Traces of fentanyl in cocaine, crack, methamphetamines, pills and heroin have been reported recently. Even if you don’t use substances that depress the nervous system, you may be at risk of unknowingly using fentanyl.
What is fentanyl?
Fentanyl is an extremely strong, fast-acting opioid. Opioids are nervous system depressants, examples are heroin, oxycodone, and morphine. Although fentanyl is a prescribed medication, it has recently begun to be created illegally, and is combined into other drugs. Sometimes sellers don’t know they are selling a product with fentanyl.
What is the danger?
An overdose caused by fentanyl use manifests itself the same as an overdose caused by heroin or some other opioid, but it comes much faster. Most of the time it is not possible to know if your product has been mixed with fentanyl, and when it is, it is not mixed evenly. This means that if you buy a bag of pills, some may have fentanyl and others may not.
Who is at risk?
Anyone who uses street drugs may be at risk of unknowingly using fentanyl and overdosing. Remember, it’s not just in heroin, it can be found in stimulants like cocaine and methamphetamine. Anyone who injects, inhales, smokes, or ingests drugs is at risk of using fentanyl.
This publication is made possible by grant number TI010004 from SAMHSA. The opinions and content of this publication are those of Sonoran Prevention Works and do not necessarily reflect the opinions or policies of SAHMSA or HHS.
What are Synthetic Opioids?
Synthetic opioids are substances that are synthesized in a laboratory and that act on the same targets in the brain as natural opioids (e.g., morphine and codeine) to produce analgesic (pain relief) effects. In contrast, natural opioids are naturally occurring substances extracted from the seed pod of certain varieties of poppy plants. Some synthetic opioids, such as fentanyl, methadone, and buprenorphine have been approved for medical use.
Street Title
U-4770: Pinky, Pink or U4, OxyCodone: 30s; 40s; 512s; Beans; Blues; Buttons; Cotton; Greens; Hillbilly Heroin; Kickers; Killers; Muchachas; Mujeres; OC; Oxy; Oxy 80s; Roxy; Roxy Shorts; Whites, Xanax®: Bars; Benzos; Bicycle Handle Bars; Bicycle Parts; Bricks; Footballs; Handlebars;, Adderall®: A-Train; Abby; Addy; Amps; Christmas Trees; Co-Pilots; Lid Poppers; Smart Pills; Smarties; Study Buddies; Study Skittles; Truck Drivers; Zing, Fentanyl: Apace, China Girl, China Town, Dance Fever, Friend, Goodfellas, Great Bear, He-Man, Jackpot, King Ivory, Murder 8, Poison and Tango & Cash
How are they abused?
Abuse of clandestinely produced synthetic opioids parallels that of heroin and prescription opioid analgesics. Many of these illicitly produced synthetic opioids are more potent than morphine and heroin and thus have the potential to result in a fatal overdose.
What are their effects?
Some effects of clandestinely produced synthetic opioids, similar to other commonly used opioid analgesics (e.g., morphine),may include relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.
What are their overdose effects?
Overdose effects of clandestinely produced synthetic opioids are similar to other opioid analgesics. These effects may include stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of triad of symptoms such as coma, pinpoint pupils, and respiratory depression are strongly suggestive of opioid poisoning.
Provided by www.dea.gov
What is Opioid Overdose? Treatments & Preventions
Substance use disorders (SUDs) impact the lives of millions of Americans. More than 100,000 people died from drug overdoses from April 2020 to 2021, an increase of 28.5% from the prior year, according to a report by the Centers for Disease Control and Prevention (CDC).
Opioid Overdose Causes
An opioid overdose can occur when a person:
- Overdoses on an illicit opioid drug, such as heroin or morphine
- Overdoses on methadone
- Accidentally takes an extra dose
- Deliberately misuses a prescription opioid or opioid-based pain medication in way that was not as prescribed by their physician
- Mixes opioids with other prescriptions, alcohol, or over-the-counter medications. Overdoses can be fatal when mixing an opioid with anxiety treatment medications or derivatives of Benzodiazepine, such as Xanax or valium.
- Uses medication prescribed for someone else. Children are particularly vulnerable to accidental overdoses if they take medication not intended for them.
How to Prevent Opioid Overdose
Opioid overdose can occur even with prescription opioid pain relievers and medications used in treating SUD such as methadone and buprenorphine. In addition, individuals using naltrexone for MOUD have a reduced tolerance to opioids, and therefore, using the same, or even lower doses of opioids used in the past, can cause life-threating consequences.
Always follow the instructions you receive with your medication. Ask your practitioner or pharmacist if you have questions or are unsure of how to take your medication.
The following tips can help you or a loved one avoid opioid overdose:
- Take medicine as prescribed by your practitioner
- Do not take more medication or take it more often than instructor
- Never mix pain medicines with alcohol, sleeping pills, or illicit substances
- Never take anyone else medication
- Prevent children and pets from accidental ingestion by storing your medication out or reach. For more information, visit CDC’s Up and Away educational campaign.
- Dispose of unused medication safely. Talk to your MOUD practitioner for guidance, or for more information on the safe disposal of unused medications, visit FDA’s disposal of unused medicines or DEA’s drug disposal webpages.
How to Recognize Opioid Overdose
Opioid overdose is life-threatening and requires immediate emergency attention. Recognizing the signs of opioid overdose is essential to saving lives.
Call 911 immediately if a person exhibits ANY of the following symptoms:
- Their face is extremely pale and/or feels clammy to the touch
- Their body goes limp
- Their fingernails or lips have a purple or blue color
- They start vomiting or making gurgling noises
- They cannot be awakened or are unable to speak
- Their breathing or heartbeat slows or stops
How to Treat Opioid Overdose
Family members, caregivers, or the people who spend time with individuals using opioids need to know how to recognize the signs of an overdose and how to administer life-saving services until emergency medical help arrives. Individuals experiencing an opioid overdose will not be able to treat themselves. Naloxone was approved by the Food and Drug Administration (FDA) as the first over the counter medication to prevent opioid overdose. Check with your healthcare provider, pharmacy, community-based distribution programs, local public health organizations or the local health departments on how to obtain naloxone in your state.
If you suspect someone is experiencing an opioid overdose, take action immediately:
- Call 911
- Begin CPR if the person has stopped breathing or if breathing is very weak (best performed by someone who has training)
- Treat the person with naloxone or nalmefene to reverse opioid overdose (if available)
Related Resources
- Opioid Overdose Reversal Medications (OORM)
- Non-prescription (“Over-the-Counter”) Naloxone Frequently Asked Questions
- Fentanyl and Xylazine Test Strips
- Evidence-Based Resources About Opioid Overdose




