What you should know about fentanyl

Photo credit: Unsplash

What is fentanyl?

Fentanyl is a synthetic opioid originally developed for pain management in advanced cancer patients. It is 50–100 times more potent than heroin or morphine.

Drug traffickers often mix fentanyl into other drugs because it is cheap to manufacture and a small amount goes a long way. This can lead to involuntary consumption and accidental overdoses and deaths.
Fentanyl is often added to:

  • Powders (like cocaine)
  • Capsules
  • Pressed pills meant to look like prescription medications (like Xanax or Oxy/M30s)
  • and much more
Photo of a lethal dose of fentanyl next to a penny.

Experts consider 2 mg of fentanyl to be lethal, but many counterfeit pills contain up to 5 mg (more than twice the lethal dose). This amount is incredibly small. Check out the image to the side for scale to see what 2 mg of fentanyl looks like. 

Important: While these drugs have tested positive for fentanyl by public health agencies, it’s important to remember that any pill or drug sold on the internet, on the streets or by a person you know could contain a potentially lethal dose of fentanyl.

How common is fentanyl?

Fentanyl may be more common than you think.

Colorado authorities have seen a large influx of fentanyl over the past year and are expecting to see an increase in overdoses in the coming months. In fact, the CDC announced that fentanyl is now the leading cause of death among adults 18 to 45 in the United States. 

Additionally, according to the U.S. Drug Enforcement Administration (DEA), nearly half of all counterfeit pills tested contained a lethal dose of fentanyl. This figure is particularly alarming because it can be difficult to distinguish genuine pills from fake or counterfeit versions. Check out the examples below to see how counterfeit pills can be designed to look just like genuine pharmaceuticals.

Graphic that shows a side by side comparison of authentic oxycodone vs. counterfeit oxycodone.


Street names include: 30s, M30s, oxy, kickers, 40s, 512s, blues 

Source: Drug Enforcement Agency (DEA)

Graphic that shows a side by side comparison of authentic xanax vs. counterfeit xanax


Street names include: bars, benzos, bricks, ladders, sticks, xanies, zanbars, z-bars

Source: Drug Enforcement Agency (DEA)

Graphic that shows a side by side comparison of authentic Adderall vs. counterfeit Adderall


Prescribed as: Adderall, Ritalin, Concerta, Dexedrine, Focalin, Metadate and Methylin.

Source: Drug Enforcement Agency (DEA)

Tips for staying safe

While fentanyl can be lethal, there are things you can do to help protect yourself and your friends. Here are some tips and strategies you can use to prevent accidental overdoses.

Please note: Due to the unpredictability of fentanyl, there is no foolproof way to eliminate the risk of overdose. 

Know what you’re getting into

Never take medications that are not prescribed to you; counterfeit pills are easy to purchase and pose a lethal risk. Assume that any pill or drug not purchased directly from a pharmacy could contain fentanyl. This includes illicit drugs (cocaine, heroin, meth, etc.) as well as prescription medications (Xanax, Oxycodone, etc.).

Carry Narcan (naloxone) and use it

Carry Narcan (naloxone) and make sure you know how to use it. Narcan can temporarily reverse an opioid overdose, but it can wear off more quickly or require additional doses for fentanyl.

Check out this video to see when and how to use Narcan: Play Video

Be prepared to call for help

Look for these signs:

  • Pinpoint (small) pupils
  • Shallow or no breathing
  • Blue or grayish lips/fingernails
  • No response to stimulus (i.e. being pinched)
  • Gurgling/heavy wheezing or snoring sound

If signs of an overdose are present:

  • Ask if the person is alright and look for a response
  • Make a fist, and use your knuckles to apply downward pressure to their sternum (do not hit them); this is a test to see if they respond to the pain stimulus

If they do not respond:

  • Call 911
  • Administer Narcan (naloxone) if available
  • Start CPR

Narcan will not harm someone who is not overdosing—when in doubt, use it!

911 Good Samaritan Law

The 911 Good Samaritan Law states that a person is immune from criminal prosecution for an offense when the person reports, in good faith, an emergency drug or alcohol overdose even to a law enforcement officer, to the 911 system or to a medical provider. 

This same immunity applies to persons who remain at the scene of the event until a law enforcement officer or an emergency medical responder arrives, or if the person remains at the facilities of the medical provider until a law enforcement officer, emergency medical responder or medical provider arrives. The immunity described above also extends to the person who suffered the emergency drug or alcohol overdose event.



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