Fentanyl and Opioids: Effects, Dangers, and Risks

In 2021, opioid-related drug overdoses accounted for more than 75% of the 107,000 fatal drug overdoses in the United States. Nearly 88% of opioid overdose deaths involved a synthetic opioid, such as fentanyl.¹

Fentanyl acts similarly to a drug like morphine but has up to 100 times more potent opioid effects.² Pharmaceutical fentanyl can be illegally diverted for non-medical misuse, but illicitly manufactured fentanyl (IMF) is responsible for most fentanyl-related overdoses.^{3, 4} Because fentanyl is relatively inexpensive and able to deliver such a potent high, it is often added to other illicit opioids, such as heroin. It is even sometimes pressed into counterfeit pills made to resemble prescription opioids, such as hydrocodone—with or without a person’s knowledge. Whether used together intentionally or unintentionally, the combination of fentanyl and other opioids is dangerous and can increase the risk of overdose and other adverse health effects.^{3, 4}

What Is Fentanyl?

Fentanyl is a powerful synthetic opioid, that is significantly stronger than heroin and morphine.² There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl (IMF). Pharmaceutical fentanyl is prescribed by doctors for severe pain but can be diverted for non-medical misuse. Much of the supply of illicit fentanyl makes its way into our country from Mexico prior to it being sold on the domestic drug market.^{4, 8} IMF may be mixed with other drugs like cocaine, heroin, and methamphetamine, and sometimes pressed into counterfeit pills made to resemble legitimate prescription drugs.^{3, 4}

Fentanyl can have several effects, including:²

• Euphoria.
• Sedation.
• Confusion.
• Nausea.
• Slowed breathing.
• Loss of consciousness.

Fentanyl misuse can increase the risk of overdose and drive the development of an opioid use disorder (OUD), characterized by compulsive drug seeking and use despite experiencing negative consequences.² It’s important to note that IMF can contain other added ingredients. These added ingredients can be toxic and may result in unpredictable reactions when combined with opioids and non-opioids.⁶

Fentanyl and Heroin

Heroin is a highly addictive, illegal opioid that is most commonly injected but is also sometimes smoked or snorted.⁷ Fentanyl is frequently mixed with heroin as this allows drug dealers to maximize profitability by extending their heroin supply.⁸ Some people may seek out heroin mixed with fentanyl, however, many people are sold “heroin” without knowing it contains fentanyl.^{2, 4}

The combination of fentanyl and heroin can have life-threatening consequences. Both fentanyl and heroin cause respiratory depression, and combining the two can dramatically increase the risk of respiratory arrest and fatal overdose. When breathing stops, a person may experience hypoxia (a condition in which there is a lack of oxygen to the brain), brain injury, and death.^{2, 7}

In recent years, the majority of fentanyl-related overdoses have been attributed to the use of heroin laced with fentanyl.⁴ According to the U.S. Drug Enforcement Administration, overdose deaths involving heroin alone decreased by 20% between 2017 and 2018, while heroin-involved overdose deaths with the presence of fentanyl increased by 12%.⁸

Studies show that emergency department survival rates are lower among people admitted for fentanyl-involved overdoses relative to heroin overdoses.⁹ Additionally, the time frame for effectively reversing a fentanyl overdose with naloxone (Narcan, Kloxxado, RiVive) is shorter compared to heroin overdoses. Significantly larger doses of naloxone may also be needed to counteract the effects of fentanyl compared to heroin.⁹

Fentanyl-Laced Pills

In recent years, there has been an increase in the presence of fentanyl in counterfeit pills sold as prescription medications. These counterfeit pills are often designed to look like familiar prescription opioids, such as hydrocodone or oxycodone, and are frequently acquired through non-medical sources, which can increase the risk of unintentional fentanyl exposure.¹⁰ The combination of fentanyl and other prescription opioids is dangerous as both substances can cause respiratory depression and increase the risk of overdose. An overdose can lead to hypoxia, brain injury, and death.^{2, 10, 11}

The U.S. Drug Enforcement Administration found that of the fentanyl-laced prescription pills analyzed in 2022, 60% contained a potentially lethal dose of fentanyl.¹²

Opioid Overdose Prevention

Opioid overdoses can be deadly. These tips can help reduce your risk of an overdose:^{13, 14}

• Learn how to recognize the signs of an opioid overdose and how to respond. If you suspect an opioid overdose, call 911.
• Telltale signs of an opioid overdose, as well as fentanyl combination overdoses, may include constricted pupils, loss of consciousness, and slowed or otherwise irregular breathing.
• Use fentanyl test strips (FTS). FTS can identify the presence of fentanyl in a drug sample. Community-based organizations, local health departments, and harm reduction and needle exchange programs may have FTS available at no cost.
• Have naloxone (Narcan, Kloxxado, RiVive) readily available if you or a loved one is at risk of experiencing an opioid overdose. Naloxone can reverse the effects of opioids in the system by competitively blocking receptor activation. Even if you administer naloxone, it is important to call 911 in the event of an overdose.
• Avoid mixing substances. Polysubstance use can increase the risk of overdose.
• Ask for help if you need it. Seek treatment if you are struggling with opioid misuse or opioid use disorder (OUD).

Addiction Programs for Opioid Use Disorder

If you are struggling with opioid misuse or opioid use disorder (OUD), professional help is available and can help improve your overall health and well-being. Treatment is different for each patient but may begin with medical detox to manage the symptoms of opioid withdrawal.¹⁵ Following detox, patients may transition to an inpatient or outpatient rehab program. Inpatient rehab involves living and receiving treatment in a facility, offering intensive, structured care. Outpatient rehab allows patients to receive treatment while living at home, offering flexibility in scheduling.¹⁵

Treatment for OUD may include a combination of medication, behavioral therapy, and evaluation and treatment for co-occurring disorders (e.g., depression).¹⁶ Medications for OUD, such as buprenorphine, methadone, and naltrexone, can help manage cravings, ease withdrawal symptoms, and block the effects of opioids. Behavioral therapy, such as contingency management, can help patients recognize and change behaviors and thoughts related to substance use.¹⁶

Finding a Polysubstance Use Rehab

If you are struggling with polysubstance use, having a conversation with your doctor can be a great way to start the search for a treatment center. You can also use our treatment locator tool to find polysubstance rehab near you.

You can also look at the facilities listed below to see if they provide the program you are looking for:

• California: Laguna Treatment Center
• Florida: Recovery First Treatment Center
• Florida: River Oaks Treatment Center
• Nevada: Desert Hope Treatment Center
• Mississippi: Oxford Treatment Center
• Texas: Greenhouse Treatment Center

American Addiction Centers can help you recover from substance misuse or addiction. Call to learn about your treatment options. It’s confidential and free, and there is no obligation to enter treatment.

Does Insurance Cover Fentanyl and Opioids Addiction Rehabs?

For those who have insurance, using health insurance to pay for rehab should cover at least some of the cost of addiction treatment. Depending on your individual insurance plan, treatment at a specific facility may or may not be covered. It’s important that you know what is covered prior to attending a rehab. Use the free online insurance coverage checker tool below to find out if your health insurance provides coverage for addiction rehab  and other rehabilitation treatment plans for substance abuse recovery.

Coverage may vary depending on your needs and insurance plan. To find out if your policy covers rehab, click here, or fill out the form below. Your information is kept 100% confidential. You can also click here to find a rehab near me.