Fentanyl: What You Need To Know

What is fentanyl?


Fentanyl is a potent synthetic (human-made) opioid drug approved by the Food and Drug Administration for pain management since the 1960s. It is approximately 100 times more potent than morphine and 50 times more powerful than heroin. 

Fentanyl is a significant contributor to fatal and nonfatal overdoses in the United States. Fentanyl can be categorized as either pharmaceutical fentanyl or illicitly manufactured fentanyl. Doctors prescribe pharmaceutical fentanyl to treat severe pain, especially after surgery and for advanced-stage cancer. Most recent cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl, distributed through illegal drug markets for its heroin-like effect. It is often added to other drugs because it is cheap to manufacture and highly potent, making drugs more addictive and dangerous.

Fentanyl Facts


  • Fentanyl can be prescribed to an individual and taken as an illicit substance. People take fentanyl knowingly and without their knowledge. This is due to the fact that fentanyl is increasingly contaminating the street drug supply as a cheap and powerful addition to other substances.  
  • According to the CDC, synthetic opioids (like fentanyl) are the primary drivers of overdose deaths in the United States. Comparison between 12 months-ending January 31, 2020, and the 12 months-ending January 31, 2021, during this period:

            – Overdose deaths involving opioids rose 38.1 percent.

            – Overdose deaths involving synthetic opioids (primarily illicitly manufactured fentanyl) rose 55.6 percent and appear                to be the primary driver of the increase in total drug overdose deaths. 


  • You cannot overdose simply by touching fentanyl. A person must introduce fentanyl into the bloodstream or a mucus membrane. While there are fentanyl patches that a person can place on the skin for pain management, this is not the formulation that drug traffickers and drug dealers mix into other substances.
  • Naloxone, commonly referred to as the brand name Narcan can effectively reverse a fentanyl overdose if administered promptly.

What does Fentanyl look like?

Across the United States, law enforcement has encountered fentanyl in various forms, including: 

 – Pills sold as fake oxycodone, Xanax and sought after medications (left) 

–  Powder form; sometimes mixed into other drugs such as cocaine, crystal meth or marijuana (right). When sold as a powder, fentanyl can look varying levels of off-white to light brown. When it is mixed into other powders, fentanyl tends to bring an off-brown color to the mixture.

–  Prescribed fentanyl patches used for purposes other than they were prescribed. 

Is Naloxone/Narcan effective in reversing a fentanyl overdose?


Yes! Naloxone/Narcan can reverse a fentanyl-induced overdose. Any claim that fentanyl is “naloxone resistant” is wrong. Like any other opioid, fentanyl will respond to naloxone if someone is overdosing. When it appears that someone overdosing is not responding to naloxone, it may be because:

  • The naloxone needs more time to take effect (wait 2-3 mins before administering more naloxone).
  • The person overdosing may need more than one dose of naloxone (wait 2-3 minutes between doses).
  • The naloxone was administered after the person had been without oxygen for too long.


It is important to stress the administration of rescue breathing when it comes to a fentanyl or other opioid related overdose. Breathing for another person while waiting for naloxone or calling 911 can be life-saving.

You can receive free naloxone training and free naloxone kits here

What are fake/ counterfeit pills, and how are they connected to fentanyl?


“Fake pills” or “counterfeit pills” are made to look like prescription pills but are illegally produced and contain unknown substances. These are sold through illegal channels and are widely available. 

Commonly found fake prescription opioids, aka fake pills, include oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®). Others include stimulants like amphetamines (Adderall®).

It is imperative to outline the risk of taking pills not prescribed by your doctor. Pills bought on the street run the risk of containing fentanyl due to the inexpensiveness and potency of the substance. The DEA has issued a warning on counterfeit pills containing fentanyl and reports having seized over 9.5 million counterfeit pills in 2021. Testing the seized fake fills revealed that 2 in 5 tablets potentially contain a lethal dose of fentanyl, about 2 milligrams of fentanyl.

Fentanyl Test Strips and Harm Reduction

Fentanyl test strips are a tool to test unregulated drugs for the contamination of fentanyl and various fentanyl analogs in power and pill form. While helpful, it is important to keep the following notes in mind.

  • Fentanyl test strips do not provide an amount or quantity of fentanyl present in the substance, which means there could be a lethal dose. They also do not test for all the fentanyl analogs. A negative result does not guarantee the substance being tested is free from fentanyl or other synthetic opioids.

  • When using unregulated drugs, it is vital to employ safer drug use practices. The fentanyl test strips should not provide a false sense of security and should always be used in addition to safer drug use practice.


For an overview of how to use fentanyl test strips, visit DanceSafe’s website and for a more detailed how-to, visit this DanceSafe page. Fentanyl test strips can be found at many needle exchanges or at https://btnx.com/harmreduction.

If using substances, it is important to employ safer drug use practices. These practices are about reducing adverse outcomes that can be caused from using drugs. As deadly doses of fentanyl continue to creep into the unregulated drug supply, these safer drug use tips can be life-saving.



  • Apace
  • China Girl
  • China Town
  • China White
  • Dance Fever
  • Goodfellas
  • Great Bear
  • He-Man
  • Poison
  • Tango & Cash

Fentanyl is a Schedule II narcotic under the United States Controlled Substances Act of 1970.

The effects of taking fentanyl with other drugs – including over-the-counter or prescribed medications – can be unpredictable and dangerous, and could cause:

Fentanyl + alcohol may increase the risk of respiratory depression.

Fentanyl + benzodiazepines: may add to the sedative effects and diminished breathing.