The New Opiate High: The Dangers of Fentanyl Addiction

Fentanyl is a synthetic opiate 80-100 times more powerful than morphine, and 40-50 more potent than heroin. First produced in the 1960s, it was originally used as an anesthetic and to manage breakthrough pain that did not respond to conventional medicines. By the 1990s, the development of personal-use products such as Duragesic, a slow-release transdermal fentanyl patch, Actiq, a lollipop, and Fentora, a buccal tablet form of the drug led to an explosion of fentanyl use both in clinical practice and amongst recreational users. Its powerful effects, rapid onset, and short half-life make it highly effective and highly addictive both for those taking it therapeutically and for those seeking out a new high.

Some people come by their fentanyl addiction through having been prescribed slow-release transdermal patches or lozenges to manage severe pain. Over time, you become dependent both physically and psychologically, and your desperation to ward off withdrawal may lead you to fabricate symptoms or doctor-shop to ensure a steady supply. Others seek out fentanyl for recreational use right off the bat, sometimes after already establishing a history of opiate use, sometimes as new users who view the prescription pain reliever as a cleaner, less stigmatized avenue to opiate-derived highs. Recreational users may smoke, inject, or swallow fentanyl in pill form, but the most common method of ingestion is eating the gel from patches. Young people, in particular, may be susceptible to seeing fentanyl as an attractive alternative to drugs like heroin. In a piece originally written for The Fix under a pseudonym, Drew Grant says:

You never tried heroin, because you hate needles. Your friends back home—who will all be addicted to heroin and shooting up in front of you every time you go stay with your parents—will make you uncomfortable with their unhygienic hypodermic [stuff], sitting with those belts or tubes tied around their arms in giant warehouses like some really depressing cliché. They don’t know what they are missing. You are classy. You are a synthetic opioid addict, not an actual heroin addict, the difference between the two being that one sounds like a character in a Phillip K. Dick book and that is cool, while heroin sounds like something you do when you give up.

In fact, fentanyl is just as addictive or more addictive than traditional street drug opiates, and its potency makes it considerably more dangerous for both new and experienced drug users. It takes an incredibly small amount of the drug to produce serious respiratory depression and lead to death. Last spring, the U.S. Drug Enforcement Administration issued a statement warning of the dangers of fentanyl across the country, after observing a dramatic increase in fentanyl-related overdoses. Dr. Karen Woodall of the Ontario Centre of Forensic Sciences says, “The big problem with fentanyl is that a lot of people who aren’t tolerant to the drug are taking it. And if you’re not tolerant, it’s a lot more likely to cause serious toxicity and even death.” Fentanyl now causes twice as many deaths in Ontario as heroin.

While many addicts use legitimately-produced fentanyl products, increased demand and decreased availability of prescriptions have led to an underground, unregulated fentanyl manufacturing industry. These products, often sold in pill form, allow users even less control over what they are taking and increase the risk of overdose. Fentanyl is also being cut with other drugs such as heroin and cocaine to maximize potency, presenting significant dangers as users are unable to regulate their dosage. Even seasoned opiate users with high tolerance levels cannot predict how much fentanyl will be present in a particular batch, and will be unable to modulate their usage to maintain relative safety. What’s even more alarming is the fact that many users don’t even know that they are taking it. Between 2005 and 2007, over 1000 people in Chicago, Detroit, and Philadelphia died from overdosing on fentanyl-laced heroin, many of them completely unaware that they were using fentanyl.