Illicitly manufactured fentanyl is a synthetic opioid that can be up to 50 times stronger than heroin and 100 times stronger than morphine. Because it is an illicit substance, its potency can change depending on the batch. It is a major contributor to fatal and nonfatal overdoses in the US, including Oregon.
Powdered fentanyl looks just like many other drugs that come in powder form. In Oregon, we have seen white and colored powdered fentanyl. It is commonly mixed with drugs like heroin, cocaine, and methamphetamine and made into pills that are made to resemble other prescription opioids such as oxycodone. Fentanyl-laced drugs are extremely dangerous, and many people may be unaware that their drugs are laced with fentanyl. It is nearly impossible to tell if drugs have been laced with fentanyl without the use of fentanyl test strips because fentanyl cannot be seen, smelled, or tasted. Oregon is experiencing an influx of counterfeit pills that contain fentanyl. Many of these pills are made to look identical to prescription opioids and are falsely marketed as legitimate. The majority of counterfeit pills resemble oxycodone 30mg pills (M30s), but can also mimic hydrocodone, alprazolam (Xanax), Adderall, and other medications. These are photos of counterfeit pills collected from a drug seizure in Oregon.
Counterfeit pills are extremely dangerous because people purchasing them may think they are purchasing legitimate prescription medications. However, these fake pills may contain lethal amounts of fentanyl.
Distributors in the US are selling counterfeit pills on social media, appealing to a younger, more opioid naïve audience that use these apps. Opioid naïve individuals are at high risk of accidental overdose because they do not have a tolerance for opioids, may not have access to naloxone, and may not know how to decrease overdose risk.
Fentanyl mixed with drugs or alcohol increases the likelihood of a fatal overdose. Naloxone is an opioid antagonist that rapidly reverses the effects of an opioid overdose. With a fentanyl overdose, two or more doses of naloxone may need to be administered. Always call 911 in the event of a suspected overdose.