Cirque Lodge > Blog > Addiction > Why Is Fentanyl So Dangerous?

Fentanyl is one of the synthetic opioids that were developed for use in medical circumstances and continues to be used for this purpose today. Fentanyl is classified as a Schedule II drug by the United States Drug Enforcement Administration (DEA).

Due to its use in the medical profession, there exists a misconception that fentanyl cannot pose too significant a risk when used recreationally or when self-prescribed. However, it cannot be stressed enough how dangerous fentanyl is as a drug. This article will seek to explain how fentanyl is made dangerous by:

  1. the small dosage that is required to push someone into a fatal overdose
  2. its exploitation by dealers in the illegal drug market meaning that many are unaware they are taking and becoming addicted to fentanyl

Remember, if you are worried about the risk that fentanyl may be posing to you or a loved one, then you don't have to struggle alone. The path to health and well-being can be difficult but, with the correct and compassionate support, a recovery is always a potential option. Medical professionals at Cirque Lodge can assist you on this journey.

Fentanyl: A Different Type of Opioid Drug

Synthetic Opioid

Fentanyl is a type of opioid. Unlike other opioids, it is not made from the opium poppy plant but is instead created synthetically in a laboratory.


Fentanyl stands out in comparison to other drugs for its incredibly high potency rates. Bear this in mind when trying to understand how the drug can be so extremely dangerous to those who use it, even when they think they are taking small doses.

To illustrate this, the equivalent dosage of fentanyl is:

  • 100 times stronger than morphine
  • 50 times stronger than heroin

That means that only 2% of the quantity of heroin that is able to cause a heroin overdose would lead to an overdose attributable to fentanyl. Therefore what looks like minuscule doses of fentanyl pose the same risk as a much larger dose of heroin, with potentially fatal consequences. It is difficult to imagine how this would look, but it is important to remember that even a trace amount can be enough to cause the body to overdose.

The difference in fentanyl potency derives from a difference in its chemical structure. As with all opioid drugs, fentanyl induces physiological effects on the users when the chemical compound binds to opioid receptors in the brain. Fentanyl, however, binds to these receptors both faster and more tightly than with any other opioid drug. This is dangerous because:

  • fentanyl overdoses can be induced within seconds to minutes (rather than the minutes to hours found with a heroin overdose)
  • fentanyl compounds bind to the receptors much more tightly making them much harder to remove with anti-overdose medication

Naloxone is used to reverse the life-threatening effects of an opioid overdose, but fentanyl is leading to a medical crisis regarding the abilities of naloxone. This is directly due to the fact that fentanyl's chemical compounds bind so tightly with the opioid receptors, that naloxone is unable to replace these compounds. It has been reported that the standard doses of naloxone provided in overdose kits or typically issued in hospitals have often proven insufficient in reversing the effects of an overdose.

What Is Fentanyl?

Fentanyl is taken both in medicinal settings and as a recreational drug. There are therefore two types of fentanyl that are consumed in the United States, one being fentanyl that has been legally manufactured in a regulated setting and the other that has been illegally created and are illicit drugs. The two will be discussed below.

Medicinal Fentanyl

As a Schedule II drug, fentanyl is legally manufactured for use in medical settings, though its use and distribution are highly regulated and controlled. The Schedule II classification recognizes that the drug is very addictive and has a large potential to be abused outside of regulated circumstances.

Fentanyl is a type of synthetic opioid, and like other opioids used in medical settings, it is prescribed as a form of strong pain relief. It can control pain almost immediately upon dosing, so is typically issued as a form of anesthesia for surgery or to ease pain experienced by cancer patients, those suffering from chronic pain, or recovering from surgery.

Doctors warn, however, that even in a controlled hospital setting, the fentanyl issued for these medical procedures can dampen the patient's breathing rate to dangerously low levels. This highlights how even in controlled settings and with controlled dosing, fentanyl poses a potentially life-threatening danger to the user.

Prescription names for fentanyl include Actiq®, Duragesic®, and Sublimaze® and come in several forms:

  • skin patches
  • injections
  • nasal sprays
  • sublingual films (under the tongue)
  • lozenges (similar to cough drops)

Illegal Fentanyl

This drug is most dangerous when it is consumed outside of controlled medical settings. Fentanyl that is sold illegally is likely to be illicitly manufactured fentanyl, though it is possible that it was produced legally and has made its way to the illegal drug market. Even in the latter case fentanyl would still pose a significant threat as it is the potency of fentanyl (rather than any concerns for its impurity) that makes it so lethal.

It is very easy to find fentanyl on the illegal drug market as it is cheap and simple to produce this form of synthetic opioid and it has similar effects on the user as heroin and other opioid drugs. It is desirable to users as it is often a cheaper alternative, meaning that those who are addicted to other drugs or suffer from different forms of substance abuse may resultantly use fentanyl.

Clandestinely produced fentanyl is typically made in laboratories in Mexico, India, or China and is then exported to the United States. On the streets, fentanyl goes by many names, the most common including Dance Fever, Poison, Apache, He-Man, Great Bear, Goodfellas, China Town, China White, China Girl, and Tango & Cash.

As an illicit drug, fentanyl is typically sold in the form of:

  • a powder
  • a pressed pill
  • eye drops
  • nasal sprays
  • a liquid
  • a liquid dispersed on blotter paper

Mixing Fentanyl With Other Drugs

Fentanyl is prevalent in other drugs, meaning that it poses dangers even to drug users who would identify themselves as primary users of drugs other than fentanyl.

In some cases, drug users are aware that they are buying drugs that have been mixed with fentanyl, or they are mixing drugs with fentanyl of their own volition.

What's more, a significant hidden danger has been exposed through testing analysis. This has proven that fentanyl is regularly present in a vast array of different street drugs and illegally obtained prescription medications, meaning that people are often unaware that they are consuming fentanyl.

This is a problem that has been developed by the illegal drug trade, as fentanyl is both cheap and highly addictive. It is therefore profitable for drug dealers to lace their products with fentanyl in order to increase other drugs' addictive qualities and enhance the high that they induce. This promotes consumption and leads to further purchases by customers. Drugs commonly involved in this system are:

  • heroin
  • cocaine
  • benzodiazepines
  • methamphetamines
  • pills that are made to look like other prescription opioids.

This exploitation of fentanyl's addictive properties is fuelling an invisible fentanyl epidemic, with many unaware that they are actually taking fentanyl and becoming addicted to this dangerous drug. For example, users could be told that they are purchasing heroin which is specifically a type of highly potent heroin.

Fentanyl is found present in a shockingly high proportion of prescription medications that are being sold by unlicensed dealers or online. Medications such as Ritalin, Vicodin, Adderall, Xanax, and OxyContin that are circulated outside of regulated pharmacies have been found to be cut with fentanyl on an extremely frequent basis - despite these pills looking completely legitimate.

How Is This Related to Fentanyl Overdose Deaths?

It is a sad fact that the US is currently living through an opioid epidemic. In the last year, the Center for Disease Control and Protection stated that it was responsible for 100,000 overdose deaths. This is a pattern that is on the rise - in the past 3 years drug overdose deaths involving fentanyl increased by 540%.

The fact that fentanyl is so frequently mixed into other drugs, be that opioids or prescription pills, is fuelling this epidemic. For example, the presence of fentanyl in other drugs is dramatically increasing their toxic potency, considering that even fentanyl in extremely small quantities can induce an opioid overdose. Testing on illegally circulating prescription medication by the Drug Enforcement Administration revealed that the majority of these pills contained some fentanyl. Furthermore, around 40% of these pills contained sufficiently high quantities of fentanyl to the taker at risk of overdose.

In every case where fentanyl has been mixed into another drug, it is impossible for the user to be able to identify it; even at lethal quantities, you won't be able to see, smell, or taste the presence of fentanyl. Fentanyl can only be detected with drug testing kits. These testing kits are distributed for free by harm reduction clinics and they can also be ordered online. Testing your drugs is the only way to ensure that you are being kept safe from the hidden dangers of fentanyl.

About a Fentanyl Overdose

Opioids are taken outside of medical settings because they bring about pleasurable short-term physiological effects. This takes place because the opioid binds with receptors in the brain's reward centers and increases the levels of dopamine. The effects often include:

  • extreme happiness
  • euphoric high
  • relaxation
  • pain relief
  • sedation
  • drowsiness

These effects contribute to the highly addictive qualities of fentanyl and other opioid drugs. However, opioids can also bring about very dangerous physiological effects as they bind in an indiscriminate way, binding with parts of the brain other than the reward center. These arrests areas of the brain that are responsible for controlling vital operations in the human body, leading these functions to shut down and put the person's life at significant risk.

Respiratory depression from fentanyl is a leading cause of death, as with other opioid analgesics. This is a medical term for when a person's inhale and exhale abilities shut down, leading them to choke to death. In the circumstances of an overdose, the fentanyl compounds have bound with the receptors that are responsible for managing the respiratory system.

A fentanyl overdose looks similar to other opioid overdoses; however, it is likely to happen much quicker. As a consequence, it is also important to act even quicker in order to save the person's life. You should look for the following signs:

  • bluish tinge on the skin/fingernails
  • shallow / no breathing
  • pinpoint pupils
  • no response to stimulus (i.e. pinching)
  • gurgling/heavy snoring or wheezing sound

The most important step if you suspect someone is having an overdose is to call 911. An overdose is a medical emergency requiring immediate medical attention. You should stay with the person until medical personnel arrives and try to keep them awake and reassure them. If naloxone is available, then this should be used as soon as possible. Naloxone has the ability to reverse the overdose in some cases.

About Fentanyl Addiction

While fentanyl addiction can be a devastating and threatening illness, it is also treatable. Medical and therapeutic-based treatment methods have allowed those living with fentanyl addiction to pass safely through the difficulties of withdrawal and then reach a place of well-being and long-term recovery.

Alina Lodge offers multiple types of addiction treatment, including fentanyl addiction treatment, in recognition that the treatment place should be made specific and responsive to each individual person. We aim to help individuals who are struggling with substance use disorders, and support them on the path to recovery while promoting the values of integrity and compassion.

If you or a loved one is in need of support, then call us today to discuss a potential route to recovery.

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