Synthetic Fentanyl: What it is & Why It’s So Dangerous

Fentanyl, a powerful synthetic opioid, is commonly found mixed in with illicit drugs. Shockingly, fentanyl is potent enough that one kilogram could potentially kill up to 500,000 people. In the United States, synthetic opioids, including fentanyl, are the leading substance behind overdose deaths1. This article will discuss what synthetic fentanyl is, why it’s so dangerous, and how to get help for synthetic opioid addiction or misuse with Hotel California by the Sea.

On a black background, there are white synthetic fentanyl pills laid out representing why it can be so dangerous.

What Is Synthetic Fentanyl?

Synthetic fentanyl is similar to morphine, another synthetic opioid. However, fentanyl is fifty to one-hundred times more potent than morphine. Unlike some opioids that are created with opium poppy plants, fentanyl is made by scientists in a lab. Prescription fentanyl is commonly given to patients struggling with severe chronic pain or following surgery.

If a patient has developed a tolerance to opioids, their doctor may prescribe fentanyl. If prescribed by a doctor, fentanyl is typically administered via shot, patch, or lozenge. Synthetic fentanyl obtained illegally is generally a powder or mixed in with other illicit substances.2

The History of Pharmaceutical Fentanyl

Synthetic fentanyl was created in Belgium by the Janssen Company in 1960. Initially, fentanyl was used as an intravenous (IV) pain reliever in Europe. In the early years of fentanyl usage, anesthesiologists in Europe spent a great deal of time exploring different drug combinations, including fentanyl.

They aimed to find a form of deep anesthesia that could be effective without altering cardiovascular function. In the 1960s, fentanyl became very popular among European anesthesiologists. However, the Janssen Company still struggled to gain Food and Drug Administration (FDA) approval in the United States.

Opponents argued that fentanyl was too potent and susceptible to abuse. In 1968, fentanyl was approved by the U.S. FDA to be used in combination with droperidol, a sedative. Over the next couple of decades, surgeons found a great deal of success using high doses of fentanyl during cardiac and vascular surgeries.

Sales and usage steadily increased, and the Janssen Company continued exploring new applications for fentanyl. Then, around 1990, fentanyl patches became available for chronic pain management and cancer patients. Presently, fentanyl is the most common opioid prescribed for surgeries in the United States.3

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The Chemical Structure of Synthetic Fentanyl

Synthetic fentanyl stimulates an individual’s opioid receptors to act as an opioid analgesic — an opioid drug given to patients to relieve pain.

Respiratory depression, fatigue, dizziness, sedation, euphoria, relaxation, and vomiting are all effects of fentanyl on the opioid central nervous system.3 Some pharmaceutical companies develop fentanyl analogs or drugs that create the same pharmacological effect. Pharmaceutical manufacturers do this to avoid policy restrictions and other repercussions.6

How Does Fentanyl Work In The Body?

Synthetic fentanyl binds to a human’s opioid receptors in the brain. Opioid receptors control a person’s pain and emotions. For instance, sedation, addiction, unconsciousness, extreme happiness, drowsiness, nausea, and confusion are effects of fentanyl use.

Other opioid drugs like heroin and morphine work the same way by binding to opioid receptors. If a person uses opioids repeatedly, the brain can adapt or develop a tolerance to the drug. During prolonged fentanyl or opioid use, a person is at risk of drug misuse and abuse.2

Why Is Fentanyl So Dangerous?

The high potency of fentanyl is why it’s so dangerous. Even if a patient has a legitimate prescription for synthetic fentanyl, their doctor still closely monitors them for possible misuse or abuse. As a street drug, fentanyl or illicit drugs laced with fentanyl are unregulated and extremely dangerous.

According to the Drug Enforcement Agency (DEA), counterfeit opioid pills that are seized often contain a lethal dose of fentanyl without any of the promised substances (hydrocodone, morphine, codeine, etc.).

Since fentanyl is highly potent and relatively inexpensive, drug dealers commonly mix fentanyl in with their heroin, cocaine, and methamphetamine. Lastly, consumers can’t know the dosage when purchasing illicit fentanyl, making the risk of opioid overdose high.1

Is Fentanyl More Dangerous Than Heroin?

Fentanyl is fifty times stronger than heroin and significantly more dangerous. When it comes to drug overdose, it’s critical to understand the difference between pharmaceutical fentanyl and illicitly manufactured fentanyl.

Pharmaceutical fentanyl is a synthetic opioid prescribed by physicians for pain management. Illicit fentanyl is made and distributed by drug dealers because of its high potency and heroin-like high. Illegal drug manufacturers have also moved towards supplying fentanyl due to potency, cost, and added likelihood of addiction.

Most fentanyl overdose deaths are caused by illicitly manufactured fentanyl and not pharmaceutical fentanyl.4

Fentanyl and Overdose Deaths

Which illicit drug is the most common cause of overdose? Fentanyl and other synthetic opioids are the leading cause of drug overdose deaths. Every single day, more than one hundred and fifty people in the U.S. die due to synthetic opioid overdose.

Illicitly manufactured fentanyl doesn’t have a unique taste or smell. If you’re buying illicit fentanyl or other street drugs, there’s no way to know if the substance contains fentanyl or what the dosage is. For this reason, it’s critical to recognize the signs of a drug overdose.4

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Signs of A Synthetic Opioid Overdose

First things first, what are the signs to look for if someone is overdosing on opioids? Signs to look for include small pupils, sudden loss of consciousness, irregular breathing, choking sounds, a limp or discolored body, and clammy skin. If you think a person is overdosing, call emergency services, administer naloxone, and try to keep them awake.

It’s also essential to turn the person over on their side to reduce the risk of choking. If you or someone you care about struggles with opioid misuse or abuse, naloxone is a life-saving medication that you should have on hand. Naloxone can reverse an opioid overdose caused by heroin, fentanyl, or prescription opioid drugs. Having naloxone on hand can prevent a fatal overdose and save lives. To obtain naloxone, discuss a prescription with your doctor.4

Fentanyl In the U.S. and Statistics

The opioid epidemic is a critical public health crisis in the United States that affects social and economic welfare. Each year, the economic burden of prescription opioid misuse and abuse is calculated to cost approximately seventy-eight billion dollars. This calculation includes healthcare costs, loss of productivity, treatment for opioid addiction, and legal issues.

In the 1990s, United States pharmaceutical companies worked diligently to assure medical providers that opioid pain relievers were not addictive. Medical providers began prescribing synthetic opioids more frequently. What happened next? Prescription opioids became widely diverted, misused, and abused. Synthetic fentanyl and opioid overdose rates rose quickly. Here are a few eye-opening statistics surrounding the opioid epidemic:5

  • Anywhere from 21 to 29 percent of individuals that are prescribed opioids for chronic pain eventually misuse them.
  • About 4 to 6 percent of people that misuse their prescribed opioids eventually transition to heroin use.
  • In 2017, over 47,000 United States deaths involved fentanyl or other opioids. 
  • In 2017, approximately 1.7 million individuals in the United States struggled with substance use disorders related to prescription opioid misuse.
  • Around 80% of people who begin using heroin start with prescription opioids.

How To Get Help If You Struggle With Fentanyl Abuse

Medication-assisted treatment (MAT), therapy, behavioral therapy counseling can treat fentanyl addiction or opioid use disorder. Some medications that are often used to treat fentanyl addiction include buprenorphine and methadone.

These MAT options can treat cravings and withdrawal symptoms. Additionally, naltrexone can be prescribed to block a person’s opioid receptors. Essentially, this prevents a person from receiving any type of reward or high from fentanyl. It’s best to discuss which option is best for an individual with their health provider.2

Behavioral Therapy for Fentanyl Addiction

Depending on the severity of a person’s substance use disorder, they may require a medical detox, inpatient treatment, outpatient treatment, or all of the above. Generally, an individual completes a substance use assessment to determine the appropriate clinical level of care.

During treatment, evidence-based approaches, including cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and motivational interviewing (MI), are used for attitude and behavior modification. Clients typically experience the most success in their recovery journey by pairing behavioral therapy and medication management.2