Fentanyl
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl. From 2019 to 2022, the number of fentanyl overdose deaths increased 12-fold, from 50 deaths in 2019 to 609 in 2022. Pharmaceutical fentanyl was developed as a pain management treatment for cancer patients and others with severe pain.
However, recent cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl, which is produced and distributed through illegal drug markets. It is often added to other drugs because of its extreme potency, which makes the drugs cheaper, more powerful, more addictive, and more dangerous. Fentanyl-laced drugs are extremely risky and frequently consumed unknowingly. Fentanyl cannot be detected by sight, taste, smell, or touch.
Illicit drugs do not come with an ingredients list and are always unpredictable and inconsistent. It is nearly impossible to tell if drugs have been laced or mixed with fentanyl unless they are tested with fentanyl test strips. Fentanyl test strips are strips of paper that can detect the presence of fentanyl in all different kinds of drugs (cocaine, methamphetamine, heroin, etc.) and drug forms (pills, powder, and injectables).
Fentanyl test strips are inexpensive and typically give results within 5 minutes, which can be the difference between life or death. However, regardless of the drug being used, an overdose risk is always present. Even if the test is negative, no test is 100% accurate. Fentanyl may not be evenly distributed and the test could miss it depending on the sample tested. Multiple harm reduction practices should always be used to lower the risk of overdose as much as possible. Contact the Injury Prevention Service about the availability of fentanyl test strips.
Touch Doesn't Kill
Illicit fentanyl comes in powder or solid form, and must have direct contact with mucous membranes or the bloodstream via snorting, smoking, or injection to cause an overdose. Fentanyl powder is not readily absorbed through the skin and would take massive amounts over time.
The American College of Toxicology and American Academy of Clinical Toxicology position statement says the “the risk of clinically significant exposure to emergency responders is extremely low.” For routine handling of drugs, it is recommended that first responders and healthcare workers follow the National Institute for Occupational Safety and Health guidelines.
Naloxone Works
Although fentanyl is very strong, naloxone should be administered. It may require several doses to reverse the overdose.
Recognizing the signs of an opioid overdose can save a life. Here are some things to look for:
- Small, constricted “pinpoint" pupils
- Falling asleep or losing consciousness
- Slow, weak, or no breathing
- Choking or gurgling sounds
- Limp body
- Cold and/or clammy skin
- Discolored skin (especially in lips and nails)
If you suspect someone is overdosing:
- Call 911 immediately.*
- Administer naloxone, if available.
- Try to keep the person awake and breathing.
- Lay the person on their side to prevent choking.
- Stay with person until emergency assistance arrives.
*A Good Samaritan law (63 O.S. § 2-413.1) was enacted in Oklahoma to provide immunity, under certain circumstances, to individuals seeking medical attention for someone who has overdosed.
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For help finding treatment referrals, call 211.
Contact Information
Mailing Address:
Oklahoma State Department of Health
Injury Prevention Service
123 Robert S. Kerr Ave., Suite 1702
Oklahoma City, OK 73102-6406
Physical Address:
Oklahoma State Department of Health
Injury Prevention Service
123 Robert S. Kerr Ave.
Oklahoma City, OK
Telephone: (405) 426-8440
Fax: (405) 900-7588
Email: injury@health.ok.gov
