Fentanyl is much worse than heroin

Of all the things I’m passionate about, if I had to pick one it would be fentanyl awareness and getting that crap off our streets.

Today’s post is not a fun read but it could save a life - so please read it!

May 10 is Fentanyl Awareness Day. I’ve searched the internet and found the information I’m sharing today here: National Center for Drug Abuse Statistics. In addition to statistics there is a ton of helpful information, I urge you to check it out.

For now, please check out what I’ve extracted from the article as the most PRACTICAL information we all need to know - as it says in the article, “education is your greatest defense against death.”

You may be thinking - but I don’t use drugs, my kids don’t use drugs, no one I know uses drugs. At the rate of fentanyl overdose deaths, we all need to know this because knowledge is power and it's important.

You don’t know when you’re going to run across someone that needs this information or needs your help in case of an overdose, they happen in public places, like the bathroom at Starbucks for example. If they pull an unconscious person out of the restroom and you are the one with Narcan in your glove compartment or purse, you could save a life! I have it with me at all times.

What is this evil substance?

“Fentanyl is a synthetic opioid, meaning it is not derived from the opium poppy plant. Instead, fentanyl and other synthetic opioids, such as methadone, are made entirely in laboratories.

• Fentanyl is a semi-synthetic opioid.

• Semi-synthetic opioids are made with natural opium involved in synthesis.

• Morphine, codeine, and heroin are semi-synthetics.

• Prescription fentanyl has been available since 1968.

• Fentanyl has been prescribed to treat children as young as 2 years old.

• Illegal manufacture and distribution of fentanyl began no later than 1979.

• Many analogs are available, all classified under the umbrella term “fentanyls”.

• One analog, carfentanil, is up to 10,000-times more potent than morphine.

• These analogs share many characteristics, including:

  • Profound physical effects. Physical impact includes drowsiness, nausea/vomiting, urinary retention, and pupillary constriction. Severe or prolonged reaction may require medical attention.

  • Highly addictive. The U.S. Drug Enforcement Agency (DEA) has classified fentanyl as a schedule II controlled substance, meaning it has a high potential for abuse, as well as severe physiological and psychological dependence.

  • Available in many forms. Once solely prepared for injection, fentanyl preparations can now be taken orally (pill, tablet, film, blotter paper, etc.), smoked, snorted or sniffed, and transdermal patch.

  • Legally prescribed for pain. Fentanyls are most often prescribed in conjunction with other analgesics to ease pain in cancer patients; transdermal patches are typically prescribed to patients who require a steady regimen of opioids to manage severe and/or chronic pain.

  • High similar to morphine. Fentanyl’s effects are comparable to other opioid analgesics, such as morphine. Users experience relaxation, euphoria, and confusion.

How Fentanyl Works

Fentanyl’s effects come on quicker than morphine, but they don’t last as long. The drug remains in the body for over a day, impacting different organs and systems.

• Once ingested, fentanyl molecules are distributed in fat and attach to human plasma proteins.

• The blood stream then delivers fentanyl to the brain, where it acts preferentially on the μ-opioid peptide receptors.

• To a lesser extent, it’s also active with κ-opioid and delta opioid receptors.

• These receptors ultimately produce the medicinal effects or “high” in the user.

• The liver metabolizes fentanyl to be excreted by the kidneys.

• Fentanyl’s narcotic effects can last anywhere from 2 to 16 hours.

• Excretion takes 6 to 32 hours.

Fentanyl Overdose Statistics

Overdose deaths from fentanyl are on the rise, nearly doubling annually, even as OD rates for other drugs have decreased. Many such deaths are users who did not know they ingested fentanyl, and most die from asphyxiation due to the drug’s respiratory depressive effect.

By the way, my son, Keven, used a gun to end his life. But his toxicology report showed this:

He had stopped using heroin and started using fentanyl exclusively because it got him more high!

• 2 mg of fentanyl is a lethal dose, but doses as small as 0.25 mg place the user at a high risk of overdose.

• Comparatively, a lethal dose of heroin is 100 mg while 250 mg of cocaine is a lethal dose.

• In 2018, Delaware reported post-mortem detection of fentanyl in 72% of all overdoses. (I'm sure its WAY higher now!)

• Asphyxiation via respiratory depression – that is, the slowing of the respiratory system – is the leading cause of death in fentanyl ODs.

• Hypoxia – that is, a lack of oxygen in the brain – is another common cause of death.

• Fentanyl’s respiratory effects outlast its analgesic effects.

• Fentanyl ODs increased from 2,600 in 2012 to 31,335 in 2018 and its doubled again since then!

• Carfentanil causes the most overdose deaths of any fentanyl analog.

• In addition to its high potency, the “hot spots” it leaves in cutting other drugs makes fentanyl among the most lethal substances available on the recreational drug market.

Signs of an Overdose

Fentanyl is deadly. If you know someone who uses opioids, watch for these overdose symptoms.

• Cold, clammy skin

• Pinpoint Pupils

• Slowed respiration

• Unconsciousness‡

If someone is sleeping or unconscious, move them into the recovery position.

Recovery Position

After calling 911, place any unconscious person in the recovery position while you wait for help to arrive. This allows any bodily fluids to drain out of the mouth and nose, reducing the risk of aspiration and asphyxiation.

• Place the person on their side.

• Bend their knees (as in the fetal position).

• Rest their head on top of the arm closest to the floor.

Risk Reduction Facts (I included this because if we can't stop people from using, we can use harm/risk reduction to make it safer)

Drug abuse and addiction is an insidious social problem. If you or someone you know uses fentanyl or drugs of the type that are commonly laced with fentanyl, education is your greatest defense against death.

• Keep a dose of Narcan or naloxone (opioid antidote) on hand. Contact community health services or the National Institute on Drug Abuse (NIDA) to find out where you can get free doses.

• Only buy from a trusted source. Most people killed by fentanyl overdoses do not realize the substance they’ve taken contained fentanyl.

• Use the buddy system. Make sure a friend knows what you’ve taken, how much, and when.

• Use in a safe environment. Opioids inhibit cognitive ability and make users less aware in general, leaving them vulnerable to other high-risk behavior.

• Smoking on foil is safer than injecting or snorting. There is no safe way to self-medicate or use recreational drugs. Smoking, however, leaves the user less vulnerable to hot spots and a deadly overdose.

• Avoid mixing fentanyl with other drugs, especially Central Nervous System (CNS) depressants, such as alcohols, barbiturates, and benzodiazepines.

• Know the signs of overdose, such as cyanosis (the skin gets a blue tinge, usually on the hands and feet or around the mouth.)

Fentanyl’s effects come on quicker than morphine, but they don’t last as long. The drug remains in the body for over a day, impacting different organs and systems.

• Fentanyl’s narcotic effects can last anywhere from 2 to 16 hours.

• Excretion takes 6 to 32 hours.

• 2 mg of fentanyl is a lethal dose, but doses as small as 0.25 mg place the user at a high risk of overdose.

• Comparatively, a lethal dose of heroin is 100 mg while 250 mg of cocaine is a lethal dose.

• In 2018, Delaware reported post-mortem detection of fentanyl in 72% of all overdoses.

• Asphyxiation via respiratory depression – that is, the slowing of the respiratory system – is the leading cause of death in fentanyl ODs.

• Hypoxia – that is, a lack of oxygen in the brain – is another common cause of death.

• Fentanyl’s respiratory effects outlast its analgesic effects.

• Carfentanil causes the most overdose deaths of any fentanyl analog.

• In addition to its high potency, the “hot spots” it leaves in cutting other drugs makes fentanyl among the most lethal substances available on the recreational drug market.

• A hot spot is a high concentration of fentanyl within a mix of other product(s). Fentanyl’s molecular nature does not allow it to mix evenly into other powders without leaving behind indetectable clumps. In order to fully mix with another powder, the concoction must be combined with a liquid and shaken before allowing the liquid to evaporate, returning the concoction to a powdered form. Failure to perform this final step all but guarantees hot spots of pure fentanyl in the final product.

Fentanyl ConsumedRisk of Overdose

0.00005 gramsDeath unlikely

0.0001 gramsModerate risk of death

0.00015 gramsSignificant risk of death

0.00025 gramsHigh risk of death

0.00004 gramsVery high risk of death

0.0007 gramsDeath likely

0.001 gramsNear-certain death

0.002 grams Death certain This is only TWO milligrams!

If you've read this far, thank you. You care. You realize that thousands upon thousands of families are losing loved ones and you want to be part of the solution. Challenge: next time you're around a teen, bring up the topic. So what if he/she gets defensive - maybe it will save their life.