Fentanyl abuse is a serious public health and law enforcement issue.
It has risen to an even bigger problem recently as drug dealers are mixing, or “cutting”, fentanyl into other substances.
What is cut with fentanyl most often? When it is cut? How can you recognize it?
According to VICE, dealers are cutting any number of drugs with fentanyl. Some of them are medicinal, like oxycodone. Others are recreational, like ecstasy, heroin, MDMA, and cocaine, “all of which could be laced with fentanyl.”
Why? According to a doctor in British Columbia, Vancouver, where fentanyl has almost completely replaced heroin in the opioid epidemic, dealers are cutting fentanyl into other drugs simply because it is cheap and easy to do so.
Fentanyl is often made to look like the diverted version of OxyContin, the prescription painkiller.
Many users think they are buying a prescription drug that will give them a safe high.
Not only is this a misconception (OxyContin can be deadly enough on its own), but they are exposing themselves to an opioid that is phenomenally more powerful.
It is capable of inducing an overdose and death with only a few milligrams.
It doesn’t stop with OxyContin. In Los Angeles, diverted Xanax is cut with fentanyl, and in Seattle, dealers press fentanyl powder into pill form and sell it as a lesser potent formulation to appeal to users who would otherwise be put off by the infamy of fentanyl proper.
Forbes magazine writes of how fentanyl is regularly cut with heroin because it can be distributed in smaller batches and creates a bigger high in lower doses than heroin. This allows traffickers to reduce costs.
Fentanyl is also mixed with cocaine. According to NPR, 7 percent of all cocaine busts in New England in 2016 contained fentanyl. In common terms, the mixture of a stimulant like cocaine with a depressant like fentanyl is known as a speedball. It is popular among users who want to try and “balance” the contrasting effects of both.
However, if a user is unaware they are buying cocaine that is cut with fentanyl, they are likely to take more cocaine to chase the stimulant effect, all the while loading their brain and central nervous system with two very different and equally devastating drugs.
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Fentanyl is an opioid medication that is used in the treatment of severe pain, including pain after surgery. It is especially useful for people who have taken medicine with opiates for chronic pain, to the point that they need stronger opioids to help them with pain management. The U.S. Centers for Disease Control and Prevention writes that fentanyl is up to 100 times more potent than morphine.
Fentanyl has its legitimate medical uses, but its incredible potency and the likelihood of misuse has led it to become a valuable commodity on the black market. This, in turn, leads to its development in many underground laboratories across the world, especially in China and Eastern Europe.
USA Today warns that the illegal distribution of fentanyl in the United States is behind an increasing number of emergency hospitalizations, overdoses, and deaths, surpassing heroin and prescription opioids as a prominent killer in the opioid crisis.
Other problems with fentanyl:
These problems are not only worrisome but lead to fentanyl cut or mixed with other drugs. Traffickers do this as a way of reducing their costs and boosting their profits. Their unwitting customers end up buying a product that is mixed with a drug that takes only 3 mg to be lethal.
A 2017 congressional hearing on fentanyl as a key player in “the next wave of the opioid crisis” reported that the drug is invisible when laced into other drugs. It can be so immediately fatal that police have found people dead while still in the act of intravenously administering it.
Fentanyl is usually cut in minute amounts. When added to other drugs, it is often invisible. So how can it be recognized?
Scientific American says that fentanyl test kits are only about $1.00, and they are very accurate. The hope among public health experts is that even though fentanyl is unrecognizable, these kits will cut down on the number of accidental overdoses that arise from users unknowingly ingesting fentanyl.
At best, a positive result from a fentanyl test kit will convince some users not to consume the drugs they bought. At worst, it might at least convince them to take a lower dose or to take the drug in the company of someone who can help them if they overdose (for example, by administering an overdose reversal drug).
To recognize fentanyl when it has been cut with another drug, the strips in test kits are able to detect when a specific antibody binds with an antigen. This indicates the presence of fentanyl.
First, the user dissolves a small amount of the drug in water. The water should be stirred, allowing the drug to dissolve until it is completely invisible.
The test strip is then placed into the water and left to dry for two minutes. If one red line appears on the strip, the drug has been cut with fentanyl. If two red lines appear, the test has not found any fentanyl.
Fentanyl test kits have the potential to help people recognize if the drugs they’ve purchased have been cut with it, but derivations of fentanyl are regularly tweaked by dealers who are trying to stay ahead of cautious customers and dedicated law enforcement. Drug manufacturers alter the chemical makeup of the fentanyl they sell, just enough to avoid detection, which also means that a fentanyl test kit might become outdated in a matter of months.
“It is imperative for people who buy recreational drugs to keep up to date with fentanyl test kits. They are the only reliable way to discover whether a substance has been cut with fentanyl.”
(December 2018. Fentanyl. U.S. Centers for Disease Control and Prevention from https://www.cdc.gov/drugoverdose/opioids/fentanyl.html
(October 2017). Opioid Crisis Has a New Leading Killer: Fentanyl. USA Today from https://www.usatoday.com/story/opinion/2017/10/25/opioid-crisis-has-new-leading-killer-fentanyl-editorials-debates/801185001/
(September 2016). Why Heroin is Deadlier Than Fentanyl, in a Single Photo. STAT News from https://www.statnews.com/2016/09/29/why-fentanyl-is-deadlier-than-heroin/
(March 2017). Hearing Entitled “Fentanyl: The Next Wave of the Opioid Crisis.” U.S. House of Representatives Committee on Energy and Commerce. from from https://docs.house.gov/meetings/IF/IF02/20170321/105739/HHRG-115-IF02-20170321-SD002.pdf
(June 2016). Why Are Dealers Cutting Fentanyl Into Recreational Drugs? VICE from https://www.vice.com/en_us/article/avazbe/why-are-dealers-cutting-fentanyl-into-recreational-drugs
(January 2018). Tackling B.C’s Overdose Crisis In 2018: Plans And Strategies for the Coming Year. CBC News from https://www.cbc.ca/news/canada/british-columbia/tackling-b-c-s-overdose-crisis-in-2018-1.4473674
(February 2018). Counterfeit Xanax Laced With Deadly Fentanyl Becoming Popular Party Drug. FOX5 from http://www.fox5dc.com/news/counterfeit-xanax-laced-with-deadly-fentanyl-becoming-popular-party-drug
(October 2017). State Finds Fentanyl in Fake Opioid Pills. King5 from https://www.king5.com/article/news/health/state-finds-fentanyl-in-fake-opioid-pills/480303571
(April 2016). Why Fentanyl Is So Much More Deadly Than Heroin. Forbes. from https://www.forbes.com/sites/alicegwalton/2016/04/09/why-fentanyl-is-so-much-more-deadly-than-heroin/#67190e6e7f6a
(March 2018). Fentanyl-Laced Cocaine Becoming a Deadly Problem Among Drug Users. NPR from https://www.npr.org/sections/health-shots/2018/03/29/597717402/fentanyl-laced-cocaine-becoming-a-deadly-problem-among-drug-users
(March 2018). $1 Fentanyl Test Strip Could Be a Major Weapon against Opioid ODs. Scientific American from https://www.scientificamerican.com/article/1-fentanyl-test-strip-could-be-a-major-weapon-against-opioid-ods/
(October 2018). Fentanyl Test Strips Prove Useful in Preventing Overdoses from https://www.sciencedaily.com/releases/2018/10/181018095403.htm
(July 2017). Drug Users Can Now Test Their Stash for Fentanyl. VICE from https://tonic.vice.com/en_us/article/qvped5/drug-users-can-now-test-their-stash-for-fentanyl
(August 2016). A Deadly New Trend: Fentanyl and Other Synthetic Opioids Sold as Counterfeits. University of California from https://www.universityofcalifornia.edu/news/deadly-new-trend-fentanyl-and-other-synthetic-opioids-sold-counterfeits