HOW IS FENTANYL USED?

As a pharmaceutical drug, fentanyl can be applied to the skin in a patch,¹ administered as a very low-dosage pill or given in a lozenge, or “lollipop,” that slowly dissolves.² There are also sprays used under the tongue or in the nose. Liquid fentanyl may be injected.

Any of these forms of fentanyl can be misused. Patches can be cut up and placed under the tongue or the contents squeezed out and swallowed.

Illicit forms of fentanyl are often found in fake prescription pills, any one of which may be fatal.³ Powdered fentanyl can be dissolved for injection or for smoking in a glass pipe. Nonpharmaceutical fentanyl can also be added to eyedrops, nasal spray or small squares of blotter paper that users place in their mouths.

Because fentanyl can be combined with methamphetamine* or cocaine, it may be snorted, smoked or injected, with users unaware they are taking fentanyl.⁴

An increasing number of illegal vape products and marijuana are also being laced^† with fentanyl, which can be lethal.⁵

* methamphetamine: a dangerous drug that disrupts the nervous system, often known as meth or crystal meth

† lace: to add a small amount of a substance to

WHY IS FENTANYL SO DANGEROUS?

A lethal dose of fentanyl (image shown at 200% actual size)

Photo credit: DEA

Two factors make fentanyl dangerous and deadly. One is its incredible potency. It is as much as 50 times stronger than heroin and 100 times stronger than morphine. As little as two milligrams of pure fentanyl, which is only a few grains, can be a fatal dose.⁶

The other factor is that people may not even know they are taking fentanyl. It is often mixed with illegal drugs such as heroin, cocaine or methamphetamine. An unknowing user can unexpectedly overdose on fentanyl.²

Powdered fentanyl is often pressed into fake pills that look like real prescription drugs. In 2023, law enforcement personnel in the United States seized more than 80 million counterfeit pills containing fentanyl from the black market.⁷