Fentanyl has changed the landscape of drug addiction in ways that make it more dangerous than anything that came before. It is 50-100 times more potent than morphine. A dose the size of a few grains of salt can be lethal. And it is now found in cocaine, counterfeit prescription pills, and other drugs — meaning people are sometimes exposed without knowing it.

What Is Fentanyl?

Fentanyl is a synthetic opioid — a man-made painkiller far more potent than heroin or morphine. It was originally developed for managing severe pain in cancer patients. Illicit fentanyl — manufactured illegally and mixed into other drugs — is now responsible for the majority of overdose deaths in the United States.

It comes in several forms: powder, pills (often pressed to look like prescription opioids), patches, and liquid. Street names include China White, Dance Fever, Friend, Goodfellas, Jackpot, Murder 8, and Tango & Cash.

Signs of Fentanyl Use

• Extreme drowsiness — “nodding off” mid-conversation
• Slowed or stopped breathing
• Pinpoint (very small) pupils
• Confusion, disorientation
• Pale, clammy skin
• Blue lips or fingertips (cyanosis) — a sign of oxygen deprivation
• Loss of consciousness

Signs of Fentanyl Overdose — Act Immediately

Fentanyl overdose can cause death within 2-3 minutes. Signs include:

• Unresponsive — cannot be woken
• Breathing stopped or extremely slow and shallow
• Gurgling or choking sounds
• Blue or purple lips, fingernails, or skin
• Limp body

Call 911 immediately. Administer naloxone if available. Start rescue breathing if trained.

Naloxone (Narcan) — Every Family Should Have It

Naloxone is a medication that reverses opioid overdose. It is available without a prescription at most pharmacies in the US. Because fentanyl is so potent, multiple doses may be needed.

• Available as a nasal spray (Narcan) or injection
• Available without prescription at CVS, Walgreens, and most pharmacies
• Free or low-cost through many harm reduction organisations
• SAMHSA Opioid Overdose Prevention Toolkit: free guidance at store.samhsa.gov

Drug Testing for Fentanyl

Fentanyl test strips can detect fentanyl in drugs before use. They are now available in many areas and have been shown to reduce overdose risk. At-home drug tests can also detect fentanyl use. See our guide: Drug Testing Kits for Families →

Treatment for Fentanyl Addiction

Fentanyl addiction is treatable. Medication-assisted treatment (MAT) is highly effective:

• Buprenorphine / Suboxone — reduces cravings and withdrawal, widely available
• Methadone — dispensed through specialist clinics, very effective for severe addiction
• Naltrexone / Vivitrol — blocks opioid effects, prevents relapse

Detox from fentanyl should always be medically supervised. See: How Long Does Drug Detox Take →

Find treatment: findtreatment.gov or call SAMHSA: 1-800-662-4357