Fentanyl-Laced Xanax: What Are The Dangers?

Medically Reviewed by Johnelle Smith, M.D. on March 17, 2023

As part of the opioid crisis in the United States currently, it is not uncommon to find fake pills for Xanax or other medications that are laced with fentanyl. Knowing how to distinguish counterfeit pills from real pills can save a person’s life.

Fentanyl-Laced Xanax

Xanax and fentanyl are two medications that have a lot of valid and beneficial purposes in healthcare but are frequently misused and abused.

Fentanyl is prescribed by healthcare providers as a painkiller for chronic pain or severe pain after other painkillers have failed.

When fentanyl and Xanax are taken at the same time, either intentionally or by accident, the risks involved are very high.

Fentanyl drug interactions may include an array of harmful side effects including overdose.

The Legitimate And Illegitimate Uses Of Xanax

Xanax, which is a brand name for the generic alprazolam, has many medical benefits when used as directed and prescribed.

Pharmaceutical Applications

Xanax drugs and other benzos are used mostly in the treatment of anxiety disorders and panic disorders, and can also be used as sleep aids because of their sedative qualities.

Substance Abuse And Illegal Use

It is not uncommon for Xanax to be misused and abused because of its euphoric effects and its ability to make people feel relaxed and pleasantly calm.

Xanax is not meant to be used in the long-term or without a prescription, however, and continued misuse can result in dependence and addiction.

Ohio Recovery Center


Plymouth, Massachusetts

The Purpose Of Fake Xanax

The production and sale of Xanax make a lot of money, both for legitimate pharmaceutical companies and also for illegal labs and black-market drug dealers.

Producing fake Xanax with an illicit mixture of drugs and chemicals can allow these black market labs to make more money without spending the money it takes to produce actual Xanax.

The Risks Associated With Fentanyl-Laced Xanax

Xanax which has been laced with fentanyl is extremely dangerous and is associated with a couple of very serious risks.

Unpredictable Side Effects

Both opioids and benzodiazepines are depressants, and they have similar side effects in that they slow down a person’s brain functions and other bodily functions such as heart rate and breathing.

When taking Xanax laced with fentanyl, a person may be surprised to feel its side effects much more intensely and quickly.

Increased Risk Of Overdose Death

Fentanyl by itself already has a high risk for overdose, because a lethal dose of fentanyl can be as small as 2 or 3 milligrams.

Xanax that is laced with fentanyl will have an unpredictable amount of fentanyl, and may even contain a lethal dose in a single pill.

Recognizing Counterfeit Xanax Pills

Identifying counterfeit Xanax pills as fentanyl pills is not an easy task, but it can help save lives.

Whenever there is any doubt as to whether or not a pill might be fake, abstinence is usually the best choice.


Even trained professionals have a difficult time recognizing counterfeit Xanax pills simply by their appearance.

Sometimes fake Xanax pills will appear more loosely held together and crumble in areas, but this is not common.

It is also possible to identify fentanyl by the color of the tablet, as green or yellow pills are likely fake.

Fentanyl Testing Strips

Rapid result fentanyl test strips can detect the presence of fentanyl in Xanax and other drugs, and are considered an important form of harm reduction.

They are simple to use – just dissolve a small piece of the Xanax pill in water and hold the test strip in the water for 15 seconds.

Other Common Counterfeit Drugs

Unfortunately, Xanax is hardly the only drug which is found to be laced with fentanyl when bought on the street.


Adderall is one of a few prescription medications that are popular on the streets as well, and is sometimes found laced with fentanyl in pill form.


Heroin is an opiate that comes in a white or off-white powder and looks very similar in appearance to fentanyl, making it very easy to lace with the synthetic opioid.


Methamphetamine is a synthetic stimulant that is made in a solid form but can be crushed up and snorted and laced or cut with fentanyl.

Fentanyl-laced meth is extremely dangerous and can quickly lead to a deadly overdose.

Oxycodone (Percocet)

Oxycodone comes in prescription pills and is another opioid that is popular on the street and that can easily hide the presence of fentanyl.

Symptoms Of A Drug Overdose

The symptoms of a fentanyl overdose are very serious and may include an array of physical and psychological signs.

Overdose symptoms may include:

  • pinpoint pupils
  • cold and clammy skin
  • slow, shallow breathing
  • confusion
  • loss of consciousness
  • making choking or gurgling noises

Responding To A Drug Overdose

A drug overdose involving fentanyl will require immediate medical attention and at least one dose of naloxone, the opioid overdose antidote.

Naloxone comes in an injectable form as well as a nasal spray under the brand name Narcan.

Getting Treatment For Your Substance Abuse Disorder

A substance use disorder involving opioids usually requires professional treatment in order to reduce the chances of relapse.


Xanax detox can either be medical or observational, but medical detox is typically the best choice for an opioid use disorder or with Xanax addiction.

This is especially true when Xanax is involved, as the withdrawal symptoms of Xanax can be fatal. It is never recommended to detox from benzodiazepines without professional help.

Evidence-Based Treatment Programs

Evidence-based treatments can include medication-assisted treatment (MAT), behavioral therapy, mental health services, and individual and group therapy.

When seeking addiction treatment, there is usually a choice between inpatient or outpatient programs.

Holistic Therapies

There are many types of holistic therapies that can help with illicit drug abuse. These include therapies such as adventure therapy, music therapy, art therapy, and yoga.

FAQs For Fentanyl-Laced Xanax

Here are some frequently asked questions about the dangers of mixing fentanyl and Xanax together.

It can be extremely difficult to identify fake Xanax from real Xanax by appearance alone. The only Xanax guaranteed to be real is that obtained from licensed pharmacies and by prescription.

There are testing strips for other adulterants but they are not typically available to the public. Even fentanyl testing strips are illegal in some states for public use.

If you think you are overdosing, call 911 immediately. If possible, find a family member or loved one to wait with you until emergency medical professionals arrive.

Find Substance Use Treatment Today

An addiction to any kind of prescription drug, such as fentanyl or Xanax, can be difficult to live with, but you are not alone and we are here to help.

Many drug use rehab centers are accepting new clients as soon as today. When you or your loved one are ready to start on the road to recovery, please give our helpline a call.

This page does not provide medical advice. See more

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

  • Was this Helpful?
  • YesNo
Medically Reviewed by
Johnelle Smith, M.D. on March 17, 2023

Canton, Massachusetts

Bedrock Recovery Center


Levels of Care:

Payment Options: Insurance Accepted, Self Pay

View Center Profile

Plymouth, Massachusetts

Ohio Recovery Center


Levels of Care:

Payment Options: Insurance Accepted, Self Pay

View Center Profile
Spring Hill Recovery Center


Addiction Resource Logo