Laced with Fentanyl - What To Look For


Man-made or synthetic opioids (mostly fentanyl and fentanyl analogs) were involved in over half of the 70,630 drug overdose deaths in 2019. Fentanyl and other intentional and unintentional opioid-related overdoses have rapidly increased over the years and continue to trend upwards. According to preliminary data released by the Centers for Disease Control and Prevention (CDC), overdose deaths involving synthetic opioids such as fentanyl increased by 55% between September 2019 and September 2020.

While some individuals intentionally purchase fentanyl or misuse prescription fentanyl, many individuals who use fentanyl do so unintentionally and are immediately at risk of overdose due to the potency of this dangerous drug. Fentanyl is often laced into other drugs due to its inexpensive cost. The DEA recently reported that 26% of counterfeit prescription pills seized and tested contained a potentially lethal dose of fentanyl (at least 2 milligrams). Similarly, a study published in The Journal of the American Medical Association(JAMA) found that cocaine was involved in nearly 22% of synthetic opioid overdoses in 2016.

What Is Fentanyl?

Fentanyl is a highly potent, addictive prescription opioid that is 50-100 times stronger than morphine. According to the DEA, fentanyl is a Schedule II drug, meaning it has medicinal purposes but also has a very high potential for abuse which may lead to severe psychological or physical dependence. Fentanyl is prescribed for severe pain associated with trauma, surgery, breakthrough cancer pain, and end-of-life care. Fentanyl can be prescribed as slow-release patches, nasal sprays, injectable formulations, tablets, and lozenges.

There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl (IMF). Any opioid, even when used for legitimate medical purposes, carries the risk of overdose. However, abusing opioids, especially illicitly manufactured fentanyl (IMF), greatly increases the danger.

Fentanyl Test Strips

It is nearly impossible to tell if drugs have been laced with fentanyl unless you test your drugs with fentanyl test strips. Test strips are inexpensive and typically give results within 5 minutes, which can be the difference between life and death. Fentanyl test strips are paramount to avoiding an accidental fentanyl overdose where a drug may be laced with fentanyl without your knowledge. Fentanyl test trips may be free in some states, and distributing locations vary by state, so it is necessary to do an online search for fentanyl test strips within your state. There are three easy steps to using fentanyl test strips to test for fentanyl:

  1. Dissolve a small amount of the drug in water, and then dip the test strip into the liquid for 15 seconds. Because the test strips are highly sensitive, a minimal amount of drug residue is sufficient to obtain a result.
  2. Set the test strip on a flat surface until results appear within 5 minutes.
  3. One line indicates fentanyl is present in the sample; two lines indicate a negative result.

Fentanyl Found In Street Drugs

Purchasing illegal and legal drugs on the street is a huge gamble, basically a game of Russian roulette. From Xanax, Adderall, and ketamine to cocaine and ecstasy, drugs in the form of powder or counterfeit pills purchased in nonmedical settings have a high likelihood of being laced with life-threatening amounts of fentanyl. Experts consider only 2 mg of fentanyl lethal, but many counterfeit pills contain up to 5 mg (more than twice the lethal dose). Because of its high potency, it is one of the most dangerous and, unfortunately, one of the cheapest opioids on the street today. As a result, drug traffickers often mix fentanyl into other drugs because of its low manufacturing cost, and a tiny amount goes a long way. Unfortunately, as a result, many individuals consume fentanyl without meaning to, which can cause accidental overdoses or deaths.

Common Drugs That Are Laced With Fentanyl

The DEA recently reported that 26% of counterfeit prescription pills seized and tested contained a potentially lethal dose of fentanyl (at least 2 milligrams). Similarly, a study published in The Journal of the American Medical Association (JAMA) found that cocaine was involved in nearly 22% of synthetic opioid overdoses in 2016. Fentanyl that is illegally manufactured in a lab can come in all different forms, including liquid, powder, and pills, and as a result, can easily be laced into other drugs that are purchased on the street. Street names for illicitly manufactured fentanyl (IMF) include Apache, Dance fever, Friend, Jackpot, and Goodfellas.

Over 150 individuals die daily from overdoses related to synthetic opioids such as fentanyl. Illicit or prescription drugs purchased on the street may contain deadly levels of fentanyl. You are unable to see, taste, or smell fentanyl, and as a result, it is nearly impossible to tell if street drugs have been laced with fentanyl unless you test the drugs using fentanyl test strips. Prescription medications that are prescribed by a doctor and dispensed by a pharmacy are safe and not laced with fentanyl; however, prescription medications and illicit drugs purchased on the street can potentially be laced with a lethal dose of fentanyl. Drugs that have been known to be laced with fentanyl include:

  • Cocaine
  • Heroin
  • MDMA (ecstasy)
  • Ketamine
  • Methamphetamine

Signs Of A Fentanyl Overdose

Fentanyl overdoses are becoming more common because it is laced into other drugs. Individuals may not know that they are at risk of a fentanyl overdose until they start showing signs and symptoms of a fentanyl overdose. Signs and symptoms of an opioid (fentanyl overdose) include the following:

  • Small “pinpoint pupils.”
  • Falling asleep or loss of consciousness
  • Slow, weak, or no breathing
  • Choking or gurgling sounds
  • Limp body
  • Cold or clammy skin

Treating Fentanyl Overdose: Naloxone Aka NARCAN

A fentanyl overdose can be lethal; therefore, you must call 911 immediately if you believe someone is experiencing a fentanyl overdose. It is also important to administer Naloxone, an opioid-blocking agent that “kicks opioids, including fentanyl,” off of their receptors in the brain resulting in opioid withdrawal symptoms and potentially saving a life. Multiple naloxone doses might be necessary because of fentanyl’s potency.

Naloxone is an opioid antagonist, and when used in a suspected opioid overdose, it can save a life. Naloxone can be purchased or administered for free over the counter in many states, and therefore it is important to search on the Internet for your specific geographical location where you can have access to Naloxone. Anyone who takes opioids (illegally or legally), who has a history of opioid abuse, who has been in treatment for opioid misuse, or whose loved one can have access to Naloxone. Naloxone is administered intranasally or can be injected, and you can request training at your local pharmacy, drug treatment center, or community substance misuse center if you feel uncomfortable administering Naloxone to yourself or someone else who may be experiencing an opioid overdose. Even if you are unsure whether the individual is experiencing an opioid overdose, it is best to still give Naloxone regardless and call 911.

Opioid Addiction And Treatment

Fentanyl misuse and overdose do not always imply that you have a fentanyl addiction, as it is possible to overdose the first time you misuse drugs. However, overdose and misuse can be warning signs associated with opioid addiction. Addiction, medically referred to as a substance use disorder is the compulsive, uncontrollable use of a substance despite all the harm it causes. Addiction may entail physiological changes (such as tolerance and dependence) and several harmful behavioral changes adversely impacting every aspect of an individual’s life. Addiction development is accompanied by functional changes within the brain that can impact an individual’s drive, motivation, thought processes, and behaviors so much that drug use becomes prioritized over all else. The development of addiction is influenced not only by repeated substance use but also by genetic, psychosocial, and environmental factors.

Treatment for opioid addiction (including fentanyl addiction) often begins with detox, which is a process that eliminates the drug from the body. Detox takes place in a safe and medically supervised setting where withdrawal symptoms are monitored and can be managed and alleviated by using certain medications. Once the individual has completed detox, addiction treatment aims to address and treat the underlying triggers and motives associated with the addiction. Addiction treatment also aims to address cravings and urges and incorporates behavioral therapy and medications to help prevent relapse.

Fentanyl Treatment at AKUA Mind and Body

AKUA Mind and Body is a full-service treatment center that provides detox, residential treatment, partial hospitalization, intensive outpatient treatment, outpatient treatment, and virtual treatment to both men and women struggling with a substance use disorder, dependency, a mental health disorder, or both (co-occurring disorder). AKUA Mind and Body provides compassionate, evidence-based treatment to all individuals and families. We combine evidence-based medications and psychotherapy approaches with holistic therapies such as meditation, yoga, and equine therapy, as we believe in treating the mind, body, and spirit.

Our clinical staff and ancillary treatment teams take great pride in the care that we provide to our clients and their families. From intake to discharge, we believe in treating the client as an individual and not just treating the disorder. As a result, we provide individualized treatment plans for every client. We offer treatment services across many locations in California, including Orange County, Newport Beach, San Diego, and Sacramento.

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