DEA Drug Fact Sheet: Fentanyl

Fentanyl is a potent synthetic opioid drug approved by the Food and Drug Administration (FDA) for use as an analgesic (pain relief) and an anesthetic. It is significantly more powerful than other opioids, being approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic.

Origin and Distribution

• Development: Fentanyl was first developed in 1959 and introduced in the 1960s as an intravenous anesthetic.
• Legal Production: It is legally manufactured and distributed in the United States.
• Diversion: Licit pharmaceutical products are diverted through theft, fraudulent prescriptions, and illicit distribution by patients, physicians, and pharmacists.
• Illicit Production: There has been a marked increase in clandestinely produced fentanyl and fentanyl analogues.

Common Street Names

Common street names for fentanyl include:

• Apache, China Girl, China Town, and Dance Fever.
• Friend, Goodfellas, Great Bear, and He-Man.
• Jackpot, King Ivory, Murder 8, and Tango & Cash.

Appearance and Dosage Forms

Fentanyl is encountered in both pharmaceutical and clandestine forms:

• Pharmaceutical Products: Available as oral transmucosal lozenges (“lollipops”), effervescent buccal tablets, sublingual tablets, sublingual sprays, nasal sprays, transdermal patches, and injectable formulations.
• Clandestine Forms: Typically encountered as a powder or in counterfeit tablets. It is often sold alone or combined with other drugs like heroin or cocaine.
  

Methods of Abuse

Fentanyl can be administered in several ways:

• Standard Methods: Injected, snorted/sniffed, smoked, or taken orally by pill or tablet.
• Other Methods: Spiked onto blotter paper.
• Patch Abuse: Users may remove the gel contents of patches to inject or ingest them, or freeze and cut patches to place them under the tongue or in the cheek.
• Counterfeit Pills: Illicit fentanyl is often identified in counterfeit pills designed to mimic pharmaceutical drugs such as oxycodone.

Effects on the Body and Overdose

Fentanyl produces effects similar to other opioid analgesics:

• Physical and Mental Effects: Relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, and pupillary constriction.
• Respiratory Impact: It causes respiratory depression.
• Overdose Symptoms: May result in stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death.
• Opioid Poisoning Triad: The presence of coma, pinpoint pupils, and respiratory depression is strongly suggestive of opioid poisoning.

Legal Status

Fentanyl is classified as a Schedule II narcotic under the United States Controlled Substances Act of 1970.