Opioid-Abatement Toolkit

Opioid-Abatement Toolkit

Communiversity Developed and Tested

Opioids 101

History and Terminology — Part 2

Fentanyl: What You Should Know

Doctors prescribe pharmaceutical fentanyl to treat severe pain, for example, for advanced-stage cancer treatment. However, illicitly manufactured fentanyl (IMF) is illegally manufactured and distributed through drug markets for its heroin-like effect and is most involved in overdose deaths. The availability of black-market fentanyl and fentanyl analogs led to a U.S. opioid epidemic that causes thousands of overdose deaths each year and destroys families and communities. President Biden, in November 2023, talked with the head of China about curbing the production of fentanyl and its analogs, but it is still very available through your local drug dealer.

  • Fentanyl is very powerful, and a little bit of it sprinkled in with other drugs may be enough to kill you or your loved ones.
  • Fentanyl is cheaper than other opioids, powerful, addictive, and dangerous.
  • Fentanyl (IMF) is available in different forms (e.g., nasal sprays, eye drops, and dropped onto paper or small candies). It can be liquid or powder and is commonly mixed with heroin, cocaine, and methamphetamine.
  • Drugs may contain very little fentanyl, not detectable by taste, sight, or smell, and it is nearly impossible to detect a fentanyl-laced drug without using fentanyl strips to test for fentanyl.
  • Beware: a negative test interpretation should be done cautiously because the fentanyl strip might not detect potent fentanyl-like drugs, such as carfentanil (Bergh et al., 2021).
  • Determining if pills were legally produced for pharmaceutical distribution or illegally produced for illegal drug sales is difficult.
  • Counterfeit prescription medications, such as a fentanyl-laced Xanny bar or counterfeit Xanax, were reportedly made at a “pill mill” or by illegal pill presses.
Signs and Symptoms of an Overdose
  • Unresponsiveness
  • Weak or no pulse
  • Cold and/or clammy, discolored or pale skin
  • Vomiting
  • Choking or gurgling sounds
  • Small, constricted “pinpoint” pupils
How to Respond to an Overdose
  • Call 911 immediately
  • Administer naloxone, aka Narcan
  • Try to keep the person awake and breathing
  • Lay the person on their side and prevent choking
  • Stay with the person until emergency assistance arrives

Fentanyl is a potent synthetic opioid drug approved by the Food and Drug Administration for use as an analgesic (for pain relief) and as an anesthetic. It is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic.

PRINCE died of an accidental overdose of the opioid fentanyl, according to a medical examiner.

CNN - Report - Prince died of self-administered fentanyl
Play Video about CNN — Report — Prince died of self-administered fentanyl

CDC — Protect Yourself
from the Dangers of Fentanyl

CDC - Protect Yourself from the Dangers of Fentanyl
Play Video about CDC — Protect Yourself from the Dangers of Fentanyl

AsapSCIENCE — Your Brain on Fentanyl

AsapSCIENCE - Your Brain on Fentanyl
Play Video about AsapSCIENCE — Your Brain on Fentanyl

The Threat of Xylazine

Xylazine is a non-opioid veterinary tranquilizer not approved for human use; it been called “an emerging threat” due to its role in the ongoing opioid crisis. Xylazine is increasingly being combined with the powerful synthetic opioid fentanyl in illicit drugs.

Xylazine News

PBS NewsHour - Why the U.S. designated the animal tranquilizer xylazine an emerging threat
Play Video about PBS NewsHour — Why the U.S. designated the animal tranquilizer xylazine an emerging threat

A drug more deadly than heroin

CBC News - The National - Carfentanil - A Drug More Deadly than Heroin
Play Video about CBC News — The National — Carfentanil — A Drug More Deadly than Heroin
From CBC/Radio-Canada

Carfentanil ia a dangerous synthetic opioid, approximately 10,000 times more potent than morphine and 100 times more potent than fentanyl. Only properly trained and outfitted law enforcement professionals should handle any substance suspected to contain fentanyl or a fentanyl-related compound, (McPhillips, 2023).

Nitazenes Is a New Threat

Isotonitazene (aka nitazene or ISO) is a synthetic opioid now available near us — to kill us. More potent than heroin and morphine (similar to fentanyl), ISO is being mixed into and marketed to make drugs more potent and cheaper to produce. This drug has caused deadly overdoses in unsuspecting victims. 

Coming soon to a drug dealer near us, will also be other synthetic opioids also made in other Chinese secret labs and shipped here to enrich drug dealers and kill us. With laws against fentanyl, this group of drugs is an end-run around them but even more harmful. 

“These drugs pose a particular challenge since there is little experience in how to reverse a nitazene overdose or potential drug-drug or drug-alcohol interactions. It often takes two doses of naloxone, often through intubation, as opposed to one or two for fentanyl. However, there is a large chance of cardiac arrest before this happens. In other words, your heart stops.”

“Public health efforts are needed to better inform street drug consumers, first responders, healthcare professionals, and the general public about these ‘new old drugs’ that are infiltrating the recreational drug supply.” (Pergolizzi, 2023). In powder form, ISO can appear yellow, brown, or off-white. This drug may be mixed into heroin and/or fentanyl (and marketed as common street drugs) with deadly consequences. Or, it may be pressed into counterfeit pills and falsely marketed as pharmaceutical medication (like Dilaudid “M‑8” tablets and oxycodone “M30” tablets). 

ISO’s high potency comes with an increased risk of overdose. Many of these overdose victims have no idea they are ingesting these dangerous and extremely potent drugs. “These synthetic opioids currently can only be properly identified after a lab test, so people don’t realize they’re buying them until it’s too late.  We want to get this info out and warn people,” says a Drug Enforcement Agency Special Agent. “If we can educate and inform our communities about the dangers of taking counterfeit prescription pills or other drugs, we stem the proliferation of these deadly opioids, stop all of these senseless deaths, and help keep our neighbors and loved ones safe. People have to keep in mind, with all the synthetic drugs out there, and the way they’re being mixed together, you never know what you’re actually buying,” says another Drug Enforcement Agency Intelligence Analyst, Maura Gaffney. Only take medications prescribed by your doctor and dispensed by your licensed pharmacist because pills or drugs obtained elsewhere are unsafe and are often deadly. 

Sources: Drug Enforcement Agency (2022, June 1). New, Dangerous Synthetic Opioid in D.C., Emerging in Tri-State Area.

Howard, Jacqueline (2023, August 29). Emerging group of synthetic opioids may be more potent than fentanyl, study warns. CNN Health.

Don’t believe DEA? Here’s a link to a scientific study:

Pergolizzi J Jr, Raffa R, LeQuang JAK, Breve F, & Varrassi G. (2023, June 21). Old Drugs and New Challenges: A Narrative Review of Nitazenes. Cureus.15(6):e40736. doi: 10.7759/cureus.40736. PMID: 37485167; PMCID: PMC10361140.

An emerging group of synthetic opioids may be more potent than fentanyl, study warns.

Willow Grove Lab Is the First in the World to Identify Nitazene Opioid

CBS Philadelphia - Willow Grove Lab
Play Video about CBS Philadelphia — Willow Grove Lab
From CBS Philadelphia

Opioid Misuse

  • The strain on one’s family
  • Possibly shorter lifespan
  • Broken families
  • Joblessness
  • Increased likelihood of poverty
Sleeping on bench
  • Financial strain/burden
  • Higher medical costs
  • Unintentional death
  • Higher risk of car crash
  • Risk of addiction
  • Increased isolation
  • Failure to contribute to society
Medical costs
  • Confusion
  • Depressed mood
  • Mood swings
  • Increased anxiety
  • Paranoia
  • Memory impairment
  • Risk of addiction
Woman having anxiety attack

Test Your Knowledge (answer yes or no)

Yes. It is so potent that even a very small amount can be deadly.

Yes. Xylazine is an animal tranquilizer usually used for elephants.

Yes. They are often mixed into drugs without consumers being aware.

Yes. It may also cause increased anxiety, paranoia, and memory problems.

Yes. If naloxone does not work the first time, a second dose may be needed.

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