Why Is Fentanyl So Dangerous?

Author: NP Addiction Clinic
Published: July 14, 2022

What Is Fentanyl?

Fentanyl is a synthetic opioid that was first synthesized in 1960 for pain relief. Much like other opioid analgesics, fentanyl is still used to treat severe pain. Individuals may use fentanyl during or after surgery, for a serious injury, or for cancer patients experiencing pain.

Applications to control pain with fentanyl can vary. Sometimes, doctors administer the drug through patches that go on the skin. Other times, they use fentanyl in the form of cough drops and tablets. There are also occasions when a doctor may apply fentanyl through nasal sprays and injections.

Drug abuse involving fentanyl and fentanyl overdoses are mainly attributed to illicitly manufactured fentanyl. This is when drug dealers cut fentanyl into heroin or press it into pills. They then sell this as a different drug, such as Xanax or Oxycodone.

Pharmaceutical companies produce fentanyl in controlled environments, unlike illicitly manufactured fentanyl. Taking this pharmaceutical fentanyl, with the help of medical professionals, is not as dangerous as illegal fentanyl use.

What Is an Opioid Drug?

Opioid drugs are a class of synthetic drugs that provides pain relief by binding to opioid receptors in the body's central nervous system, as well as other areas. Being a synthetic opioid, fentanyl is different from non-synthetic opiate drugs. Unlike heroin, codeine, and morphine, fentanyl isn't made from the opium poppy plant. Instead, scientists synthesize it in laboratories using a similar chemical structure to opiates.

Some other drugs that are also opioids include;

  • Loperamide (e.g., Imodium)
  • Hydrocodone (e.g., Vicodin)
  • Oxycodone (e.g., Oxycontin, Percocet)
  • Oxymorphone (e.g., Opana)
  • Methadone (e.g., Dolophine)
  • Carfentanyl/carfentanil (e.g., Wildnil, for veterinary use)

The Drug Enforcement Administration (DEA) has classed some opioids as Schedule I substances. This means that they are illegal to use, even medicinally. The DEA has also classed other opioids, such as prescription opioids, as Schedule II substances. Schedule II substances are those that are legal, only if used medicinally.

How Does Fentanyl Affect the Body?

Fentanyl works, like all opioid drugs, by binding to opioid receptors. Through these receptors, it is able to take effect.

Taking fentanyl produces a variety of different effects which can include any of the following:

  • relaxation
  • euphoria
  • pain relief
  • confusion
  • drowsiness
  • dizziness
  • nausea
  • vomiting
  • urinary retention
  • pupillary constriction
  • respiratory depression

The most common unwanted side effects include constipation, feeling nauseous, and drowsiness.

Fentanyl Withdrawal Symptoms

Once an individual becomes dependent on fentanyl, it is important to reduce doses gradually to minimize withdrawal symptoms. Once addicted, if a drug abuser comes off of fentanyl suddenly, it is likely that they could experience a number of uncomfortable symptoms. Health professionals categorize these symptoms as either early symptoms or late symptoms.

Early symptoms are symptoms that typically develop within the first twenty-four hours after an individual stops taking a substance. These include:

  • aching muscles
  • restlessness
  • increased anxiety
  • runny nose
  • excessive sweating
  • sleeping problems
  • lacrimation (eyes tearing up)

Later symptoms are symptoms that typically develop after the first twenty-four hours or so. Experts also consider them to be more intense and can include:

  • diarrhea
  • abdominal cramps
  • nausea
  • vomiting
  • dilation of pupils (and possibly blurry vision)
  • rapid heart rate
  • high blood pressure

While opioid withdrawal syndrome can result in death, most deaths from fentanyl addiction come from an overdose.

Overdose Deaths

Heroin and fentanyl are two of the most common drugs involved in overdose deaths. In 2020, 74.8% of overdose deaths in the US involved the use of an opioid drug. Out of these opioid-related drug overdoses, 82.3% of these involved synthetic opioids, such as fentanyl. Evidently, there is a fentanyl epidemic, but why is this the case?

What Makes Fentanyl So Dangerous?

Fentanyl's powerful opioid properties make it an effective pain-relieving medication. For this reason, the Drug Enforcement Administration (DEA) has categorized it as a Schedule II substance under the Controlled Substances Act. This means that fentanyl is only legal if it is medicinal.

Fentanyl is so effective in fact, that it is 50 times stronger than even the most highly potent heroin and 100 times stronger than Morphine. It is possible for dependence and addiction to fentanyl to come from medicinal use. Its high potency and addictiveness make it the biggest cause of drug overdose in the US.

Fentanyl Production

The production of fentanyl takes place in two ways. The first is the legal way. In this way, pharmaceutical scientists produce the substance in controlled environments. Doctors then go on to prescribe it to individuals with chronic pain. The other way is illicitly manufactured fentanyl. This illicitly produced substance is the main product that is being sold illegally through the underground drug market. Fentanyl-related drug abuse can come from both types.

Illicit Fentanyl

Due to the fact that it is not controlled, clandestinely produced fentanyl is more dangerous than the pharmaceutically produced drug. Illegal drug manufacturers are mixing fentanyl with heroin, and other drugs. They also press it into pills and sell it as a different drug, such as Xanax. The reason they do this is to reduce their costs in order to increase their profits.

This is extremely dangerous because a drug user might think that they are purchasing heroin or Xanax, when in fact they may be unintentionally purchasing something much stronger. It is becoming increasingly common to see drug dealers mixing fentanyl with other drugs, such as cocaine, methamphetamine, and MDMA.

Mixing fentanyl with other drugs, accidentally or not, can cause serious harm. The drug user may use their standard dose but because of fentanyl's high potency, even small doses could lead to a fentanyl overdose. However, the illegal form isn't the only type of fentanyl use that is dangerous. Medicinally manufactured and controlled fentanyl can also, sadly, lead to overdose deaths.

Pharmaceutical Fentanyl

Whilst illegal fentanyl is the leading cause of opioid overdose, medicinal fentanyl has the potential to be just as destructive. Medically prescribed fentanyl can be addictive, therefore, medical use of fentanyl is carefully managed by medical professionals. Like all prescription medications, you should only take fentanyl as per your doctor's recommended dosage.

Unfortunately, an individual who has a prescription may develop an addiction to the drug. When they are no longer able to obtain the drug medicinally, they may go on to find an illicit and unregulated form of it. When an individual engages in illegal fentanyl use, the chances of an overdose increase dramatically.

Fentanyl Overdose

Deaths from fentanyl and other opioid drugs are the leading cause of overdose deaths in the US. While they are dangerous, if medical personnel arrive on time, overdose deaths from fentanyl are preventable.

According to this study in 2019, some symptoms and signs of an overdose on fentanyl include:

  • Low blood pressure
  • Drowsiness
  • Dizziness
  • Nausea and vomiting
  • Limp body
  • Changes in pupillary size
  • Cold and clammy skin
  • Blue-colored lips and fingernails (cyanosis)
  • Respiratory system failure
  • Decreased heart rate
  • Reduced or loss of consciousness
  • Coma

Someone experiencing an overdose on fentanyl requires immediate medical attention. If medical workers are able to get to the individual in time, they are able to administer a drug that counteracts the dangerous effects of the opioid. Naloxone, or Narcan, attaches to opioid receptors and rapidly reverses the effects of opioids.

If you or someone you know is using fentanyl and is experiencing these symptoms, you should call 911 immediately as they could be having an overdose.

Fentanyl Addiction Treatment

It is important for someone with a fentanyl addiction, along with any other kind of addiction to illicit drugs and prescription drugs, to get treatment. If you or someone you know is battling an opioid addiction, it can be relieving to know that it is possible for anyone to break free of the damaging hook of opioids. With the right care and support, you can leave the troubles of drug addiction behind you.

With the help of medical professionals, both medication and therapy are available to an individual who is ready to put an end to their fentanyl addiction. When an individual uses medication and therapy together, treatment tends to be more effective.


Fentanyl addiction treatment in the form of medication includes both buprenorphine and methadone. These work by binding to the same receptors in the brain as fentanyl to reduce cravings and withdrawal symptoms. Treatment can also include the use of naltrexone. Naltrexone blocks opioid receptors to stop fentanyl from having an effect. Speak to a medical professional to discuss which treatment might be best for you.


Various behavioral therapies are effective for fentanyl addiction. These therapies help individuals to modify their behaviors and attitudes related to drug use, promote healthy life skills, and stick to their medication.

According to the National Institute on Drug Abuse, these behavioral therapies include:

  • Cognitive-Behavioral Therapy (CBT)
  • Contingency management
  • Motivational interviewing

Being the addictive and highly potent drug that it is, addiction to fentanyl can be a scary thing. That is why it is so important to treat individuals suffering from substance use disorder with compassion and care.

At NP Addiction Clinic, we offer long-term programs combining treatments for individuals struggling with substance use disorders. We don't heal through punishment; we heal through connection. That is why, if you choose to join an addiction treatment, you will be under the care of our compassionate and expert staff.

If you or a loved one feels ready to break free from the tight grip of addiction, then please reach out, and start your journey to wellness today.

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