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Why Is Fentanyl So Dangerous?



Medically Reviewed by Dr. Mohammed Saeed, MD.

The U.S. Drug Enforcement Administration (DEA) considers fentanyl one of the most lethal drugs in the United States — singlehandedly dominating the “opioid crisis.” Fentanyl is involved in the vast majority of opioid overdose deaths and is causing more and more overdoses every year. According to the CDC, fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths. Fentanyl is classified as a Schedule II controlled substance by the DEA and is available by prescription only.

What Is Fentanyl?

Fentanyl is an extremely powerful synthetic opioid, used as a prescription painkiller in hospital settings for the treatment of severe pain. It is used predominantly in cancer patients or individuals suffering from chronic pain. Like heroin, morphine, and other opioids, fentanyl binds to the body’s opioid receptors, increasing dopamine levels in the brain and quickly producing an incredibly potent but short-lived high. However, it can also produce devastating physiological effects that can lead to death.

Doctors normally administer fentanyl through transdermal patches that go on the skin. Fentanyl can also be used as cough drops, tablets, nasal sprays, and injections. Illegal/illicit fentanyl generally comes as a white, tan, or gray powder — or a liquid — and has many street names (Murder 8, Apache, Jackpot, Tango and Cash, among others). Because of its high potency and addictive nature, fentanyl abuse/addiction can come from both legal and illegal drugs.

Fentanyl is like morphine but roughly 100 times more potent, and 50 times stronger than even the most highly potent heroin. It is made in a laboratory rather than from the opium poppy plant like natural opiate drugs (morphine, heroin, etc.). The chemical structure is similar to opiates, but not identical, which accounts for the higher potency.

How Potent Is Fentanyl?

One 2 milligram (mg) dose of fentanyl is enough to kill the average adult. Heroin is lethal in a dose of about 30 milligrams. Drug traffickers usually distribute fentanyl by the kilogram. One kilogram of fentanyl has the potential to kill 500,000 people.

Fentanyl can kill within a matter of 2 minutes, usually because of respiratory failure (breathing that has stopped). Breathing stops altogether, and the brain does not get the oxygen needed to survive. Some may also vomit while unconscious and choke to death.

Fentanyl is only given to patients who are “opioid-tolerant,” meaning they have already been taking other opioids for severe pain and have built up a tolerance for them.

Effects Of Fentanyl

Fentanyl produces effects similar to heroin, including relaxation, euphoria, and pain relief. Unwanted side effects are usually confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.

Because of the potency, it is easy to overdose on fentanyl. Those who use other illegal drugs are at high risk of fentanyl overdose as well. When used in combination with other central nervous system depressants like opioids, alcohol, or benzodiazepines, overdose risk multiplies.

What Makes Fentanyl Dangerous?

Many street drugs are intentionally contaminated with fentanyl because of its potency and low cost and is consumed unknowingly. Drug dealers cut fentanyl into heroin or press it into pills and sell them as different drugs such as Xanax or Oxycodone. Other drugs laced with fentanyl (heroin, methamphetamine, cocaine, or crack) can lead to overdose or fatal drug interactions. The user may take their standard amount but because of fentanyl’s high potency, even small doses can lead to overdose.

Fentanyl overdose is characterized by stupor, pinpoint pupils, cold and clammy skin, cyanosis (bluish discoloration of the skin, lips, or fingernails), decreased heart rate, coma, respiratory depression, and/or failure leading to death.

The opioid antidote naloxone (Narcan) may be able to reverse a fentanyl overdose and respiratory depression if administered in time and in a sufficient dose.

Overcoming Fentanyl Addiction

Breaking fentanyl addiction is difficult and requires gradual tapering to minimize withdrawal symptoms. Cold turkey detox will lead to brutal withdrawal symptoms like body aches, anxiety, sweating, sleep disturbances, tremors, intense cravings, diarrhea, nausea, vomiting, blurred vision, rapid heart rate, and high blood pressure. Sometimes serious opioid withdrawal syndrome can result in death, so medically assisted detox is almost a necessity, as few can deal with detoxing alone safely.

The most effective addiction treatment method is detox (either residential or outpatient, sometimes assisted by medication), then therapy programs designed to help individuals to modify their behavior and teach effective life skills, all followed by a supportive aftercare program.

Why Choose Into Action Recovery Centers?

Into Action Recovery Centers takes pride in providing a high level of treatment and a holistic approach to recovery for those who suffer from addiction. Our comfortable facility is designed with the client’s needs foremost in mind. Our staff includes master’s level counselors, licensed chemical dependency counselors, 24-hour nursing professionals, a staff psychiatrist, a staff chef, and direct care personnel. Our counseling staff provides individualized treatment and care for our clients with an emphasis on tailoring treatment to the specific needs of each individual. Additionally, our staff provides family counseling, relapse prevention, life skills, and grief and trauma counseling.

Into Action Recovery Centers provides an abstinence-based program, and all of our staff members have a strong understanding of the recovery process through personal experience. Sharing the process involved in living a drug and alcohol-free life is something we are passionate about. We offer free aftercare for the men who complete our program and have a strong alumni network that remains active in the community. We also offer other amenities, such as dietician-prepared meals, mindfulness-based meditation training, outings, and fitness training.


Dr. Mohammed Saeed, MD.

Dr. Saeed is a psychiatry specialist with over 40 years of experience in the medical field. He received training in General Psychiatry at the University of Texas Medical Branch, where he was selected as the Medical Director of the Division of Child and Adolescent Psychiatry. He currently serves as the medical director at Into Action Recovery Centers. Full Bio

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