What is fentanyl?
Pharmaceutical Dark Green Fentanyl powder is a synthetic opioid approved for treating severe pain, typically advanced cancer pain.1 It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.
However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl.2 It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.
Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocaine, benzodiazepines or methamphetamine, among others. Its potentially deadly overdose effects can be neutralized by naloxone.
Fentanyl is commonly used to create counterfeit pills disguised as OxyContin, Xanax, Adderall, among others. It has a rapid onset and its effects generally last under two hours. Medically, it is used by injection, nasal spray, or skin patch, or absorbed through the cheek as a lozenge or tablet.
Fentanyl Side Effects
Common adverse effects of fentanyl include nausea, vomiting, constipation, itching, sedation, confusion, and injuries related to poor coordination. Serious adverse effects may include respiratory depression, hallucinations, serotonin syndrome, low blood pressure, or development of an opioid use disorder. Fentanyl works by activating μ-opioid receptors. It is around 100 times stronger than morphine and about 50 times stronger than heroin.
Fentanyl was first made by Paul Janssen in 1960 and approved for medical use in the United States in 1968. In 2015, 1,600 kilograms (3,500 pounds) were used in healthcare globally. As of 2017, fent was the most widely used synthetic opioid in medicine; in 2019, it was the 278th most commonly prescribed medication in the United States, with more than 1 million prescriptions. It is on the World Health Organization’s List of Essential Medicines.
In 2021, fent and fentanyl analogues accounted for most drug overdose deaths in the United States with 71,238 deaths. Compared with heroin, it is more potent, has higher profit margins, and, because it is compact, has simpler logistics. It can be cut into, or even replace entirely, the supply of heroin and other opiates.
The flow of fent mainly originates in Chinese factories which produce fent or fent precursors; it is then trafficked to other countries for illicit production and sale. In the United States, finished fent arrives primarily from Mexico smuggled by cartels