Synthetic Opioids: What Is Fentanyl?

Fentanyl is an extremely potent synthetic opioid, 50 to 100 times stronger than morphine, which is used medically but is also the leading cause of overdose deaths due to illicitly manufactured versions. A lethal dose can be as small as two milligrams, and the substance is highly addictive, with symptoms including severe respiratory depression and constricted pupils in case of overdose. To combat the crisis, the article highlights the importance of harm reduction strategies, such as using Naloxone and fentanyl test strips, and seeking treatment through medication-assisted treatment (MAT).

Fentanyl is a powerful synthetic opioid, significantly stronger than morphine. While it has legitimate medical uses, it’s also a major contributor to the opioid crisis due to illicitly manufactured versions. Understanding what fentanyl is, how it works, and the dangers it poses is vital for protecting yourself and your loved ones.

More About Fentanyl

Fentanyl is a synthetic opioid, meaning it’s created in a lab rather than derived from the opium poppy like natural opioids such as morphine. The history of synthetic opioids began in the mid-20th century, with fentanyl being first synthesized in 1959. It was introduced into medical practice in the 1960s as an intravenous anesthetic.

Opioids encompass a broad category of drugs, including natural, semi-synthetic, and synthetic varieties. Synthetic opioids like fentanyl are entirely lab-made, setting them apart from natural (morphine, codeine) and semi-synthetic (heroin, oxycodone) options.

Fentanyl vs. morphine potency is a critical distinction. Fentanyl is estimated to be 50 to 100 times more potent than morphine. This extreme potency makes it incredibly dangerous; a tiny amount can be lethal. How much fentanyl is a lethal dose? As little as two milligrams, roughly the size of a few grains of salt, can be fatal for an average adult.

Medical Applications of Fentanyl

Despite the risks, fentanyl has important medical uses. What is fentanyl used for in hospitals? It’s used for

• Preoperative analgesia
• Anesthesia adjunct
• Regional anesthesia support
• General anesthesia
• Post-operative pain control
• Treatment of breakthrough pain in opioid-tolerant patients

Sublimaze, an intravenous form of fentanyl, is commonly used in hospitals for acute pain management. Fentanyl patches, like Duragesic, provide sustained pain relief for chronic conditions. Fentanyl patches release medication through the skin over 48 to 72 hours, offering a consistent dose.

How Fentanyl Works in Your Body

Understanding how long fentanyl stays in your system is crucial. The duration depends on the administration method:

• Intravenous: Half-life of 2-4 hours
• Transdermal (patch): Half-life of approximately 17 hours after removal
• Lozenges: Half-life of 5-15 hours

Urine tests can detect fentanyl within 24 hours of use, with detection possible for up to 72 hours or longer in frequent users. Blood tests have a narrower window, typically detecting fentanyl for only 12 hours. Hair follicle testing can detect fentanyl for up to 90 days.

Fentanyl is available in various forms, including intravenous solutions, transdermal patches, oral transmucosal lozenges (lollipops), sublingual tablets and sprays, and nasal sprays.

The Dangers of Fentanyl Addiction

Fentanyl is highly addictive due to its potency and rapid effects. Signs of fentanyl addiction can include:

• Drowsiness
• Confusion
• Constricted pupils
• Nausea
• Respiratory depression
• Increased secrecy
• Changes in social circles
• Neglect of responsibilities
• Loss of interest in activities
• Mood swings
• Anxiety
• Depression

Tolerance develops quickly, requiring higher doses to achieve the same effect. Dependence can also develop rapidly, even with short-term use.

The side effects of fentanyl patches and other formulations include 

• Constipation
• Headache
• Dizziness
• Fatigue
• Loss of appetite
• Nausea and vomiting
• Skin reactions

More serious side effects include 

• Respiratory depression
• Altered mental status
• Agitation
• Fever
• Muscle stiffness
• Changes in heartbeat
• Chest pain
• Seizures
• Difficulty breathing

Fentanyl overdose symptoms include severe respiratory depression, drowsiness, disorientation, pinpoint pupils, and clammy skin. Immediate emergency medical response is critical.

Fentanyl withdrawal symptoms can include muscle and bone pain, sleep disturbances, diarrhea and vomiting, cold flashes, irritability, insomnia, increased heart rate, and depression.

The Illicit Fentanyl Crisis

The biggest threat comes from illicitly manufactured fentanyl. The dangers of illicitly manufactured fentanyl include extreme potency, contamination with substances like carfentanil, and being mixed into other drugs without the user’s knowledge. Why is fentanyl added to other drugs? It’s a cheaper way for dealers to increase potency and profits.

Since 2016, fentanyl has been the leading cause of overdose deaths. Encouragingly, data show a 26.2 percent decrease in drug overdose deaths between 2023 and 2024, largely due to a decrease in synthetic opioid deaths.

A concerning trend is the combination of fentanyl with xylazine, a veterinary sedative. This combination increases overdose risks and causes severe wounds.

Carfentanil is an extremely dangerous fentanyl analogue, estimated to be 10,000 times more potent than morphine. Deaths involving carfentanil increased significantly between 2023 and 2024.

Staying Safe: Harm Reduction Strategies

Harm reduction strategies can save lives. Fentanyl test strips near me can help users detect fentanyl in their drugs before use. Naloxone (Narcan) is a life-saving medication that can reverse opioid overdoses. It’s now available over the counter. If you suspect an overdose, call 911 immediately and administer naloxone if available.

Can you touch fentanyl without overdosing? It’s extremely unlikely to overdose from incidental skin contact or inhalation. Misinformation about this has caused unnecessary fear

 and delayed treatment.

Treatment and Recovery

Medication-assisted treatment (MAT) is the gold standard for treating opioid use disorder. It combines medications like methadone, buprenorphine, and naltrexone with therapy and support.

If you or someone you know is struggling with substance abuse, Mountainside can help. We offer individualized and comprehensive treatment that meets people where they are. Speak with an admissions specialist today to discover your options!