  Some victims of the fentanyl epidemic have struggled with addiction and have developed a chemical dependency to the drug, but this is not always true. Fentanyl has stolen the lives of small children, college students, professionals, athletes, and celebrities. Fentanyl has taken children from wealthy families, poor families and families of every race and color. Fentanyl is an indiscriminate killer, it is swift, and often times quiet. Many parents who have lost children to fentanyl have reported not having had concerns about their child and drug use until it was too late. Educating our children, friends, family, and communities at large around the risks of fentanyl poisoning is a powerful way to arm ourselves and our society in the war on drugs.

#5 – Fifth Thing You Probably Didn’t Know About Fentanyl

Fentanyl is manufactured in both powdered and liquid forms – IMF is available on the drug market in different ways including powder, dropped on blotter paper, in eye droppers or nasal sprays, disguised to look like candy, and made into pills that look like real prescription opioids. It is a common misconception that all IMF only comes in the form of a small blue pill. While sometimes this is true IMF has many faces is dangerous regardless of its form. Beginning in August 2022, DEA starting seizing rainbow fentanyl across the United States. Rainbow fentanyl is a form of IMF that comes in a variety of bright and attractive colors. These fake pills are easily mistaken for candy and are especially dangerous for young children who might think they have stumbled on a sweet treat. According to the DEA, the distribution of rainbow fentanyl is done intentionally. Drug traffickers use the bright colors and candy like design to lure kids and young adults into the addiction. With fentanyl being as addictive as it is lethal, new users are either poisoned with the first dose or have become addicted to the drug very quickly.

Because of the variety of ways that the drug is produced it is easily added to other substances. Criminal drug networks are mass-producing fake pills and falsely marketing them as legitimate prescription pills to deceive us all. Street drugs like heroin, cocaine, and methamphetamine are often laced with fentanyl without the knowledge of drug users. Many poisonings happen because a person believes that they are taking a legitimate pill when it is actually fentanyl. The recreational drug culture has changed significantly since the “Just Say No” campaign warned young children to avoid illicit drugs by saying, “No!” In today’s drug culture, “One pill does kill”. Too often, experimentation leads to death. Fentanyl is so strong that many users are poisoned and pass away the first time they take a fake pill or smoke marijuana that is laced with fentanyl.

Narcan Administration

When a person has been poisoned by fentanyl, there are a few crucial steps to be taken. Narcan needs to be administered and emergency services needs to be contacted. Narcan should be given to the person being poisoned as soon as possible and then every two to three minutes until the person begins breathing normally. The early arrival of first responders is extremely important because Narcan’s effects do not last long and many times the effect of the overdose or poisoning returns within a few minutes of Narcan being administered.

Many people make the choice to jump in and provide CPR when a person has stopped breathing. Providing rescue breaths is a very big risk when fentanyl is involved. A transfer of the poison can quickly lead to a secondary emergency. Providing compression only CPR is a way to keep the heart pumping while waiting for the arrival of the First Responders.

Narcan is quickly and easily inserted into the nostril and then sprayed by pressing down to release the medication. It is helpful to be comfortable holding and manipulating Narcan before finding yourself in an emergency situation. Training is not required before providing care to a person experiencing an overdose however, Many American Red Cross Trainers do facilitate Narcan training as a skill boost in CPR/First Aid courses.

Drug Induced Homicide

According to California state representative for Drug Induced Homicide, Mareka Cole, “Drug Induced Homicide supports families of victims who were illegally delivered a controlled substance in which someone dies. When families lose their children to illegally manufactured invisible fentanyl, they are devastated. Fentanyl is colorless, odorless, and deceitful. Drug induced homicide raises awareness about the effectiveness of a criminal investigation and prosecution. We advocate for a shift in thinking focusing on classifying fentanyl cases as criminal (and not accidental). We advocate for laws that provided greater accountability to those who distribute illicit drugs. The dead cannot cry out for justice. It’s our duty, being a living advocate to do so for them. We are the survivors of the victims, and this is our fight.”

As a mama whose entire world was shattered with the loss of a child to fentanyl poisoning, it is extremely humbling to step back and acknowledge the families of victims around the world. Every year fentanyl’s death toll rises. Currently, in California the drug is responsible for one in five of deaths of people between the ages of 15-24 years old. Globally, the drug has taken more lives than the Iraq, Afghanistan, and Vietnam war, the war on terror every year for the past three years.  As society sees the uptick in tragic and preventable losses the need for attention, education, and advocacy increases.