Categories
Fentanyl Harm Reduction

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.

Categories
Fentanyl

What Does “Fentanyl” Mean? Where Does Fentanyl Come From? Shining Light on Commonly-Held Misconceptions Regarding Fentanyl

We’ve all heard sensationalized reports of fentanyl in news reports. I bet you’ve heard about fentanyl in the news within the past week! If not, you must be living under a fucking rock. 

What is fentanyl? When local news stations, government agencies, or laypeople talk about fentanyl, what do they mean?

Most of us do not have a common understanding of fentanyl. 

Is fentanyl is a prescription painkiller?

How do illicit opioids on the American market end up having fentanyl in them? 

Are diverted fentanyl prescriptions to blame?

Do American illicit opioid users often use prescription fentanyl? 

Is the current rash of fentanyl overdoses caused by prescription fentanyl?

Let’s find out. I’ll be finding recent mentions of fentanyl in news articles published by local, regional, and national publications alike and explaining them briefly.

Example 1

“Congress Takes Notice as Investigators See Rise in Fentanyl”

WBBJ is a local news source in West Tennessee. Outside of Memphis, it’s the only news source in West Tennessee. On January 17, 2020, WBBJ posted an article on its website that began as such:

“Investigators are finding fentanyl on our streets as state leaders work to restrict access to the deadly drug.”

How Can We Classify This Article’s Mention of Fentanyl?

In this case, “fentanyl” refers to illicit fentanyl that’s primarily sourced from illegal Chinese labs that ship fentanyl internationally using run-of-the-mill couriers, such as the United States Postal Service. Chinese vendors network with customers through web-based drug markets accessible via Tor browser. These markets are considered to be part of the “darknet.”

Here in the United States, fentanyl is typically found in other opioids. The two most common illicit opioids in which fentanyl is found are illicit heroin and counterfeit opioid tablets.

Fentanyl found in heroin and counterfeit opioid tablets is never taken from pharmaceutical fentanyl. People are, in fact, sometimes prescribed fentanyl to relieve severe chronic pain. However, formulations of fentanyl available in the U.S., including Actiq lollipops, Subsys under-the-tongue (sublingual) spray, Lazanda nasal (intranasal) spray, Duragesic on-the-skin (transdermal) patches, and quick-dissolving Fentora in-the-cheek (buccal) tablets.

Example 2

“China Bans All Types of Fentanyl, Cutting Supply of Deadly Drug to U.S. and Fulfilling Pledge to Trump”

The New York Times is an international leader in journalism and is the publisher of this article, which came out on April 1, 2019.

China’s chemical and pharmaceutical industries outgrew government agencies’ ability to provide regulatory oversight in the 1980s. Up until 2019, manufacturers in China were legally allowed to manufacture drugs that are typically punished with jail time, probation, and fines in other countries.

Although manufacturing fentanyl in China is illegal now, countless chemical and pharmaceutical manufacturing interests continue to pump out such drugs in a high-quality, voluminous fashion.

These sources provide some 90%, if not even more, of fentanyl and fentanyl analogues that end up getting consumed by American users.

How Can We Classify This Article’s Mention of Fentanyl?

In this article, “fentanyl” refers to high-quality, illicit fentanyl that ends up being incorporated into batches of other drugs — primarily heroin and counterfeit opioid tablets.

Example 3

“Fentanyl Can Lead to Overdoses in Hospitals, Too”

This article was published in March 2019 by the Indianapolis, Indiana-based Side Effects Public Media.

Ohio is known for being ravaged by the opioid crisis disproportionately, having taken more damage than virtually every other state in the union. This article references one of Ohio’s top hospitals — Columbus’ Mount Carmel — and a handful of patient deaths that took place in the weeks leading up to this article’s publication date.

In early 2019, Mount Carmel’s long-time physician Dr. William Husel was let go after an investigation that confirmed that Dr. Husel had been directly involved in the management and upkeep of dozens of patients who had eventually kicked the proverbial bucket as the result of fentanyl overdose.

A quick glance at “Fentanyl Can Lead to Overdoses in Hospitals, Too” will reveal brief descriptions of several patients who had died at the hands of William Husel.

Troy Allison, a 44-year-old male whose wife phoned an ambulance after Troy was experiencing respiratory issues. Just a few hours after Mr. Allison’s arrival, Mrs. Allison received news that her husband was dead. The non-opioid-tolerant patient was administered a whopping 1,000 micrograms’ worth of fentanyl. One study reports the average fentanyl dose in emergency departments is 180 micrograms.

In late 2018, Sandra Castle passed away immediately following the administration of an excessive dose of fentanyl by none other than Dr. William Husel to the tune of 1,000 micrograms. For non-physicians, just know that 1,000 micrograms is a seriously excessive dose!

73-year-old Peggy Francies died roughly a year before Ms. Castle after Husel’s administration of a 200-microgram dose of the ultra-powerful painkiller. Ms. Francies had initially been welcomed to Mount Carmel due to renal failure, which had shortly after yielded an infection of the bloodstream, or sepsis, in other words.

Just for the record, it’s possible for an article to mention hospitalizing people for having misused illicit fentanyl. However, if you glanced at the article, that isn’t what happened — not at all.

How Can We Classify This Article’s Mention of Fentanyl?

In this article, an anesthesiologist misused a hospital’s supply of pharmaceutical fentanyl. This fentanyl holds the same molecular structure as illicit fentanyl. The largest two differences are that:

  1. Pharmaceutical fentanyl is legal to possess by hospitals, physicians like Dr. William Husel, and other medical institutions.
  2. The fentanyl that Dr. Husel used was much more potent and free of impurities than illegally-manufactured and -distributed fentanyl.

Breaking Down Why Pharmaceutical, Prescription-Only Fentanyl Does Not End Up in the American Illicit Opioid Supply

Pharmaceutical fentanyl is not what’s incorporated into counterfeit opioid tablets, heroin, and -– to a much lesser degree — other, non-opioid drugs.

Just for the record, here’s why this wouldn’t work. Fentanyl comes in several different formulations. One popular formulation of prescription fentanyl is that of lollipops such as Actiq. Imagine separating one or two grains salt from a lollipop. During the manufacturing process, the salt became infused into the figurative lollipop. Just as you couldn’t separate salt from a lollipop, you can’t separate fentanyl from an Actiq fentanyl lollipop.

Duragesic is the name brand of fentanyl transdermal patches that slowly release the powerful synthetic opioid through the skin over a 72-hour period. Transdermal patches, to which there are generic alternatives, provide the easiest way for determined users to abuse the extended-release patches.

Depending on the manufacturer, some fentanyl patches host fentanyl in the form of a gel, whereas the other technology simply sprays a thin layer of fentanyl over a durable sheet of plastic; a protective adhesive layer is placed on top of the fentanyl, effectively creating a fentanyl sandwich. This kind of fentanyl transdermal patches can be chewed on for a quicker release, though actually separating fentanyl from this “matrix” technology, as it’s called, doesn’t really happen.

Even the most readily-separable form of fentanyl, Sublimaze, the name-brand form of injectable fentanyl, wouldn’t be worth one’s time. 50-milliliter vials of Sublimaze contain 2,500 micrograms of the drug — or 2.5 milligrams, in other words.

Depending on what source you use, you’ll find that a dose of roughly 3 milligrams’ fentanyl is capable of killing a fully-grown, healthy adult male.

While this is enough for a few uses, don’t plan on getting your hands on Sublimaze, though.

All considered, even the most suitable formulation we can use to isolate fentanyl from the rest of the medication’s ingredients isn’t very practical.

Example 4

“Jackson Man to Serve 6 Years for Distributing Heroin, Fentanyl Mixture That Caused Overdoses”

This article is also from Jackson’s WBBJ and was published on May 31, 2019. A 67-year-old man was sentenced to six years’ federal prison time for heroin-fentanyl mixture distribution throughout Central-West Tennessee’s Gibson County and Madison County. He was sentenced to this time for being caught distributing between 100 and 400 grams of the mixture.

The United States Attorney General’s Office shared with WBBJ that the 67-year-old admitted to the distribution of a minimum of 100 grams’ heroin-fentanyl mixture. The report goes on to say that at least two end-users of the combination opioid suffered an opioid overdose. Fortunately, both of the users ended up making it.

The man was undoubtedly feeling nothing short of bummed when he caught wind of the fact that a federal grand jury returned an indictment spanning a total of eight counts against the 67-year-old man. 

Of course, he didn’t end up getting sentenced for all eight counts, though that’s not to say he won’t be doing some serious time in the Federal Bureau of Prisons.

After the man serves 80 consecutive months — the sentence began on March 1, 2019 — he’ll be required to adhere to four years’ parole following his release.

How Can We Classify This Article’s Mention of Fentanyl?

In this article, the fentanyl undeniably came from an illicit source. It’s not clear whether the distributor sourced heroin locally and fentanyl from a Chinese source via one of the dark net’s illicit good retail vending sites.

Unless a newspaper, county clerk’s office, news agency, or another source specifically states that someone was arrested with fentanyl in a diverted prescription form, you can safely assume the fentanyl came from an illicit source.

What You Need to Know About Fentanyl

Fentanyl is fentanyl is fentanyl is fentanyl.

You might be surprised to learn that healthcare practitioners across the United States have fielded countless concerns from patients about being administered fentanyl, whether that be for general anesthesia, advanced pain management, the acute management of severe pain in emergency room settings, or otherwise.

The primary difference between fentanyl sourced from pharmaceutical companies through prescriptions from licensed physicians and its illicit counterpart is that the former is more reliable thanks to market regulation. Thanks to a lack of regulation, the modern American illicit opioid market is home to dangerous things like heroin-fentanyl mixtures of unknown potency regularly being sold as “heroin,” fentanyl-filled opioid tablet replicas that seem legitimate but don’t contain the active ingredient they’re advertised as having, and some counterfeit tablets and batches of heroin having inactive ingredients that cause sometimes-severe allergic reactions in users.

Put simply, due to the unregulated nature of the market, illicit fentanyl is inherently dangerous! Further, the illicit American opioid market is similarly dangerous.

As long as a licensed physician you trust prescribes you a pharmaceutical formulation containing fentanyl or directly administers fentanyl in a hospital-type setting, you’ve got nothing to worry about.

Planning on Using Fentanyl?

If you ever come across any substance that tests positive for fentanyl or is known to be a potent batch of fentanyl, you should consider volumetric dosing.

Volumetric dosing consists of dissolving your drugs in water to dose more consistently. Working with fentanyl in powder form is difficult because it’s so potent. Making a mistake can mean you don’t feel anything at all, or you might end up dying.

While you should unarguably avoid fentanyl from the jump, if you insist on using fentanyl, resort to volumetric dosing if at all possible.

Categories
Fentanyl Harm Reduction

Why Meth Is Adulterated With Fentanyl

We’re all familiar with sensationalized news stories about cannabis, cocaine, and other illicit drugs being adulterated with fentanyl.

On the street, however, I’ve yet to cross paths with cannabis or any other drugs that actually are adulterated with fentanyl — outside of heroin and other illicit opioids, of course.

I have no personal experience with meth (drug nerds like me might use its full name, methamphetamine). However, I do have ties to people whose drug of choice is meth.

Earlier today, I talked to a fellow long-term sufferer of substance use disorder and resident of Northwest Tennessee (NWTN) who shared with me the fact that multiple major sources of meth here in NWTN are routinely adulterated with fentanyl. He, whose drug of choice is meth, also provided his take on why this is.

For the sake of simplicity, I’m going to refer to my friend as Jonah, which is not his real name.

What’s the Purpose of This Article?

As you may know, Northwest Tennessee is unarguably one of the most underserved regions throughout the Volunteer State. We are more far away from major cities than any other part of Tennessee — except for Southern Middle Tennessee, where I’m from — and have no organizations that practice harm reduction (See “An Aside” at the bottom of this article for an elaboration on this; in short, however, I’m not familiar with any persons, government agencies, organizations, or businesses that practice harm reduction in this area).

People like me need to report on the area-specific challenges that plague the Tennesseans who are most harmed by the opioid epidemic: long-term opioid users themselves, and now even people who don’t use opioids like the chronic meth consumer I mentioned earlier in the article. It’s important for me to do this because virtually nobody else in Northwest Tennessee is voicing the personal experiences of drug users to the world.

Note that this article is largely based on Jonah’s anecdotal report. This doesn’t mean that we should ignore what Jonah said just because he’s not a researcher, academician, medical professional, etc. — we should very much place weight on his report because few sources are voicing the anecdotes of long-term drug users living in Northwest Tennessee.

Also, Jonah’s insight may help the national harm reduction community better understand why non-opioids with complete opposite effects of opioids are adulterated with the ultra-powerful opioid fentanyl.

Typical Patterns of Methamphetamine Users

Yes, I understand that not all meth users go on days-long benders. However, many people whose primary drug of choice is methamphetamine do, in fact, use several days in a row and eschew sleep in the name of getting geeked out.

Oftentimes, chronic, daily meth consumers fail to drink and eat as much liquids and food as their bodies need.

These two factors — the lack of sleep and lack of proper nutrition — cause meth users’ bodies to feel tender or sore, if not outright hurt.

Here’s What Jonah Told Me

Jonah, who has been incarcerated for several months, shared with me earlier today that he was court-ordered to enter two rehabs. As a part of the two programs’ intake processes, Jonah was given a drug screen. Each time, he tested positive for both meth and opioids — specifically fentanyl — though Jonah never uses opioids.

Jonah hadn’t been drugged or anything like that. He is not prescribed any opioids from physicians. Put simply, there’s no way he could have had opioids in his system other than if the meth he had been using were adulterated with fentanyl.

And that’s what happened.

Here’s the Most Important Part of This Article

Why, exactly, does Jonah think he’d been using meth that was adulterated with fentanyl?

Remember just a few paragraphs ago when I identified the typical patterns of methamphetamine users and how those two things cause users’ bodies to hurt?

That’s why Jonah feels that fentanyl is actually purposefully included in the domestic illicit methamphetamine supply — to help ease the discomfort and pain associated with using meth several days in a row.

This Was Unbeknownst to Me

Of course, I don’t know everything — but I at least know a few things about the real-life use of illicit drugs and harm reduction. With that being said, I had absolutely no idea about the reasons for including fentanyl in the domestic illicit meth supply before talking to Jonah earlier today.

I’m sure that dozens, if not hundreds — hopefully even thousands — of people have proposed this very reason to explain why participants in the North American illicit drug market adulterate methamphetamine with fentanyl. If you, the reader, haven’t yet heard of the idea that Jonah proposed to me earlier today, please consider its merits and share this idea with others. Or, if you think Jonah’s idea is nothing but a crock, reach out to me — my contact info can be found at the bottom of “Who Am I?”, another page on this website. I’m very much interested in hearing what you have to say about why fentanyl has been found in illicit drugs other than opioids here in North America.

What I Learned From Jonah Today

Before today, I thought there wasn’t any legitimate purpose to include fentanyl in batches of methamphetamine.

I thought the only reason why there had been instances of fentanyl found in the non-opioid portion of the domestic illicit drug supply in the United States — and Canada, for that matter — was because manufacturers and high-level distributors had not exercised due diligence in adulterating their inventory with other suitable active ingredients or inactive cuts, either one.

For example, assume Bob is a high-level distributor. He stocks and distributes both heroin and methamphetamine as part of the United States’ illicit drug market. Assume that Bob breaks down his heroin supply, adds fentanyl, and combines the two. Further, assume Bob used a credit card, gift card, or driver’s license in the adulteration process.

Now it’s time for Bob to adulterate his meth supply, though he forgets to clean the fentanyl from his card, coffee grinder, or other drug adulteration equipment.

Assume that Bob blows up (adds inactive cuts to bulk up his supply of meth) his meth with methylsulfonylmethane (MSM) — and for the record, I have no experience with adulterating any drugs, so I’m not sure if MSM is a high-quality, safe, inactive adulterant.

Anyways, so Bob breaks down his supply of meth into a fine powder, mixes in MSM, and then recrystallizes his supply to return his meth to shard form (I think that’s how meth is adulterated, but, then again, I have absolutely no experience in doing this; please forgive me if that’s not how this process works, but, either way, whether this is the or a common way meth is cut, it doesn’t have any bearing on my example).

Although Bob might not care about keeping fentanyl out of his meth supply, there’s still fentanyl in his batch of meth now as a direct result of being careless.

This example was the only reason I could come up with to explain why non-opioid drugs on the domestic illicit drug market ever tested positive for fentanyl.

Putting It All Together

I’m glad I ran into Jonah earlier today and even more glad that he shared his ideas with me.

Jonah isn’t a genius and neither am I. He may very well be wrong. He may very well have hit the nail on the head. I encourage you to take this article with a grain of salt and not take it as fact, just as you should with all information — not just harm reduction stuff, but all types of information — you come across, whether a long-term drug user such as myself or Jonah with lots of real-world experience, an academician with limited real-world experience, a social services professional, or someone else presents it to you.

I think both the reasons I presented in this article are valid as to why fentanyl is included in non-opioid drugs on the American illicit drug market.

However, I’m sure there is at least one other valid, legitimate reason explaining why fentanyl has been reportedly found in illicit non-opioid drugs here in the United States. I’m more than open to hearing your suggestions — if you have any suggestions as to why fentanyl appears in drugs other than opioids here in the United States, please contact me.

About Jonah

I’ve known Jonah for about a year. I met him through one of my now-former dealers. I offered to give him syringes, to which he obliged — since then, Jonah has played a role in community distribution here in Northwest Tennessee.

Jonah, a White, working-class male, is about 45 years old and has lived in or around his current county of residence since birth. He uses “weed, speed, and beer” — the phrase has a nice ring to me — and has for a very long time. Meth is his primary drug of choice.

Jonah works manual labor and did not complete high school, though he did get a GED. He has been in and out of jail throughout his adult life, though not because he’s a bad guy — he’s simply been slapped with criminal charges related to drug use several times.

An Aside

Note: The only practitioner of forward-thinking, evidence-based harm reduction efforts that I know of in NWTN is Melesa Lassiter, who is paid by the state as a Regional Overdose Prevention Specialist (ROPS). ROPS distribute Narcan and train people to use it. Melesa has been helpful to me, personally, as I’ve reached out to her for guidance several times, though she and other ROPS — there are 20 throughout Tennessee in total, though only one in Northwest Tennessee, known officially as Region 6N by the state — are largely unable to reach at-risk users throughout NWTN. Of course, I’m not throwing any shade to her; I’m simply stating that the sate of Tennessee has largely failed to reach populations of opioid users within the state, including through the Regional Overdose Prevention Specialists the state government has hired to distribute Narcan.

Categories
Fentanyl Harm Reduction

Reasons Why the Illicit Opioid Market’s Participants Are Incentivized to Use Fentanyl

Fentanyl is an opioid that is much stronger than most opioids. It’s actually more responsible for fatal overdoses here in the United States than any other single opioid.

Most heroin here in Northwest Tennessee contains at least some proportion of fentanyl.

Whenever I use “heroin” in this article, just know I’m referring to mixtures of fentanyl and heroin. Although, in some cases, American heroin users might not receive mixtures of fentanyl and heroin all the time, most of the time, fentanyl is present. Also, don’t forget that the market contains counterfeit pharmaceutical opioids that contain fentanyl.

Here are a few reasons why dealers — a less fancy way of saying “the illicit opioid market’s participants” — are incentivized to keep using fentanyl.

Fentanyl-Free “Heroin” Might Not Satisfy Users’ Dependencies

Fentanyl causes much more intense opioid withdrawal syndrome symptoms than other less-powerful opioids, generally speaking, that is. Most people who use “heroin” actually use fentanyl-heroin mixtures whether they know it or not.

Dealers may notice a drop in sales or complaints from customers if they seek out fentanyl-free street heroin.

Exceptionally Strong Batches Bring Extra Traffic

It is true that news of overdoses spreads like wildfire within drug-using communities. If Jimmy’s most recent batch is rumored to have caused a number of overdose deaths, many users in that community will flock to Jimmy in search of heroin.

Jimmy may be incentivized to sell “heroin” that contains greater proportions of fentanyl than usual to achieve such short-term notoriety among opioid users in his community.

Note that such instances are more common among open-air markets, such as in Philadelphia.

Fentanyl Is Easier to Smuggle

Since fentanyl is much more potent than heroin, dealers are incentivized to continue using heroin mixed with fentanyl, if not use batches of “heroin” that contain nothing but fentanyl, as opposed to just heroin.

Fentanyl — when comparing IV fentanyl to IV heroin — is anywhere from 10 to 25 times stronger than heroin.

Stick out your pinky. Now make a fist. The difference in volume between your pinky and fist is a rough analogy between how much fentanyl one would need to smuggle, as compared to heroin, to get however-many users high.

Even if participants in the illicit opioid market aren’t smuggling pure fentanyl, for every bit more fentanyl that they include in their heroin-fentanyl mixtures, the less bulk they have to carry.

Users Report Drawing More Utility From Heroin-Fentanyl Mixtures

In my roughly three years of using heroin intravenously, I preferred my batches to include at least a little bit of fentanyl. I’d get more bang for my buck that way. Plus, the rush was a little stronger.

Many anecdotal reports from fellow opioid users, tons of which can be found online, indicate that they, too, preferred their heroin to contain fentanyl.

Fentanyl Is Easier to Manufacture

Although I don’t have any history whatsoever in manufacturing fentanyl or any other drugs, I do understand that fentanyl is easier to manufacture than other opioids. This is due to its synthetic nature.

The main reason why illicitly-manufactured fentanyl is easier to make is that its manufacturers don’t have to cultivate opium poppies en masse. Rather, they can source already-made chemical precursors. This reduces the burden on manufacturers in a number of ways.

What You Can Take Away From This

Put simply, fentanyl is far more dangerous than other opioids. When using street heroin — or any other opioid, for that matter — you should use fentanyl test strips to determine if your drugs have fentanyl. Fentanyl test strips are cheap and can even be sourced for free from Next Distro, though only in limited quantities.

If you don’t have any means of testing drugs before you use them, always use around other people and take super-small test doses with every new batch you get before dosing as you normally would.

Also, of course, make sure to have naloxone around, as well as someone who knows how to use it.