What is fentanyl?
Pharmaceutical fentanyl is a synthetic opioid, approved for treating severe pain, typically advanced cancer pain.1 It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.
However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl.2 It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.
Deaths involving illicitly manufactured fentanyl on the rise
Rates of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl and fentanyl analogs, increased over 16% from 2018 to 2019. Overdose deaths involving synthetic opioids were nearly 12 times higher in 2019 than in 2013. More than 36,000 people died from overdoses involving synthetic opioids in 2019.3 The latest provisional drug overdose death counts through May 2020 suggest an acceleration of overdose deaths during the COVID-19 pandemic.4
What can be done?
The increase in overdose deaths highlights the need to ensure people most at risk of overdose can access care, as well as the need to expand prevention and response activities. CDC issued a Health Alert Network Advisory to medical and public health professionals, first responders, harm reduction organizations, and other community partners recommending the following actions as appropriate based on local needs and characteristics:
- Expand distribution and use of naloxone and overdose prevention education.
- Expand awareness about and access to and availability of treatment for substance use disorders.
- Intervene early with individuals at highest risk for overdose.
- Improve detection of overdose outbreaks to facilitate more effective response.
- CDC MMWR: Drug and Opioid-Involved Overdose Deaths – United States, 2017-2018
- Fentanyl: Preventing Occupational Exposure to Emergency Responders
- CDC Health Advisory Network Update: Rising Numbers of Deaths Involving Fentanyl and Fentanyl Analogs, Including Carfentanil, and Increased Usage and Mixing with Non-opioids
- CDC Health Advisory Network Update: Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds Further Increases Risk of Fentanyl-related Overdose and Fatalities
- CDC Health Advisory Network Update: Increases in Fentanyl Drug Confiscations and Fentanyl-related Overdose Fatalities
- National Alliance for Model State Drug Laws: Naloxoneexternal icon
- DEA Issues Nationwide Alert on Fentanyl as Threat to Health and Public Safetyexternal icon
- Tracking Fentanyl and Fentanyl-Related Substances Reported in NFLIS-Drug by State, 2016–2017external icon
- SAMHSA Opioid Overdose Toolkit pdf icon[PDF]external icon
- Call Poison Control at 1-800-222-1222.
- Algren D, Monteilh C, Rubin C, et al. Fentanyl-associated fatalities among illicit drug users in Wayne County, Michigan (July 2005-May 2006).external iconexternal icon Journal Of Medical Toxicology: Official Journal of the American College Of Medical Toxicology [serial online]. March 2013; 9(1):106-115.
- Department of Justice, Drug Enforcement Administration, DEA Investigative Reporting, January 2015.
- Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P, Davis NL. Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths — United States, 2013–2019. MMWR Morb Mortal Wkly Rep 2021;70:202–207.
- Centers for Disease Control and Prevention. CDC Health Alert Network Advisory: Increase in Fatal Drug Overdoses Across the United States Driven by Synthetic Opioids Before and During the COVID-19 Pandemic. CDCHAN-00438, 2020 Dec 14.