Fentanyl is a prescription pain reliever, normally distributed as a strong muscle relaxant after surgery or significant trauma. The drug, which is up to 100 times more potent than morphine, is responsible for an estimated 70% of all opioid overdoses, largely because it is so strong. That becomes increasingly more important as Illicitly manufactured fentanyl, known as IMF, becomes more popular.
Here, users face not just risks of overdose but also lack of standards, lack of purification, and contaminants from dealers cutting the drugs. While prescription fentanyl is already extremely dangerous to use and abuse, IMF is significantly worse.
However, for most users, abusing fentanyl is already extremely risky.
The National Survey on Drug Use and Health shows that 0.1% of the total U.S. population aged 12 and older misuses fentanyl products, or about 356,000 people. That same study notes that no specific studies are underway to assess the use of illicitly manufactured fentanyl rather than prescription fentanyl. This means that the abuse of fentanyl could be much higher – simply because usage isn’t being tracked.
In addition, many people use IMF mixed into heroin or sold as heroin, despite the product being advertised as heroin. This happens because dealers cut their drug supply to increase volume and then add a stronger drug – like fentanyl, to maintain potency.
The largest difference between fentanyl and illicitly manufactured fentanyl is place of manufacture. Unfortunately, that difference can have significant effect on the quality, purity, and chemical makeup of the drug. Fentanyl is a synthetic opioid, which means it can be easily manufactured in a lab. Medical or prescription fentanyl is manufactured to exacting standards, with specific ingredients, and dosage assured down to the 100th of a microgram. That is never the case with illicit fentanyl.
Most illicit fentanyl is manufactured in Mexico and other parts of South America, in drug labs. These same labs may be used to manufacture other illicit drugs, such as heroin, methadone, cocaine, or even amphetamines. These drugs are then packaged and sold by the kilo or more when smuggled across the border.
Purity – Prescription fentanyl is made in pills to tiny doses, which are safe to take. Any fillers are typically harmless cellulose or another, similar substance. People can take and consume it according to the dose with no bad side effects. IMF is not always made to those standards. If the drug contains filler, it’s whatever the lab had on hand. Often, it’s also cut by the dealer, sometimes with substances like baby powder used to fill pills to an expected size. This means that taking IMF could expose you to toxic chemicals, including cleaning agents, talc, and even lye. In tiny doses, these are unlikely to cause harm. But, over time, they could cause significant damage to the gut, liver, and kidneys.
Dosage – Another important thing about prescription fentanyl is that it’s sold in carefully regulated doses. In fact, fentanyl tablets are normally sold in doses of 100 micrograms up to 1300 micrograms. Doses of 2 milligrams are enough to prove fatal for persons with a low body weight or low tolerance. Yet, the DEA found that at least 42 percent of all fentanyl pills seized from the illicit market contain at least that dose. In fact, the normal range for IMF is .02 to 5.1 milligrams – with some containing more than twice a potentially lethal dose. Worse, those pills are almost never careful weighed and measured. You can buy a bag of IMF pills with that same dosage range between pills. If you take one and realize it’s not doing anything and take another, it could kill you. Prescription fentanyl is also potentially lethal, but it’s much easier to see and control the dose. That holds true even with liquid fentanyl – providing you dose it properly.
Labeling – While persons buying prescription fentanyl or diverted fentanyl from a prescription manufacturer almost always know exactly what they are getting, that is often not the case with IMF. In fact, many people buying illicit fentanyl assumed they were buying heroin or another opioid. Dealers often told them this was the case – even mixing heroin into fillers and adding fentanyl. This makes it much more dangerous – simply because users aren’t aware of how much caution they should be using. It’s also important for usage, because fentanyl hits faster and harder than heroin. When someone takes heroin, it breaks down into morphine and then slowly absorbs over time. Fentanyl is directly absorbed and passes through the fat layer of the brain more quickly – meaning you’ll be high and unable to function much more quickly. That can be disastrous for someone who knows how long it takes for heroin to hit and decides to drive a car. Similarly, fentanyl can interfere with Naloxone, because it requires more of the overdose inhibitor to work properly.
If you or a loved one is using fentanyl outside of a prescription, it’s dangerous, habit forming, and will hurt you. Getting help is important, and that remains true whether you’re taking prescription fentanyl or IMF. Fentanyl is 100 times more potent than morphine, harder to treat in case of an overdose, and present in an estimated 70% of all opioid overdoses. It’s also habit forming and causes addiction, with many showing symptoms of addiction just weeks into starting usage.
If you’re struggling, behavioral therapy and motivational therapy can help you to treat the underlying causes behind seeking out drugs, to build healthy coping mechanisms, and to learn to deal with cravings so you can get your life back on track. Most of us use to self-medicate, to escape, and to feel better, but drugs like fentanyl only make us feel worse. Getting help and getting treatment designed to help you build a better life for yourself will help in ways that fentanyl cannot.
If you or your loved one isn’t ready to go to treatment, the official advice is to carry Naloxone in a double dose, so that it’s effective in case you or your loved one do overdose.