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What is fentanyl? -

Fentanyl is a potent synthetic opioid drug approved by the Food and Drug Administration (FDA) for use as an analgesic (pain reliever) and anesthetic. 

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Potent and powerful -

The synthetic opioid is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic, according to the United States Drug Enforcement Agency (DEA).

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Two types of fentanyl -

There are two types of fentanyl: pharmaceutical fentanyl and illegally made fentanyl. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain, especially after surgery and for advanced-stage cancer.

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Correct use of fentanyl -

When prescribed by a physician, fentanyl can be given as a shot, a patch that is put on a person's skin, or as lozenges that are sucked like cough drops, notes the National Institute on Drug Abuse (NIDA).

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Potential side effects -

Pharmaceutical fentanyl's adverse effects are identical to those of other narcotic opioids and include addiction, confusion, and respiratory depression. 

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Danger of overdose -

Fentanyl needs to be taken carefully and under the strict direction of a doctor because depending on the method of delivery, fentanyl can be very fast-acting. Ingesting even a relatively small quantity can cause an overdose.

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A small quantity can kill -

In fact, a two-milligram dose of fentanyl powder (seen here on a pencil tip) is a lethal amount for most people.

Image: Drug Enforcement Administration

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High price to pay -

Here is the same amount of fentanyl placed next to a US penny, which is 0.75 in (19 mm) wide. 

Image: Drug Enforcement Administration

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Illegal fentanyl -

Most cases of fentanyl-related overdose are linked to illegally-made fentanyl. Pictured is a DEA agent with a sample of the narcotic seized in a drug bust. 

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Street names -

According to the DEA, fentanyl sold illegally on the street is dealt under a variety of names, for example, Trigger Happy, He-Man, China Girl, Murder 8, and Poison. It's available in different forms, including liquid and powder. 

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Deadly combination -

Illegal fentanyl is cheap to make. Unscrupulous dealers commonly mix fentanyl with drugs like heroin, cocaine, and methamphetamine to maximize profits. Fentanyl can also be made into pill form, and can be mixed in with other counterfeit pills (pictured). 

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Laced with danger -

By making fentanyl pills that resemble other prescription opioids, for example oxycodone, people may be unaware that their drugs are laced with this extremely dangerous narcotic. 

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National crisis -

The United States is currently facing a crisis of overdose deaths, a fact highlighted by the Department of Justice as early as 2017. In 2021, more than 106,000 Americans lost their lives to drug-involved overdoses —including more than 1,100 teens that year alone, reported CNN. 

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Grim statistic -

In 2023 that statistic had risen to 150 people every day succumbing from overdoses related to synthetic opioids like fentanyl, according to the Centers for Disease Control and Prevention (CDC). That's a staggering 54,750 lives lost every year. 

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'The Faces of Fentanyl' -

The problem is so acute that the DEA has created 'The Faces of Fentanyl' at the agency's Arlington, Virginia headquarters. The special exhibit commemorates the lives lost from fentanyl poisoning. Ray Donovan (pictured), DEA chief of operations, recently commented that the opioid crisis "is the most dangerous epidemic that we've seen."  

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A new threat -

And the DEA has warned of an emerging new threat in the United States, that of an animal tranquilizer called xylazine increasingly being found in the country's illicit drug supply and linked to overdose deaths. Xylazine can be life-threatening and is especially dangerous when combined with opioids like fentanyl. Pictured is US Senator Charles Schumer speaking at a press conference while holding a photo of a bottle of xylazine and a letter issued by the DEA alerting the public to the threat.  

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Instant killer -

The fight against fentanyl is compounded by the fact that street drugs may contain deadly levels of fentanyl, but you can't see it, taste it, or smell it. "Fentanyl is not like any other illicit narcotic; it is that deadly instantaneously," warned the DEA's Ray Donovan. 

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Fake fentanyl -

In 2023, the DEA seized more than 78.4 million fentanyl-laced fake pills and nearly 12,000 pounds of fentanyl powder. These 2023 seizures are equivalent to more than 388.8 million lethal doses of fentanyl.

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Millions of deadly doses -

And 2024 fentanyl seizures so far represent over 41.1 million deadly doses. The bags of heroin pictured here include some laced with fentanyl. 

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'One Pill Can Kill' -

The DEA's current anti-drugs campaign is called 'One Pill Can Kill'—a reference to the fact that just 2 mg of fentanyl equates to a potentially deadly dose. 

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Highly addictive and commonly abused -

Oxycodone, another highly addictive and commonly abused drug, is also being targeted. Pictured is an officer from the US Customs and Border Protection, Trade and Cargo Division seizing oxycodone pills at John F. Kennedy Airport.  

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City-wide health alert -

Meanwhile, New York City officials have distributed leaflets warning of the dangers of illegal opioids. It reads in part: "FENTANYL IS KILLING NEW YORKERS. It's showing up in heroin, cocaine, street pills marked as Xanax, and other drugs. It's involved in more overdose deaths than ever before."  

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Overdose effects -

The effects of an overdose include small, constricted "pinpoint pupils," losing consciousness, cold or clammy skin, and discolored skin (especially in lips and nails). 

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Life-saving medication -

Naloxone is a life-saving medication that when given in time can reverse an overdose from opioids, including heroin, fentanyl, and prescription opioid medications. Effects begin within two minutes when given intravenously, five minutes when injected into a muscle, and ten minutes as a nasal spray (pictured). 

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Take the test -

Fentanyl test strips are a low-cost method of helping prevent drug overdoses and reducing harm. These small strips of paper can detect the presence of fentanyl in all different kinds of drugs. 

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Prince (1958–2016) -

The dangers of using the drug were further highlighted when it was reported that Prince had died of an accidental overdose of fentanyl. According to Associated Press, it later transpired that the musician didn't know he was taking the dangerous drug, which was laced in counterfeit pills made to look like a generic version of the painkiller Vicodin.

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Tom Petty (1950–2017) -

Tom Petty passed away after taking a cocktail of drugs to combat a number of medical problems. An autopsy revealed a combination of fentanyl and oxycodone in his system, among other prescription drugs. 

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Mac Miller (1992–2018) -

American rapper and singer-songwriter Mac Miller's cause of death was determined as acute combined drug intoxication, that being an accidental intake of fentanyl, cocaine, and alcohol. 

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Angus Cloud (1998–2023) -

And 'Euphoria' actor Angus Cloud was just 25 years old when he died of an accidental drug overdose involving fentanyl.  

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Fentanyl is killing America -

While these high-profile celebrity deaths serve to put the dangers of drug abuse under the spotlight, it's the many hundreds of thousands of young lives claimed by fentanyl that keep this powerful opioid in the disapproving public eye. 

Sources: (FDA) (DEA) (NIDA) (Cleveland Clinic) (CNN) (CDC) (Associated Press) (Rolling Stone) (Forbes) 

See also: Dopamine: Are we all addicted to something?  

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