Fentanyl contamination in cocaine, methamphetamine, ketamine, MDMA, and certain “prescription” drugs is common. Fentanyl is often found in heroin as well as illegally manufactured opioids and benzodiazepines. Naloxone, sold under the brand name Narcan, can completely reverse an opioid overdose. Fentanyl poses an very high overdose risk, due in part to having an extremely unpredictable fatal dosage when mixed with other drugs.
A kilogram of heroin laced with fentanyl may sell for more than $100,000, but the fentanyl itself may be produced far more cheaply (about $6,000 per kilogram); this provides incentive for drug dealers to cut high amounts of it into their product. As of 2018, fentanyl was the most common opioid in overdose drug deaths, surpassing heroin.
There were 81,230 drug overdose deaths during the 12 months from May 2019 to May 2020, the highest number of overdoses for a 12-month interval ever recorded for the U.S. In 2021, the Public Health Agency of Canada noted that 87% of accidental opioid toxicity deaths involved fentanyl. Deaths involving synthetic opioids such as fentanyl increased by a marked 22% in 2021, according to the CDC data.
In the past, media outlets have reported stories about police officers being hospitalized after contact with powdered fentanyl, or after brushing it from their clothing. Transdermal (via the skin) and inhalative exposure to fentanyl is extremely unlikely to cause overdose (except in cases of prolonged exposure with large quantities) and first responders are at minimal risk of fentanyl poisoning through accidental contact. The effects being reported (rapid heartbeat, hyperventilation and chills) were more commonly associated with a panic attack.
A 2021 paper expressed concern that these physical fears over fentanyl may inhibit effective emergency response to overdoses by causing responding officers to spend time on unnecessary precautions, and that such media coverage could perpetuate social stigmas that people who use drugs are dangerous to be around.
The CDC recommends the following; the need to expand distribution and use of naloxone and overdose prevention education locally; to expand access and availability of treatment for substance use disorders; to intervene early with individuals at highest risk for overdose; and to improve detection of overdose outbreaks, in order to facilitate a more effective response.
An effective social media campaign has been put into motion by the United States DEA called “One Pill Can Kill” with the goal of spreading awareness about the prevalence of counterfeit pills, and to show the difference between counterfeit pills and real prescription pills. It also offers resources for help with drug addiction and rehabilitation.
