Fentanyl goes by many names. As a prescription, it's known as Sublimaze, Actiq, and Duragesic. On the street, it goes by Murder 8, TNT, Apache, White China, and a host of other monikers.

So what is it? Fentanyl is an extremely potent synthetic opioid that was introduced in the 1960s as an anesthetic. It's also used for pain relief. Compared to morphine, fentanyl is up to 100 times more powerful. Compared to heroin, it's 50 times more powerful.

Although fentanyl can be extremely dangerous in inappropriate doses, it is legally manufactured and distributed throughout the United States. Doctors throughout the country prescribe fentanyl on a daily basis.

Fentanyl works just like most other opioids—it bonds to a user's opioid receptors, which are found in the brain and signal when a person is feeling powerful emotions or pain.

The drug is highly addictive, and it affects the brain in such a way that, over time, users struggle to feel anything when they are deprived of the drug.

Fentanyl users may feel euphoria, or extreme happiness, when taking the drug. But less pleasing side effects include:

  • Nausea
  • Drowsiness
  • Labored breathing
  • Constipation
  • Confusion
  • Loss of consciousness
Because of these side effects, along with the drug's potency, it can be easy to overdose on fentanyl.

The Medical Uses of Fentanyl

Fentanyl affects the way a user's brain interprets and responds to pain. It is only prescribed to treat what doctors call breakthrough pain, or episodic pain that occurs suddenly despite the use of other narcotic pain medication.

Fentanyl is used to treat patients with severe pain who are 18 years or older. It can be prescribed to post-surgical or cancer patients in conjunction with other pain medications.

Fentanyl should never be used to treat short-term pain like a migraine or headache.

Prescriptions come in one of three forms:

Fentanyl Lozenges

Fentanyl lozenges come on a handle and should be actively sucked and twirled until the lozenge has dissolved. It may take around 15 minutes to finish the lozenge and no other food or beverage should be ingested during this time.

Remnants of the lozenge can be harmful or deadly to children, so the stick should be safely disposed of.

Fentanyl Tablets

Fentanyl tablets are similarly easy to use but take between 15 and 25 minutes to dissolve. Users must insert the tablet between the cheek and the gums. No biting, sucking, or chewing is necessary or recommended.

Liquid Fentanyl

When fentanyl is used after surgery or as a form of anesthesia, it can be given intravenously or injected. This form is quick to be absorbed (between 5 and 10 minutes) and can last up to four hours.

In any form, fentanyl should always be stored out of the reach of children or pets. Outdated medication should be safely disposed of or returned to the pharmacy.

The Street Value of Fentanyl

Any time fentanyl is used by someone without a prescription, the drug is considered to be a form of street fentanyl. This type of drug use is dangerous.

Fentanyl makes it into the hands of illicit users via illegal drug labs or from products sold or stolen from people with prescriptions.

Illegal labs are largely found in countries with looser drug restrictions, like Mexico and China. Fentanyl price structures from these countries tend to be low. From there, it is smuggled across country lines, mixed with other drugs, and sold in the form of nasal sprays, pills, and powder.

Naturally, there is no quality control or oversight over illegal manufacturing. As such, the sprays, pills, and powder may contain more fentanyl than is safe.

Fentanyl can be lethal in doses as small as two milligrams, so overdosing on street fentanyl is a huge risk and a reality for tens of thousands of drug users each year.

What Does a Fentanyl Overdose Look Like?

Fentanyl overdoses can be difficult to catch early on. At first, a user may appear to be drowsy. They may fall asleep. Over time, the person's breathing may become shallower until, eventually, their skin, lips, and fingertips may turn blue. The user may then experience respiratory failure or even death.

Here are a few other overdose symptoms to be aware of:

  • Stupor
  • Uneven eye dilation
  • Coma
  • Pale or clammy skin
  • Limpness
In the case of an overdose, naloxone should be administered quickly. This will restore normal breathing and reverse the effects of an overdose.

Fentanyl Dangers

This drug is especially dangerous. In addition to the low price of fentanyl, which makes it attractive to street users, it is nearly impossible to detect. If a pill or powder is laced with fentanyl, you won't be able to smell or taste the difference. The seller may not even be aware of its presence, let alone the user.

Add this to the fact that fentanyl is extremely potent (up to 50 times stronger than heroin). Ultimately, few drugs are more dangerous than fentanyl. In fact, it's responsible for as many as 60,000 deaths in the United States each year, a number that continues to grow.

As the overdose epidemic continues to devastate the country, officials are attempting to get the drug off the street. In September 2021, more than 800 people were arrested for possession of fentanyl-laced pills by the Drug Enforcement Administration (DEA).

According to the agency, illicit fentanyl currently accounts for almost three-quarters of all fatal drug overdoses in the United States.

The Street Price of Fentanyl

StreetRx works with RADARS, a surveillance system that monitors the misuse of drugs, to monitor the black-market of price of drugs like fentanyl. This collected information helps epidemiologists and policymakers to better understand the trends of the illegal drug trade.

According to the data obtained by StreetRx, the street price of fentanyl is much lower than that of heroin or other comparable narcotics. As such, it presents even more of a threat to public safety.

Of course, the street price of fentanyl depends on many factors, including the drug's form. But, on average, it is sold for around $195 per milligram. This is an estimate based on data from the United States, Canada, France, Germany, Italy, Spain, Australia, and the United Kingdom.