Substance Use

Fentanyl Overdose: What You Need to Know

powder fentanyl with syringe

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In the past few years, the opioid crisis has been getting worse, and fentanyl overdoses have become a big problem. What is fentanyl, though, and how is it different from other opioids? Anyone who might come into contact with this strong drug needs to know about the risks and dangers of fentanyl overdose.

Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. (1) It is often added to heroin or disguised as other prescription medications, leading to unintentional overdoses. With more and more people dying from fentanyl overdoses, it’s important to know what to do in an emergency and what the signs and symptoms of an overdose are.

We help you understand the risks of fentanyl abuse and what you need to know to keep yourself and your family safe from this growing problem. Know what’s going on and stay safe.

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Facts About Fentanyl Overdose

Fentanyl is a strong synthetic drug that can kill if it is used too much. Benzodiazepines, like fentanyl, work by attaching to receptors in the brain and spinal cord. This makes pain feel less intense. (2) When taken in large doses, it can produce a sense of euphoria and relaxation. As a result, some people take fentanyl for recreational purposes. 

Not only is fentanyl found in fake pills, but it is also in stimulants like cocaine and methamphetamine, as well as opiates. (3)

Dealers are also mass-producing fake pills, falsely marketing them as legitimate prescription pills and selling them to unsuspecting people.

According to the U.S. Drug Enforcement Administration (DEA), nearly half of all counterfeit pills tested contained a lethal dose of fentanyl. This figure is particularly alarming because it can be difficult to distinguish genuine pills from fake or counterfeit versions. (4)

They are also often sold on social media and e-commerce platforms, making them available to anyone with a smartphone.

DEA analysis has found counterfeit pills ranging from .02 to 5.1 milligrams (more than twice the lethal dose) of fentanyl per tablet.

  • 42% of pills tested for fentanyl contained at least 2 mg of fentanyl, considered a potentially lethal dose.
  • Drug trafficking organizations typically distribute fentanyl by the kilogram.  One kilogram of fentanyl has the potential to kill 500,000 people. (5)

According to the Centers for Disease Control and Prevention (CDC), drug overdose deaths involving illicitly manufactured fentanyl are a public health crisis. Rates of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl and fentanyl analogs, increased over 22% from 2020 to 2021.

The rate of overdose deaths involving synthetic opioids in 2021 was nearly 22 times the rate in 2013. Nearly 71,000 drug overdose deaths involved synthetic opioids other than methadone in 2021.

The latest provisional drug overdose death counts suggest overdose deaths accelerated during the COVID-19 pandemic. (6)

These fentanyl facts give us a clear understanding of the predicament involving fentanyl overdose.

Can You Overdose on Fentanyl?

Yes, you can overdose on fentanyl. According to the National Institute on Drug Abuse (NIDA), fentanyl is about 50 to 100 times more potent than heroin. (7) Because it is so powerful, taking even a tiny amount of fentanyl can lead to an overdose.

Fentanyl abuse can be extremely dangerous, as an overdose can slow or stop breathing. This decrease in oxygen levels, a condition called hypoxia, can lead to coma and permanent brain damage. In some cases, it can even be fatal. (8)

What to Do in an Emergency?

If you suspect someone close to you is overdosing on fentanyl, call 911 immediately to request help. First responders (e.g., emergency medical services and law enforcement) should be contacted as soon as possible. While waiting for help to arrive, it’s important to stay with the individual and monitor their vital signs, such as breathing and pulse.

What Are the Treatment Options for a Fentanyl Overdose?

The first step in treating a fentanyl overdose is to call 911. If available, administer naloxone, a medication that can reverse the effects of opioid overdose. (8) Naloxone works by binding to opioid receptors in the brain, which reverses the respiratory depression caused by an overdose.

Naloxone is available in a nasal spray and can be legally used with a prescription in most states. (9

It is very important to keep giving supportive care until emergency medical personnel come to help more. In addition, they will take the person to a medical center for more care and observation.

The hospital’s medical staff will provide supportive care, such as oxygen therapy, intravenous fluids, and medications to ease withdrawal symptoms. In some cases, healthcare professionals may need to mechanically ventilate the individual. 

Is a Fentanyl Overdose Dangerous?

Fentanyl overdoses are particularly dangerous because the drug can cause respiratory depression, leading to death.

For this reason, it is crucial to be aware of the risks associated with fentanyl and to seek assistance from a healthcare provider immediately if you or someone you know begins to experience any signs of an overdose.

How Much Fentanyl Does It Take to Overdose?

As little as two milligrams of fentanyl can cause adverse health effects such as:

  • Breathing difficulties
  • Dizziness
  • Possible overdose 

Two milligrams are about the size of five grains of salt. (10) The amount of fentanyl it takes to cause an overdose can vary widely due to its potency.

Fentanyl is much stronger than other opioids like heroin, so even a small amount can be dangerous.

Naloxone is very important for saving lives when someone has overdosed. Overdose deaths involving fentanyl have been on the rise in recent years. This shows how important it is to have easy access to naloxone.

Toxicology reports help doctors figure out how much fentanyl is still in a person’s body after an overdose. This helps them treat and help the person properly.

What Are the Signs and Symptoms of a Fentanyl Overdose?

The most common signs and symptoms of a fentanyl overdose include:

  • Slow or shallow breathing
  • Confusion and drowsiness
  • Tiny pupils
  • Cold or clammy skin
  • Loss of consciousness
  • Muscle rigidity (11)

Fentanyl overdoses require emergency medical treatment, as the effects can progress quickly and be life-threatening.

Other Fentanyl Side Effect Complications

Fentanyl is also associated with other potential side effects and complications, particularly when used with other drugs.

For instance, users have reported mental health problems like:

  • Anxiety
  • Depression
  • Hallucinations
  • Paranoia

Sometimes, these side effects can be so severe that they result in hospitalization.

Additionally, fentanyl use can lead to

  • Increased risk of liver
  • Kidney damage
  • Respiratory failure
  • Heart problems

Finally, because fentanyl is often produced in illicit labs, there is no quality control. Users may unwittingly consume dangerous impurities that can further exacerbate the above side effects.

What Increases the Risk of a Fentanyl Overdose?

One of the most significant dangers of fentanyl is that it is often added to illicit drugs such as heroin and methamphetamine without the user’s knowledge. (12) Black market suppliers do this because it takes very little fentanyl to produce a high. This makes it cheaper than other options.

Why Does a Fentanyl Overdose Occur?

A fentanyl overdose can occur due to several factors contributing to the heightened risk of overdose. One primary reason is the variability and unpredictability of the drug supply, particularly in illicitly manufactured fentanyl and fentanyl-laced substances.

Users may unknowingly consume fentanyl mixed with other drugs, increasing the likelihood of overdosing.  

Fentanyl is now common in the illicit drug supply, and in recent years, has become more common than heroin. Synthetic opioids, primarily illicitly manufactured fentanyl, are involved in most drug overdose deaths in the U.S. (13)

Additionally, the high potency of fentanyl compared to other opioids means that even a small amount can lead to overdose. Fentanyl is an incredibly dangerous drug that can kill even first-time users.

Lack of awareness about the presence of fentanyl in illicit drugs and the tendency to underestimate its potency further worsen the risk.

To stop overdoses, people need to know more about how dangerous fentanyl is, have easier access to naloxone, and learn about ways to reduce harm. Some of these are fentanyl test strips, which lower the risks of drug use.

How to Tell If Someone Is on Fentanyl?

Some signs that someone may be using fentanyl include:

  • Acting unusually sleepy or sluggish
  • Slurred speech
  • Seizures
  • Pinpoint pupils

Why Would Someone Take Fentanyl?

People use drugs recreationally for a variety of reasons. For some, it is a way to escape the stresses of daily life or to feel more uninhibited.

Others use drugs to experience new and different sensations. And for some people, recreational drug use is simply a reflection of curiosity.

Fentanyl binds to the body’s opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. These receptors are responsible for regulating pain and emotions.

When fentanyl enters the brain, it attaches to these receptors and causes an influx of dopamine. Dopamine is a neurotransmitter associated with feelings of pleasure and reward. The flood of dopamine caused by fentanyl leads to the intense high that users feel. 

How to Help Someone With a Fentanyl Use Disorder?

If you suspect that someone you know is struggling with a fentanyl use disorder, there are some things you can do to help.

  1. Stage an intervention and try to talk to the person about your concerns. Let them know you are there for them and want to help them get the treatment they need. If they are unwilling or unable to talk to you, you can reach out to a professional addiction counselor or interventionist for assistance.
  2. Encourage the person to seek professional help. Many treatment options are available for fentanyl addiction, and the sooner the person gets help, the better their chances of recovery. You can offer to go with them to their first appointment or help them find a reputable treatment center.
  3. Be supportive throughout the person’s recovery journey. Addiction is a chronic disease, so relapse is always a possibility. However, with continued support and referral to appropriate treatment, people with fentanyl use disorders can, and do, recover.

Is fentanyl use a problem for you or a loved one? Zinnia Health offers a safe and supportive environment with medication-assisted treatment options like methadone and buprenorphine. Our team of dedicated professionals has extensive experience helping people recover from substance use disorders, and they are committed to providing the highest quality care possible. We also offer aftercare services that help people stay on track after they leave a treatment program. Our goal is to help our clients develop the toolkits they need to overcome addiction and lead healthier, happier lives. Call our helpline 24/7 at (855) 430-9439 to get started.


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