The Hidden Killer: Fentanyl | Center on Addiction

The Hidden Killer: Fentanyl

The Hidden Killer: Fentanyl


For years, we’ve been telling parents to talk to their children about the dangers of prescription drug misuse, because these conversations can help reduce teen substance use and prevent addiction. Now there is a new reason for parents to have “the talk”– to warn them about the dangers of fentanyl, a deadly opioid being laced in drugs or substituted for other commonly abused opioids like heroin, OxyContin, Vicodin and Percodan.

The danger of “laced” drugs isn’t new: many of the substances sold on the street are either laced with a more potent substance or completely disguised as another. We’ve often heard the story of laced marijuana causing severe reactions among users. But there is a more deadly danger with fentanyl. Fentanyl is one of the most powerful pain killers ever invented, and it’s showing up laced in heroin and prescription anxiety medications like Xanax. Over 18 percent of 12th graders have misused a prescription drug in their lifetime – so 1 in 5 kids may be at risk. It’s more important than ever to talk with teens about the risks of misusing prescription medications. 

The backstory

Fentanyl was created in 1960 – a synthetic chemical designed to help relieve pain for those in surgery. Fentanyl is about 80 to 100 times more potent than morphine and approximately 40 to 50 times more potent than heroin. It’s so potent that a pure dose of a tiny amount can kill you. Unlike other opioids, it doesn’t require harvesting and refining the poppy plant. Instead, it can be created easily and inexpensively in a lab.

For many years, fentanyl was primarily used for its only FDA-approved purpose – treating individuals with severe pain from cancer. Even as opioid prescriptions became more frequent in the 1990’s and early 2000s, very few physicians recommended this particular pain killer. Its potency was considered too dangerous, its properties highly addictive, and its effects known to last only up to about two hours – not nearly long enough for medical use for other pain conditions. It remained used principally for patients who were physically resistant to other opioid medications, or those who desperately needed an extremely powerful level of pain relief.

Despite the relatively low rate of prescribing fentanyl, it has recently become a notable problem in the prescription drug and opioid epidemic. As those addicted to prescription opioids moved to heroin, many drug cartels realized they could quickly and cheaply produce fentanyl – and then cut heroin with it. Instead of heroin being cut and made weaker, fentanyl makes the substance exponentially more dangerous, due both to the narcotic’s power, and because some of those using this heroin aren’t aware it’s laced with such a dangerous chemical.

The death toll from the opioid epidemic is growing worse. The rise in drug-related deaths is related to more people using heroin, and heroin laced with fentanyl.

Fentanyl is difficult to identify

In the last few months, there have been a number of cases of illegally purchased prescription drugs labeled Xanax – a medication that’s normally used to reduce anxiety – that contained fentanyl. Many people who took the pill were young and without any knowledge of what the pill actually contained. And while it’s unclear why fentanyl was being labeled as Xanax, the consequences of this mislabeling were dire. In Florida, Texas and California (among other states), people died from ingesting the mislabeled Xanax. There have been other cases of it being manufactured to look exactly like OxyContin.

Fentanyl has also been smuggled into the U.S. in its pure form and occasionally sold as heroin.  In New England, hundreds of individuals using opioids have died from using fentanyl-laced heroin or pure fentanyl.

What you can do as a parent

Though many teenagers believe they know what they’re doing when they take a pill like Xanax or OxyContin, these recent cases of fentanyl overdoses raise a new concern that is too dangerous to overlook.

Talk to your teenager about the dangers presented by many of these prescription pills – laced or not – and remind them that even if they think they know what a medication is, it can be something else entirely. Being aware of the dangers of these drugs may deter many adolescents from trying them and prevent accidental death by overdose, the leading killer of youth in this country. With fentanyl killing so many people, it’s now more important than ever to have an honest discussion about the dangers of misusing prescription drugs. 

 Max Dorfman, MA

 Max is a Science Writer at Center on Addiction


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