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Reviewed by Fentanyl, first developed in 1960, revolutionized pain management as the most potent opioid anesthetic and analgesic of its time. Its rapid onset and potency, 50โ100 times stronger than morphine and 30โ50 times stronger than heroin, made it a groundbreaking tool for treating moderate to severe pain, particularly in cancer patients.
However, its misuse has become a significant public health crisis in the U.S. Fentanyl is now often illicitly synthesized and mixed with heroin, cocaine, and methamphetamine. This has led to a sharp increase in overdose deaths, marking the start of the third wave of the opioid epidemic in America, with an estimated 81,083 fentanyl deaths in 2023.
Understanding the symptoms of fentanyl overdose is crucial for timely drug intervention and prevention. Keep reading to learn about the critical signs of fentanyl overdose and how to respond effectively to save lives.
Table Of Contents:
Fentanyl Overview
Fentanyl is a powerful synthetic (lab-made) opioid that is FDA-approved to treat severe pain related to surgery or complex pain conditions. Its high lipophilicity allows it to rapidly cross the blood-brain barrier, resulting in fast-acting analgesic and rewarding effects by binding to and activating ฮผ-opioid receptors (MORs) in the brain.
These ฮผ-opioid receptors are found in many brain regions and are involved in various functions, including analgesia, reward, and mood regulation. When fentanyl binds to these receptors, it not only provides significant pain relief but also produces intense euphoria, which can lead to dependence and fentanyl addiction.
The high potency and rapid onset of fentanyl further contribute to its misuse, as individuals seeking quick and powerful effects may turn to this opioid as a recreational drug.
Why Is Fentanyl So Dangerous?
Fentanyl differs from more familiar opioids, such as morphine, codeine, or even heroin, primarily in its potency, which is the amount of a substance needed to produce a certain therapeutic effect.ย Fentanyl is 100 times more potent than morphine, meaning that if you need 10 mg of morphine for pain relief, you will only need 0.1 mg of fentanyl to achieve the same effect.
Lethal Dose of Fentanyl
Illicitly produced fentanyl is often synthesized in unregulated laboratories, resulting in inconsistent and unpredictable dosages. As little as two milligrams of fentanyl can be lethal, depending on a personโs body size, tolerance, and past drug use.
A United States Drug Enforcement Administration (DEA) analysis found:
- Counterfeit pills containing between 0.02 to 5.1 milligrams of fentanyl per tablet.
- 42% of pills tested for fentanyl contained at least 2 milligrams.
This data underscores the dangers of street drugs. People can unknowingly take fentanyl pills containing a fatal amount, and even those aware it contains fentanyl cannot be sure of the dose. This unpredictability, combined with fentanyl’s high potency, means that even a slight miscalculation in dosage can result in an accidental fentanyl overdose or death.
What Is A Fentanyl Overdose?
A fentanyl overdose occurs when an individual consumes a toxic amount of fentanyl, overwhelming the bodyโs ability to metabolize the drug safely. Due to its extreme potency, even a small amount of fentanyl can cause severe and potentially fatal consequences. An overdose can quickly lead to respiratory depression, unconsciousness, and death if not treated promptly.
Fentanyl Overdose Symptoms
Being aware of fentanyl overdose symptoms and differentiating them from regular fentanyl side effects is crucial for timely intervention. Recognizing the symptoms can mean the difference between life and death. Here are the main symptoms of fentanyl overdose:
- Respiratory depression: It can cause slow, shallow breathing or even complete respiratory arrest.
- Pinpoint pupils: The person’s pupils will be very small and constricted.
- Loss of consciousness: The person may become unresponsive or seem to be in a deep sleep.
- Decreased muscle tone: The person’s body may go limp.
- Confusion: The person may be confused or disoriented.
- Nausea and vomiting: The person may vomit.
- Blue-tinged skin (cyanosis): This can occur as the body is deprived of oxygen.
- Seizures: In some cases, the person may experience seizures.
If you suspect someone is having a fentanyl overdose, there are critical steps you can take while waiting for emergency services to arrive. In these cases, acting quickly can save a life.
What to Do During A Fentanyl Overdose?
The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a comprehensive toolkit designed to guide first responders through the critical steps necessary during an opioid overdose emergency. These guidelines are crucial for ensuring timely intervention and improving the chances of survival.
Below are the essential steps outlined by SAMHSA for first responders:
Step 1: Call 911 Immediately
- Dial 911 and inform the dispatcher that someone is unresponsive and not breathing.
- Give a specific address or description of your location.
- Follow the dispatcherโs guidance, which may include starting CPR based on your level of training.
Step 2: Administer Naloxone (Narcan) if Available
Naloxone, commonly known by the brand name Narcan, is a life-saving medication that can reverse the effects of an opioid overdose, including those involving fentanyl. It works by quickly binding to opioid receptors in the brain, displacing the opioids and reversing their effects.
This intervention can restore normal breathing and consciousness within minutes. Take into account that fentanyl can be very potent, so multiple doses of naloxone might be required to reverse the overdose completely.
- Administer one dose of naloxone if the person is not breathing.
- If there is no response within 2-3 minutes, administer a second dose.
- Naloxone can be given via intranasal spray or intramuscular, subcutaneous, or intravenous injection.
- Follow the product instructions carefully.
Step 3: Provide Rescue Breathing
- Ensure the person’s airway is clear of any obstructions.
- Tilt the head back, lift the chin, pinch the nose shut, and give two slow breaths.
- Watch for the chest to rise (not the stomach), then give one breath every five seconds.
Step 4: Monitor the Person’s Response
- Monitor for recurrence of overdose symptoms for at least four hours from the last naloxone dose.
- For those who have taken long-acting opioids, extended monitoring is necessary.
- Ensure the person gets to an emergency department for professional fentanyl overdose treatment.
Fentanyl Addiction Symptoms
According to the American Medical Association (AMA), an estimated 3% to 19% of people who take prescription pain medications develop an addiction to them. People misusing opioids may try to switch from prescription painkillers to other readily available drugs. For example, about 45% of people who use heroin start with an addiction to prescription opioids.
Fentanyl addiction can develop rapidly due to its high potency and the fentanyl withdrawal symptoms associated with opioid dependence. Identifying the signs of addiction early is crucial for seeking appropriate treatment. Common symptoms of fentanyl addiction include:
- Using fentanyl in larger doses or for longer than prescribed
- Needing to use fentanyl more often to get the same effect (tolerance)
- Experiencing withdrawal symptoms when you stop using fentanyl
- Continuing to use fentanyl even though it is causing problems in your life
- Cravings for fentanyl
- Engaging in risky behavior to obtain fentanyl
Treatment for Fentanyl Addiction
If you or someone you know is struggling with fentanyl addiction, it is essential to seek help. There are many effective treatment options available, including:
Medication-assisted treatment (MAT) uses medications to reduce cravings for fentanyl and ease withdrawal symptoms. Medications commonly used in MAT for fentanyl addiction include:
- Methadone suppresses and reduces cravings for fentanyl.
- Methadone reduces opioid cravings and withdrawal, blocking the effects of opioids.
- Naltrexone blocks the euphoric and sedative effects of opioids and prevents feelings of euphoria.
Behavioral therapy helps people identify and change the thoughts and behaviors that contribute to their addiction. Common forms of behavioral therapy used in fentanyl addiction treatment include:
- Cognitive-behavioral therapy (CBT)
- Motivational interviewing
- Contingency management
Other options include inpatient and outpatient treatment. Inpatient treatment may be recommended for people with severe fentanyl abuse or who have co-occurring mental health conditions, providing 24-hour care in a structured environment. On the other hand, outpatient treatment allows people with a strong support system to live at home while attending treatment sessions several times a week.
Fentanyl Overdose Symptoms โ Final Takeaways
Fentanyl is the deadliest drug threat facing the U.S. today. Just two milligrams of this synthetic opioid can be fatally toxic, making it significantly more potent than heroin and morphine.
The dangers of fentanyl are amplified because it is often illegally manufactured and laced into counterfeit prescription pills. Unfortunately, DEA lab tests revealed that 6 out of 10 fake prescription pills contain a potentially lethal dose of fentanyl. To avoid an accidental drug overdose, check a pill identifier and educate yourself and others about the effects of fentanyl and how to respond to a drug abuse emergency.
If you or someone you know is struggling with opioid addiction, call SAMHSAโs National Helpline at 1-800-662-HELP (4357), find support in a local narcotics anonymous group, or contact a local rehabilitation center.
People Also Ask
How do you know when it is fentanyl?
Without laboratory testing, it’s nearly impossible to determine if a substance contains fentanyl, especially in illicit drugs, as it can be mixed with other substances and is often undetectable by sight or taste. The only way to know fentanyl dosage is by getting prescription medication from licensed pharmacies.
How much fentanyl can kill you?
A lethal dose of fentanyl can be as small as two milligrams, depending on an individual’s body size, tolerance, and previous usage.
How much fentanyl to overdose?
An overdose can occur with just a tiny amount of fentanylโless than two milligrams can cause severe respiratory depression, leading to overdose and potential death.
Page Sources
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- Understanding the opioid overdose epidemic. (2024, April 5). Overdose Prevention. https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html
- U.S. overdose deaths decreased in 2023, first time since 2018. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm
- Severino, A. L., et al. (2020). ฮ-Opioid receptors on distinct neuronal populations mediate different aspects of opioid Reward-Related behaviors. ENeuro, 7(5), ENEURO.0146-20.2020. https://doi.org/10.1523/eneuro.0146-20.2020
- Han, Y., et al (2022). Unique pharmacology, brain dysfunction, and therapeutic advancements for fentanyl misuse and abuse. Neuroscience Bulletin/Neuroscience Bulletin, 38(11), 1365โ1382. https://doi.org/10.1007/s12264-022-00872-3
- Facts about Fentanyl. DEA. https://www.dea.gov/resources/facts-about-fentanyl
- Walter, K. (2023). Fentanyl overdose. JAMA, 329(2), 184. https://doi.org/10.1001/jama.2022.22462
- Substance Abuse and Mental Health Services Administration. SAMHSA Opioid Overdose Prevention Toolkit. HHS Publication No. (SMA) 18-4742PT2. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018.
- Lifesaving naloxone. (2024, April 2). Stop Overdose. https://www.cdc.gov/stop-overdose/caring/naloxone.html
- Opioid use disorder. https://www.psychiatry.org/patients-families/opioid-use-disorder
- Medications, counseling, and related conditions. SAMHSA. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions
- DEA Laboratory Testing Reveals that 6 out of 10 Fentanyl-Laced Fake Prescription Pills Now Contain a Potentially Lethal Dose of Fentanyl. DEA. https://www.dea.gov/alert/dea-laboratory-testing-reveals-6-out-10-fentanyl-laced-fake-prescription-pills-now-contain