Fentanyl Opioid Infographic

Fentanyl Facts and Dangers –  The Most Dangerous Drug in History

We created this fentanyl infographic to bring more awareness to this very deadly opioid that is making the rounds in the heroin using community and, unfortunately, causing many accidental overdoses.

After learning about the rate at which fentanyl is causing accidental fatal overdose, it can almost seem like the invention of an evil “super villain” in a fictional superhero cartoon.  Read more below to understand the scope of it’s danger and destruction.

What is Fentanyl?

Doctors prescribe fentanyl to patients who are dealing with great pain from surgeries (or other ailments, like cancer). Fentanyl is a synthetic drug that mimics other opiates.  Therefore it’s active ingredient is functionally the same as what users become addicted to in heroin (the opium poppy). Fentanyl is not new, as it was initially created in 1959 by Paul Janssen of Janssen Pharmaceuticals, but it was not until the 1990s when the transdermal patch became a very popular option for doctors to offer patients that it’s notoriety really started growing. Fentanyl works by blocking the brain’s ability to perceive pain, creating a “downer effect” on the user, which induces a state of relaxation and euphoria. Because fentanyl is so powerful, it has a high potential for addiction and abuse. However, the high is short-lived, making it easier for recreational users to overdose.

On top of the patch, another seemingly innocuous method of ingesting fentanyl is via lollipop. The drug is highly addictive and intended to be used primarily in surgical situations to help with “breakthrough” (severe) pain during and after the operations.  The drug is also ingested via pill taken orally.

Fentanyl is Shockingly Potent

Fentanyl is up to 100 times as potent as morphine, and over 50 times as potent as pure pharmaceutical grade heroin.

Fentanyl is increasingly being manufactured in home labs, illegally manufactured in China,  and then being sold on the street to users who are hooked on heroin.  In California, this resulted in dozens of overdoses in just a few weeks in early 2016. Keep in mind that these users were typically already accustomed to injecting heroin – which is typically considered the highest risk of overdose. it is not clear if this rash of overdoses is a result of confusion about whether the fentanyl was heroin or if it was a “bad batch” of heroin.

But the upshot is the same: because fentanyl is much more powerful than heroin, it’s much easier to overdose on it. Extreme caution should be used and extreme action taken if someone you love is using fentanyl.


Carfentanil is a synthetic analog to fentanyl (meaning it’s a different set of ingredients with the same effect and purpose. Other names for carfentanil include furanylfentanyl and acetylfenanyl, and these two versions are much less potent.

Carfentanil can be:

  • 100 times as potent as a comparably sized dose fentanyl
  • 5,000 times as potent as the same size dose of heroin
  • 10,000 times as potent as the same size dose of morphine

Are you starting to understand why the potential for overdose is so overwhelming?

According to the CDC, “Because of its extreme potency, even limited circulation of carfentanil  <in the opiate community> could markedly increase the number of fatal overdoses.”

Rashes of Overdoses

As you may have seen, the recent overdose deaths of music superstars Tom Petty and Prince were partially attributed to fentanyl, which was found in their system.  That’s just the tip of the iceberg.

When fentanyl (whether authentic or counterfeit) hits the streets in a heroin using community, the results can be disastrous. Death from accidental overdose is becoming so common that the Canadian government declared fentanyl overdose a public health crisis in 2015, and in 2016 the average death toll from fentanyl in British Columbia was 2 people per day, and this pace more than doubled during the first 4 months of 2017.

The typical pattern is that the drug is disseminated to the heroin using community and before the word can get out about the potency, it is too late for many users.  Fentanyl is now blamed for more fatal overdoses than heroin. It’s very common in the last several years to read headlines like:

  • Fourteen people overdosed on Fentanyl in a four our period in South Camden, New Jersey
  • 12 people in Sacramento County overdosed in a matter of days in (and “scores of other people” in Northern California) (source: Sacramento Bee)
  • 69 Year old mother of son who fatally overdosed on fentanyl dies from exposure while cleaning up the scene of his death (source: Miami Herald)
  • Coroners are keeping narcan on hand to use in the event of exposure to the fentanyl in a corpse they are providing an autopsy on (narcan is an emergency medication which mitigates an opiate overdose)

Counterfeit Fentanyl

According to the CDC, illicitly manufactured fentanyl is primarily responsible for the rise in overdose deaths in the United States since 2016 (source: CDC).  Chinese labs in particular have been prolific in manufacturing illicit fentanyl intended for consumption by the U.S. market. The drug is also made in home labs in the U.S. No matter the source, what is already a very dangerous drug is made even more so by the potential for unpredictable ingredients and potencies.

Fentanyl Being Purchased Online

Many users of Fentanyl purchase the drug online and then it is shipped (via u.s. mail most commonly) to their home in North (and South) America. The danger of accidental overdose is ever present due to the potential for unpredictable potencies due to unregulated manufacture abroad.

Fentanyl is also known as (street names and brand names):

Typically fentanyl is called fentanyl as it is a very high profile substance due to it’s potency.  Here are some of the brand names of medications that contain fentanyl:

  • Actiq (the lollipop)
  • Durogesic or Doragesic (the transdermal patch)
  • Fentora
  • Matrifen
  • Haldid
  • Onsolis
  • Instanyl
  • Abstrat
  • Lazanda

How is Fentanyl Ingested or Used?

Fentanyl comes in the form of a pill, a pain patch or sometimes a lollipop containing the medication. It can also be injected, which is the most dangerous way for recreational users to use the drug.

SUBSYS® Sublingual Fentanyl Spray

Fentanyl sublingual spray looks and works similar to an asthma inhaler and is a very quick delivery method for the drug. Originally approved only for terminally ill cancer patients, the spray formulation was irresponsibly marketed by some doctors which led to prison time for many unethical practitioners and that list includes the big pharma executive John Kapoor who was the  inventor of SUBSYS® and 74 years old at the time of his arrest.

The MSNBC Show American Greed brought great exposure to the dangers and irresponsible prescribing of SUBSYS® in their episode which chronicled the rise and downfall of Dr. John P. Couch and Dr. Xiulu Ruan who were the most prominent prescribers of SUBSYS®, which they did out of their Alabama pain clinic and pharmacy. These two criminal doctors prescribed the drug primarily to non-terminal patients for whom the drug’s potency and quick delivery was inappropriate and this led to chemical dependency complications for several unsuspecting patients.

Fentanyl Used to Execute Death Row Inmate in Nebraska

In what is surely a “sign of the times” of how dangerous fentanyl is, it has been chosen by Nebraska as the drug with which they execute prisoners. On Tuesday, August 18th, 2018 they executed a death row inmate with fentanyl. The fact that this drug is being unsuspectingly ingested by opiate users and is also considered “the simplest way to kill prisoners” shows how dire the addiction epidemic has become in this country.

Signs and Symptoms of Fentanyl Use, Abuse, Addiction & Facts

What are the Symptoms of Fentanyl Use?

Friends and family of a fentanyl user may be able to notice changes in their loved one when they’re high, and the symptoms are similar to those for all opioid. A fentanyl user under the influence will be short of breath, and have small, constricted pupils when they’re under the influence. They may also appear disoriented. The user be incoherent, seeming completely awake at one moment and passing out, or “nodding off the next.  Somebody who is high on fentanyl may appear “heavy” when high, unable to even lift his or her head.

A fentanyl user who injects the drug will also keep paraphernalia to use the drug around. There may be needles or syringes around with no medical purposes. You may notice burned silver spoons or bags with a white powdery residue.

What Are the Long-Term Effects and Dangers of Fentanyl Use?

Fentanyl is a dangerous narcotic drug that can cause death every time it’s used. Because of its incredible potency,  there is a very serious danger of overdose. Users who inject the drug run a risk of drug overdose or HIV/AIDs from re-used needles. They are also likely to suffer from bacterial or staph infections from unsanitary conditions and poor nutrition.

Habitual opiate abusers are at risk for poor health in general. They may have frequent skin infections, infections of the heart and heart-related illnesses. When in withdrawal or even when under the influence, they may have seizures.

Long-term users may suffer from chronic pneumonia, pulmonary diseases, and liver disease, blood clots or tissue death resulting from collapsed veins.

Transition to Heroin

The most alarming risk (beyond fatal overdose) is the possibility that the abuser of fentanyl will transition to other drugs, including street heroin.  This process happens every day throughout the United States, frequently in some very affluent areas.  This occurrence speaks to how truly addictive fentanyl is.

Signs and Symptoms of Fentanyl Dependency/Addiction

Fentanyl users can become addicted fairly quickly the drug because of its powerful ability to kill pain and resulting euphoria.

An addict will have many changes in their life and behavior that you may recognize. Among these is continued drug-seeking behavior that causes problems in their daily life. They may lie to doctors to try and get a prescription or steal to get the money to buy the drug on the street.

Users who inject the drug may wear long sleeves in hot weather to hide needle marks. They may get sick a lot, or get skin or heart infections. You may notice that a fentanyl user has rapidly lost weight and appears pale or sickly.

Somebody who is addicted to opiates will eventually have financial problems, legal problems,  and trouble keeping a job. Their drug use will also cause dramatic behavior changes, such as poor hygiene or a change in their friends. They may seem to have lost motivation and interest in future goals. They may lie to their family and friends and start hanging out with a “new crowd” that they seem to have little in common with. They may seek out other, similar opiates, such as heroin or morphine from illicit sources.

As a person become more dependent on fentanyl, they may lose interest in their hobbies, or become increasingly hostile to concerned family members. Side effects from fentanyl abuse and addiction can change as the disease progresses.

What are the Symptoms of Fentanyl Withdrawal?

Fentanyl addicts often feel compelled to continue using the drug. Known for its intense pain relieving effects, as well as intense withdrawal symptoms, fentanyl users often fear quitting the drug.

Fentanyl withdrawal symptoms can start a few hours to one day after sustained use of the drug stops. Withdrawal symptoms include intense cravings, sweating profusely, muscle aches, bone aches and intense cramping that causes the user to kick their legs.

If you’re looking to get clean from fentanyl, you should not attempt to detox on your own. Medical supervision is necessary to make you as comfortable and safe as possible.

Withdrawal symptoms following fentanyl dependence can cause serious medical complications, and sometimes, even death.

Getting Help for Fentanyl Addiction

If you think you have a fentanyl problem, or want to know more about recovering from addiction to fentanyl and/or other drugs, we’re here to help. You can detox and recover in a safe, supportive environment that’s focused on helping you reclaim your life.

The recent development of MAT (Medication Assisted Treatment), including drugs like Sublocade (extended-release buprenorphine or BUP-XR) has greatly improved the comfort of getting sober and the long-term positive outcomes of treatment.

All phone calls are 100% confidential. Call us at the number above.