Addiction Center is not a medical provider or treatment facility and does not provide medical advice. Its potency and widespread availability have contributed to a dramatic increase in opioid-related deaths. The fentanyl crisis has become a significant public health issue in recent years.

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Some experts suggest that a “fourth wave” of the opioid epidemic is underway, in which illicit fentanyl is more frequently mixed with other drugs, and the combination of fentanyl and stimulants can be particularly dangerous. Synthetic opioids, primarily fentanyl, were involved in about two-thirds of those deaths. Purdue Pharma and its owners, members of the Sackler family, reached a multibillion-dollar settlement this year to resolve thousands of lawsuits alleging that the pain medication OxyContin caused a widespread opioid addiction crisis in the US.

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Trump pledged to make ending the fentanyl crisis a top priority for his administration, and has cast the drug as an insidious foreign tool devised to undermine American greatness. Anne Fundner, the mother of a 15-year-old who overdosed from a fentanyl-laced pill, gave an emotional speech at the Republican National Convention last year, blaming her son’s death on the Biden administration’s border policies. South American cocaine and marijuana account for the overwhelming majority of maritime seizures, according to Coast Guard data, and there isn’t a single instance of a fentanyl seizure—let alone “bags” of the drug—in the agency’s press releases. “Each boat that we sink carries drugs that would kill more than 25,000 Americans.” Already, the administration has killed 17 people—“narco-terrorists,” Trump calls them—in air strikes on three boats allegedly from Venezuela and loaded with what the president has described as “big bags of cocaine and fentanyl.”
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Avery Kalafatas, an 18-year-old from the Bay Area, says she knew nearly nothing about fentanyl until it killed her cousin, Aidan Mullin. The 2021 National Survey of Drug Use and Health found only about 60% of surveyed year-olds self-reported that they saw or heard drug or alcohol prevention messaging in school. And in schools across the country, drug education is ad-hoc, not standardized and oftentimes outdated. Of the 20 largest districts in the country, only five confirmed to NPR that they stocked naloxone in all of their schools last school year.
In addition, counterfeit pills resembling popular painkillers are a common disguise for this synthetic opioid. So, while it might seem affordable (compared to several other drugs) initially, the gamble with fentanyl’s potency can lead to astronomical personal costs. Its inclusion makes street drugs more potent and cheaper to make, driving its frequent use in the production of illicit substances.

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If you or someone you know is struggling with fentanyl abuse, seek professional help immediately. It can be purchased from drug dealers, online marketplaces, or through illegal importation from other countries. However, for the purposes of this article, we will discuss where fentanyl is typically sold and distributed. It is important to note that buying fentanyl is illegal and can result in serious legal consequences. It costs Jess Tilley $1 to purchase a fentanyl test strip—a small sum, until you consider that she’s buying them by the hundreds. When I went to my probation officer – this was like the last time before I turned myself in – it popped up that I had fentanyl, cocaine and amphetamines.
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Scientists are also working on opioid vaccines that would cause a person to develop antibodies to particular opioids and block their effects. For people who are addicted to fentanyl, there are safe and effective treatments available. There is no way to tell how much fentanyl might be present in a particular street drug. In some cases, these illicit formulations of fentanyl are made to look like other prescription opioid tablets. Potent benzodiazepines, or tranquilizers, are now further contaminating the illicit fentanyl supply, causing more complicated overdoses. In the second decade of the 21st century in the United States, fentanyl was one of the deadliest drugs of abuse.
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However, drugs you buy on the street are never safe. When fentanyl is taken by mouth or by intravenous (IV) injection, it has a stronger effect than most other opioids. Buyers may think they’re getting oxycodone, but they’re getting another opioid drug that has fentanyl and other substances in it. It’s up to 100 times stronger than other opioids like morphine, heroin, or oxycodone.
Medical Use
- Try snorting or smoking instead of injecting to reduce risk
- If you or someone you know is struggling with fentanyl abuse, seek professional help immediately.
- Naloxone (Narcan) is an antidote for fentanyl and other opioid overdoses.
- Additional doses of naloxone are therefore sometimes necessary.
You should call 911, administer naloxone, try and keep the individual awake, lay the person on their side, and stay with them until emergency services arrive. Some symptoms include losing consciousness, limp body, slow or weak breathing, and small, constricted pupils. For instance, pharmaceutical-grade fentanyl is often more expensive than illicitly manufactured fentanyl. The risk is enormous. “Well, by the time it reaches anywhere,” Webb explains, “pretty much the drug has already changed hands anywhere from five to 10 times — they've already been paid.
If you decide to use the drugs after testing them, you can drink them or inject them. If you plan to use IV drugs, prepare the shot, set the needle aside, and add about one-fifth teaspoon of water to the spoon/cooker with the drug. Use 1 teaspoon of water per every 10 mg of crystal or powder meth, MDMA, or ecstasy to dissolve the drugs in a small container (like a soda bottle cap). The best way to use them is to dissolve all the drugs you plan to use in water. Other research from Brown University showed that half of test strip users found fentanyl in their drug supply.
This is not an addiction but instead a physiological response. There is also the category of medical dependence. If a person has a susceptibility to addiction, then it is a situation where the person is more likely to develop a substance use disorder. It is often said that fentanyl is highly addictive due to its potency and rapid onset of action.
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The Trump administration has delayed and may cancel roughly $140 million in grants to fund fentanyl overdose response efforts, according to four staff members with close knowledge of the process at the Centers for Disease Control and Prevention. (Trump, in his UN speech, falsely claimed that 300,000 Americans were killed by drugs last year.) Overall U.S. overdose deaths have been declining since 2023; there were roughly 80,000 last year. It has been the policy of the United States and its partner nations in the region to seize the drugs and prosecute suspected traffickers, not kill them. Although cocaine is a potentially lethal drug, it is far less deadly than fentanyl.
If fentanyl is used by a child or an adult who has not been prescribed the medication, try to remove the medication from the person's mouth and get emergency medical help. Talk to your health care provider immediately and ask for guidance if you think that you have an opioid addiction or call the U.S. Even if the test is negative, take caution as test strips might not detect more potent fentanyl-like drugs, like carfentanil.10 It can cause harm or death to people with opioid use disorders or who may have accidental exposure to the drug.
With interprofessional coordination of activities and open communication, fentanyl therapy can be successful and adverse events avoided or managed if they arise. When prescribing fentanyl, the dose and duration should be the lowest and shortest effective, and the patient is continually assessed for compliance and/or diversion in outpatient settings. Also, an IV neuromuscular blocker may be employed in cases of severe muscular rigidity to assist the controlled respiration treatments.