Why Fentanyl Is So Dangerous

You’ve likely seen the headlines. Fentanyl is behind a growing number of overdoses – and often, people don’t even know they’ve taken it.

“Fentanyl is incredibly potent and fast‑acting,” says J. Craig Allen, MD, vice president of addiction services for Hartford HealthCare and medical director of the Rushford Center, part of its Behavioral Health Network. “Even a few grains can slow or stop breathing within minutes. That’s what makes it so dangerous.”

Here’s what makes fentanyl different – and how to protect yourself or someone you love.

What is fentanyl?

Fentanyl is a synthetic opioid, sometimes prescribed for severe pain. But most fentanyl found in overdose cases isn’t prescribed – it’s made illegally and mixed into other drugs.

“It’s cheap to make, easy to hide and often cut with other harmful ingredients or laced into street drugs and counterfeit pills,” says Dr. Allen. “Potency can vary between batches, putting even long-term users at risk. And, sometimes, people don’t even know it’s there.”

> Related: How to Help Someone Who May Be Addicted to Drugs or Alcohol

Here are 5 reasons fentanyl is so dangerous

1. It’s extremely strong

Fentanyl is a synthetic opioid that’s 50 to 100 times stronger than morphine and far more potent than heroin. That strength is exactly what makes it so dangerous. Just a few grains can be lethal.

And because illegal fentanyl isn’t made in a controlled setting, potency can vary wildly from batch to batch, making it even more unpredictable.

2. It acts fast

Fentanyl reaches the brain in seconds to minutes, much faster than many other opioids.

As the drug takes effect, breathing slows rapidly and can stop altogether. People may lose consciousness before they can call for help or before anyone realizes it’s an overdose

3. It’s often hidden

One of the biggest dangers of fentanyl is that many people don’t know they’re taking it. Dealers mix it into heroin, cocaine, meth or pills that look like Adderall, Percocet or Xanax.

“People think they’re taking one thing,” says Dr. Allen. “But if it’s laced with fentanyl, one pill can kill you.”

4. It’s often cut with other dangerous substances

Fentanyl is frequently mixed with other drugs to increase profits or intensify effects, which adds another layer of risk.

For example, Xylazine, a powerful animal tranquilizer, has been found in the majority of Connecticut’s fatal fentanyl overdoses.

5. Overdoses are harder to reverse

Fentanyl overdoses often need multiple doses of naloxone (Narcan) – and even then, the effects may come back.

“Sometimes the person starts breathing again, then stops,” Dr. Allen says. “That’s why staying with them until help arrives is so important.”

Know the signs of overdose

If you suspect someone has overdosed, look for:

• Blue or gray lips and nails.
• Pinpoint (tiny) pupils.
• Gurgling or choking sounds.
• Very slow or no breathing.
• Unconsciousness or not waking up.

“This is a medical emergency,” Dr. Allen says. “Call 911 immediately. Good Samaritan Laws protect you, and if you have it, give naloxone.”

What to do while waiting for help:

• Give naloxone (Narcan). If there’s no response within a few minutes, try a second dose.
• Start rescue breathing or CPR.
• Lay the person on their side to keep their airway clear.
• Stay until help arrives.

“You don’t need to be sure it’s an opioid overdose to use naloxone,” adds Dr. Allen. “It won’t hurt someone who doesn’t need it – but it can absolutely save a life.”

> Related: 6 Things to Know About Drug Withdrawal 

How to stay safe from fentanyl

Fentanyl is risky – but there are ways to reduce the danger.

Dr. Allen recommends:

• Carry naloxone. You can get it at most pharmacies or community programs without a prescription.
• Don’t use alone. Have someone who can call for help or administer Narcan.
• Test your drugs. Use fentanyl test strips – they’re simple, fast and often free.
• Avoid mixing substances. Combining alcohol, benzos or opioids makes overdose more likely.

> Related: Can You Rewire You Brain from Addiction? 

Get support today

Fentanyl is powerful – but so is treatment.

Medications like methadone or buprenorphine can help people stop using opioids safely and successfully.

“Too many people don’t get help because of the stigma out there,” says Dr. Allen. “But treatment works. And you’re not alone. People care and want to help you recover.”