What You Need To Know About Fentanyl

Photographed by Tayler Smith.
On April 21, Prince was found dead at his home. A medical examiner's report was released yesterday confirming that he died of an accidental overdose of fentanyl, a synthetic opiate painkiller. This drug is prescribed after surgery or to those with chronic pain or cancer that's causing severe pain, but it is also increasingly being illicitly made and added to heroin. The report did not make it clear whether Prince was prescribed the drug or not, as CNN notes, only that it was self-administered. As media coverage continues around Prince's tragic death, you are probably going to be hearing a lot more about fentanyl. Here's what you should know about the drug.
What does fentanyl do?
Fentanyl is an opiate painkiller, meaning that it acts on our endogenous opioid receptors to help relieve pain. These receptors are concentrated in the brain areas related to pain and emotions, so these drugs can also induce feelings of euphoria and relaxation. Like other opioid drugs, fentanyl can cause serious side effects. In the case of an overdose, these drugs cause your lungs to slow down and eventually stop sending oxygen to your brain. At that point, you'll die without a speedy medical intervention. Is fentanyl addictive?
Although pain management is a legitimate use of opiates, chronic pain patients may build up a tolerance to less potent opiates over time and require stronger ones (like fentanyl) to feel the same effects. This scenario often leads the way for patients to develop a dependence on and even an addiction to opioid painkillers. In fact, as of March, the FDA requires similar opioid painkillers to add a new black box warning about these potential effects.

Is fentanyl more powerful than heroin?
Fentanyl is more potent than heroin, meaning it can cause the same effects at a lower dose. But, as the Drug Policy Alliance explains, saying something like fentanyl is "50 times more powerful than heroin" is somewhat misleading: Both can cause the same very real problems — including overdoses.

How can we prevent more overdoses?
It's complicated. But one thing that's clear is that we need a better approach to managing chronic pain than prescribing increasingly potent opioid drugs. Unfortunately, fentanyl is also making its way into heroin, causing drug users to unwittingly ingest more potent drugs. This is particularly dangerous because if heroin users don't know that they're actually taking heroin cut with fentanyl, then the risk for an overdose, especially in anyone with a lower tolerance, goes up. Keeping everyone safe may require a more compassionate and creative approach to drug policy than the U.S. is currently used to. That could include expanding access and training to use the overdose-reversing drug naloxone and potentially introducing supervised injection sites to several parts of the country.

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