What Is Fentanyl? 10 Things to Know About the Drug That Killed Prince

A Minnesota medical examiner has reported that the music icon Prince died from an accidental overdose of the powerful painkiller fentanyl.

Officials have not disclosed how Prince obtained the drug or whether a doctor had prescribed it. What we do know is that the beloved musician is only one of thousands who have fallen victim to fentanyl. The synthetic opioid is considered a treatment of last resort — typically for cancer patients — when other pain medications have failed. Fentanyl is up to 100 times more powerful than morphine and 50 times stronger than heroin.

According to the DEA, abuse of fentanyl initially appeared in the mid-1970s. Between 2005 and 2007, more than 1,000 deaths in the U.S. were attributed to fentanyl. The source of that fentanyl was traced to a single lab in Mexico, and when that lab was located and dismantled, the surge ended.

The current outbreak, however, involves a wide array of people including new and experienced abusers. Not only are Mexican drug cartels involved in the importation of fentanyl, but it’s also being manufactured in such places as Turkey and China. Fentanyl can even be ordered online.

Just a pinch of the drug sprinkled into a batch of heroin can kill, hence the street names “Drop Dead,” “Murder 8” and TNT. It is frequently mixed with heroin and cocaine to give those drugs a bigger kick, in many cases without the user’s knowledge. Ingesting a tablet the size of an aspirin would result in rapid death.

“Heroin is bad enough, but when you lace it with fentanyl, it’s like dropping a nuclear bomb on the situation,” Mary Lou Leary, a deputy director in the White House’s Office of National Drug Control Policy, recently told NPR. “It’s so, so much more dangerous.”

What you should know about fentanyl:

  1. Fentanyl was synthesized in 1960 and soon began to be used as a general anesthetic. It is sold under brand names including Actiq, Duragesic, Subsys, Fentora, Abstraland and Onsolis, and is one of the most expensive pain relievers on the market. It can be consumed through a patch, an injection, smoking and a lollipop. One of the problems with the patches is that addicts will cut them up and chew the bits, a particularly dangerous practice.
  1. Fentanyl is extremely addictive. Many people report craving it after just one use.
  1. Like other opioids, fentanyl can overwhelm the respiratory system and kill. But with fentanyl, the most powerful opioid, the body shuts down far more quickly.
  1. The danger of fentanyl isn’t just to users, but to public health workers and first responders who come into contact with it. Fentanyl can be absorbed through the skin or be accidentally inhaled. In 2015, New Jersey law enforcement officers conducting a narcotics field test experienced shortness of breath, dizziness and respiratory distress after coming into contact with fentanyl.
  2. Fentanyl is considered a knockout drug, typically used today in hospital settings for sedation during medical procedures. Because it is “fast on and fast off,” it doesn’t produce the long-lasting effect found with heroin.
  3. There were 618 fentanyl seizures in 2012, 945 in 2013 and 4,585 in 2014, according to the U.S Centers for Disease Control and Prevention. The CDC notes that most of fentanyl-related overdose deaths were attributed to illegally manufactured fentanyl — not diverted prescription fentanyl — that was mixed with other drugs. This year in California, fentanyl was passed off as the popular painkiller Norco and sold on the streets. In just 10 days, the drug was responsible for at least 10 deaths and 52 overdoses.
  1. Because fentanyl is odorless, colorless and tasteless, it is easy to slip into other drugs.
  1. Some addicts are deliberately taking fentanyl, a substance so deadly that Israel’s spy agency sprayed it into the ear of a Hamas leader in a failed assassination attempt in 1997, and Russian officials used fentanyl gas in an effort to rescue some 900 hostages held by Chechen rebels in 2002. Fentanyl was also reportedly considered for tactical roles in Vietnam.
  1. Fentanyl crosses the blood-brain barrier more quickly than other drugs, and is extremely efficient in targeting the brain’s opioid receptors. Physicians are advised not to prescribe it for pain relief after surgery due to the high potential for addiction. What’s more, fentanyl was never intended for that purpose.
  1. Drug overdoses can be reversed with naloxone (Narcan), a fast-acting antidote, but fentanyl’s potency can make it difficult for police or paramedics to restore a person’s breathing. Someone who has overdosed on fentanyl typically requires larger or multiple doses of naloxone to recover.
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