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An Easy Guide to Understanding Why Fentanyl Is So Deadly

Want to finally understand why you hear about fentanyl all the time? Maybe without reading a novel or some complicated journal article written by doctors or college professors? Look no further.

What Is Fentanyl?

Fentanyl is a synthetic opioid available via prescription and the black market that’s about 50 to 100 times stronger than morphine.

Synthetic opioids aren’t inherently bad. Methadone is an example of another synthetic opioid that’s actually used in opioid replacement therapy or medication-assisted treatment (MAT) programs and to treat chronic pain.

Why Are People Dying From Fentanyl?

Opioid use is popular right now in the United States. Heroin is used by many in place of prescription opioids. Most heroin found in the modern American opioid supply actually contains a mixture and fentanyl and heroin. Fake prescription opioid tablets marketed as real ones are used similarly.

Both heroin and fake prescription opioid tablets that contain fentanyl are sold on an unregulated market. That means nobody ever knows what’s actually in their heroin, alleged prescription opioids, or other drugs.

Even if people are prepared to use fentanyl, it’s so potent that measuring out accurate doses is difficult. Also, because heroin, fake opioid pills, and other illicit drugs aren’t made in safe, regulated, pharmaceutical-quality environments, one customer could get sold product that has several times as much fentanyl as another. Concentrations of active ingredients like fentanyl are called “hot spots” among people who use drugs (PWUD) like me.

How Does Fentanyl Cause Death?

Opioid overdose causes death by making users super-duper sedated — or conked out, in slang terms — and losing the ability to easily breathe due to our airways becoming obstructed.

Oftentimes, fatal opioid overdoses result from a combination of drugs, not just opioids. Also, all opioids can cause death — not just fentanyl.

PWUD Don’t Know How to Stay Safe

I’m a long-term opioid user. My history includes over three years of heroin use — intravenous heroin use, that is — and three overdoses. Today, I do things like give out free, clean syringes and naloxone (the opioid overdose antidote) and educate people how to use drugs safely.

Why do I do this? Because dead people don’t recover.

Up until just three years ago, I wasn’t aware of how to stay safe while using drugs. All I knew was that drugs are bad and that I shouldn’t be using them in the first place.

There are many, many issues that plague modern American opioid users. The solutions below aren’t a cure-all in any way. If you know somebody who uses opioids — including yourself — these things can help keep you safe:

  • Enroll in a medication-assisted treatment (MAT) program immediately. In the United States, buprenorphine and methadone are prescribed as an alternative to other opioids. One way to find these programs is through this free tool.
  • Get naloxone (Narcan) immediately. In Martin, Tennessee, where I am, for example, you can hit up Melesa Lassiter, Northwest Tennessee’s Regional Overdose Prevention Specialist, for free Narcan. Live somewhere else? Visit naloxoneforall.org for state-by-state information about where people can access in-person naloxone and other free resources.
  • Use around at least one other person who knows you’re using, knows how to use naloxone, and isn’t also using at the same time as you.
  • Get fentanyl test strips. The ones I’m familiar with are the green-label “Rapid Resposne 1 Strip.” Find them from harm reduction organizations like FentAware (though only 6 at a time) for free, or from health product supply stores online. DanceSafe has got some, too.
  • Always assume any drugs you use contain fentanyl.

It’s always safer to not use drugs than to use drugs. Even if you follow the precautions above, it’s still possible to overdose. I don’t condone drug use. If you haven’t already started using drugs, please don’t use.

By Daniel Garrett

I'm a self-employed writer, long-term drug user, and resident of rural Tennessee. Find me on Twitter at @DanielGarrettHR or email me at danpgarr@ut.utm.edu.

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