Fentanyl is in the news every day, but where did it come from? Why is it suddenly such a concern?
What is fentanyl?
Fentanyl is a synthetic opioid that is 50-100 times more potent than morphine.
Pharmaceutical fentanyl
When it is produced for medical use, it is known as pharmaceutical fentanyl. This is prescribed under the brand names Actiq, Duragesic, and Sublimaze for severe pain, aftercare of surgery, and chronic pain. Analogs of fentanyl include carfentanil, furanylfentanyl, acetylfentanyl, and sufentanil. An analog is a drug that is functionally similar to another drug, even if they have different formulas. Pharmaceutical fentanyl comes in injectable shots, topical patches to be applied on the skin, nasal sprays, and oral lozenges.
Illicitly manufactured fentanyl
Fentanyl is commonly used as an illicit drug. Some of this is pharmaceutical fentanyl that is being misused or diverted, but most of it is illicitly manufactured fentanyl. Reportedly, street names for it include: Apace, China Girl, China Town, China White, Dance Fever, Great Bear, He-Man, Poison, and Tango & Cash. Illicit fentanyl is often sold in the form of pills or powder, and is often added to other drugs (whether the recipient knows it or not).
Where did fentanyl come from?
Fentanyl was first created by Dr. Paul Janssen, a Belgian chemist, in 1960. It was originally developed as an intravenous anesthetic. In the late 1970s and early 1980s, fentanyl was used primarily as pain medication for cardiac and vascular surgeries. Over time other analogs of fentanyl were introduced. The potency can vary with each analog. In the late 1980s, Duragesic was created, a patch that is applied to the skin. It is primarily used for patients who experience chronic pain. It now comes in many generic forms. Since then, pharmaceutical fentanyl has been made into oral lozenges, sublingual tablets, and oral sprays.
The dangers of fentanyl
With the rising use of fentanyl in the medical field, there also came a rise in fentanyl misuse. The most potent analog is carfentanil, which is estimated to be 10,000 times more potent than morphine.
Illicit fentanyl is primarily manufactured overseas and then trafficked into the United States. Trafficking primarily comes from Mexico and China. Illicit fentanyl comes in the form of sprays, powders, and pills. Illegal drug manufacturers often press powders into pill form that mimics prescription medication. The resemblance between these pills compared to the actual prescription is uncanny. This has led many people to overdose on fentanyl after taking what they thought was an illicitly obtained Vicodin or Xanax.
Illicit fentanyl is also being found more and more frequently in other illegal drugs, such as heroin, methamphetamines, cocaine, and even marijuana. With the increase in drug-lacing, fentanyl-related overdoses and deaths have increased to all-time highs. It is an epidemic racing through the nation. The Centers for Disease Control (CDC), recorded that in 2021 an estimated 107,622 people died from an overdose. With the increase in fentanyl and its presence in other illicit drugs, it truly is a problem that we can’t afford to ignore.
Harm reduction around fentanyl
There are some things that people who take drugs can do to reduce the risk of fentanyl.
- If you or people you know use drugs, you should always carry naloxone (Narcan). Ideally, carry multiple doses, as the effects of fentanyl can last longer than the effects of naloxone.
- Never use alone. If you don’t have anyone with you when you use, Neverusealone.com is available, and someone will stay on the phone with you while you use.
- Fentanyl test strips can help to determine if your supply is laced with fentanyl, so that you don’t take it unknowingly.
- And if you are ready to make a change in your substance use—whether that means quitting or cutting back—Workit Health (or another treatment program) can help.