You might have heard of the drug fentanyl from Prince's death report, which found that an overdose of the synthetic opiate painkiller is what killed him.
More and more people have been using fentanyl in recent years: A 2016 Centers for Disease Control and Prevention report found a 79% increase in synthetic opioid overdose deaths and a 426% increase in drugs found by police containing fentanyl from 2013 to 2014. But how does fentanyl work, and why is it so dangerous? A new video by AsapSCIENCE answers these questions.
Fentanyl is prescribed to chronic pain patients, cancer patients, and people who have just received surgery to relieve severe pain. It's also sold on the black market and sometimes added to heroin. Many people became addicted to fentanyl when it was prescribed to them and then found it illegally when their doctors stopped prescribing, according to the video.
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Fentanyl works as a painkiller by blocking pain signal pathways in multiple parts of the nervous system. In addition to reducing physical pain, it can lead people to feel calm and euphoric, since it binds to the brain's opioid receptors, causing the release of extra dopamine — a neurotransmitter linked to happiness. But it's also incredibly dangerous, making it hard for the brain to detect CO2 in high doses, which can deprive it of oxygen and lead to death.
Because fentanyl passes through the blood-brain barrier quickly, it kicks in almost immediately. It also produces effects at much lower doses than other drugs. AsapSCIENCE says it has 100 times the strength of morphine and 50 times the strength of heroin, though as the Drug Policy Alliance notes, those drugs can be just as powerful at higher doses. And since a typical dose is 2 mg — around the size of two grains of salt — it's extremely easy to overdose.
If someone who has overdosed on fentanyl gets medical attention right away, they can get a Naloxone injection to stop it from binding to their opioid receptors. But often, it's too late. There were 65,000 drug overdose deaths in the U.S. in 2016 — a 7,000 increase since 2015 — largely due to opioids. People suffering from drug addiction are often unable to quit on their own, and many lack the resources to get support. Some don't seek help because that would force them to stop using drugs entirely. To curb this problem, some experts advocate safe sites for people to use drugs in a supervised setting and get assistance fighting their addictions.