What Are The Different Types Of Fentanyl?

Fentanyl is a Schedule II opioid analgesic that is prescribed for chronic pain after surgery or for cancer patients. Due to its potency, many people use fentanyl for its powerful euphoric effects. There are several types of fentanyl. Some formulations are made in pharmaceutical labs while others are manufactured in clandestine laboratories and sold illegally on the street.

People battling fentanyl addiction are at a high risk of a drug overdose. Treatment programs for fentanyl abuse may include detoxification, counseling, and co-occurring disorder care.

Synthetic Opioids Vs. Natural Opioids

Natural opiates such as codeine and morphine are derived from the seed pod of the poppy plant. While they occur naturally, drugs made from the poppy are still highly addictive and dangerous. Synthetic opioids are man-made substances that cannot be found in nature. They include fentanyl, tramadol, methadone, and pethidine.

The primary difference between synthetic and natural opioids is their origin and potency, as fentanyl is up to 100 times more powerful than morphine. Any type of opioid drug can lead to dependence and addiction when used over time.

Different Types Of Fentanyl

There are two types of fentanyl on the market today: pharmaceutical-grade fentanyl and illicitly manufactured fentanyl. Both types are made in labs and are equally addictive.

Pharmaceutical Fentanyl

Pharmaceutical fentanyl is used to treat chronic or severe pain. In its prescription form, fentanyl is known by brand names such as Actiq, Duragesic, Carfentanil, and Sublimaze. For medical use, fentanyl is typically given as a shot, a transdermal patch, or a lozenge that can be sucked on, similar to a cough drop or hard candy.

Illicit Fentanyl

Illicit forms of fentanyl are produced illegally and sold as a powder, dropped onto blotter paper, or put in nasal sprays or eye droppers. Many drug dealers will mix fentanyl with other substances such as heroin, cocaine, methamphetamine, and MDMA (ecstasy) to increase profit margins in the illegal drug market.

Street names for fentanyl include apache, china girl, dance fever, goodfellas, and china white.

Rainbow Fentanyl

This is a type of fentanyl that resembles candy or multicolored pills or powders. Without laboratory testing, it’s impossible to know the amount of fentanyl in each dose.

Counterfeit Pills

Illicit fentanyl may also come in the form of fake pills that resemble over-the-counter or prescription opioids. Counterfeit pills may resemble prescription drugs such as oxycodone or benzodiazepines such as alprazolam (Xanax), but oftentimes contain an unknown quantity of fentanyl.

Learn more about pharmaceutical and illegal fentanyl pills.

Common Routes Of Administration For Fentanyl

Below are some of the most common ways to ingest fentanyl.

Oral Lozenge

Oral lozenges containing fentanyl look similar to cough drops and are meant to be sucked on. Fentanyl will slowly be absorbed into the body over a period of time.

Intravenous Injection

Liquid fentanyl may also be injected using a needle and syringe or slowly infused intravenously. This method of administration will have a rapid onset of effects.

Fentanyl Patch

Transdermal patches containing fentanyl are stuck to the skin and slowly dose fentanyl throughout the day. Fentanyl patches may be prescribed by a doctor or purchased on the black market.

Find more information about fentanyl transdermal patches.

Fentanyl Lollipops

Actiq is a brand name for fentanyl that currently comes as a lozenge on a handle, similar to a lollipop. When used, fentanyl is absorbed through the oral mucosa and gastrointestinal tract.

Read about fentanyl lollipops.

Identifying “Hidden” Fentanyl

It is becoming increasingly easy to ingest fentanyl accidentally, particularly when using other types of illicit drugs. Luckily, there are ways to identify fake pills and fentanyl-tainted drugs.

Visual Identification

When the powder form of fentanyl is mixed in with drugs, it may produce a brown spot in the substance. Counterfeit pills containing fentanyl may be identified by abnormal color or pressed letters or numbers in the tablet.

Fentanyl Test Strips

A fentanyl test strip may be used to see if there’s fentanyl present in a given substance. The strips are used by mixing water in a container with at least 10 milligrams (mg) of the drug. The test strip is then inserted in the liquid and then placed on a flat surface for up to five minutes.

A positive result will show a single pink line, while two pink lines indicate a negative result.

Why Fentanyl Is So Often Hidden In Other Drugs

One of the most dangerous aspects of today’s drug supply is how often fentanyl shows up in substances where it isn’t expected. Drug dealers frequently mix fentanyl into heroin, cocaine, methamphetamine, and counterfeit prescription pills because it’s cheap to produce and extremely potent, allowing them to stretch their supply further while still delivering a strong effect. Unfortunately, this means people using other drugs, sometimes for the first time or after a period of abstinence, can be exposed to fentanyl without any way of knowing it’s there.

This unpredictability is part of why overdose deaths involving fentanyl have risen so sharply in recent years, even among people who never intended to use fentanyl in the first place. Because there’s no way to visually detect fentanyl in another substance, harm reduction tools like fentanyl test strips, along with never using alone and keeping naloxone on hand, have become essential safety measures for anyone who uses illicit drugs.

The Manufacture Of Fentanyl

Pharmaceutical fentanyl was originally developed for the pain management treatment of cancer patients. Due to its powerful euphoric high, it was quickly diverted for abuse. On the illicit drug market, fentanyl is manufactured in clandestine labs primarily in Mexico or China, and trafficked into the United States.

India is also a source of fentanyl powder and precursor chemicals.

Responding To A Fentanyl Overdose

Using fentanyl even only once may result in an overdose, particularly among people with little to no opioid tolerance. Being able to recognize the signs of an overdose may save a life.

Know The Signs

The most common signs of a fentanyl overdose include pinpoint pupils, losing consciousness, respiratory depression, gurgling sounds, drowsiness, sedation, and bluish-tinged skin on the lips and nails. If someone is exhibiting one or more of these signs it’s imperative that emergency medical personnel are called immediately.

Carry Naloxone (Narcan)

Naloxone is a medication that can reverse an opioid overdose when given quickly. Naloxone comes in a prefilled nasal spray or injectable to be given into the muscle or under the skin.

When administered properly, naloxone can restore normal breathing within two to three minutes.

Call Emergency Medical Services

Calling 911 is essential to surviving a fentanyl overdose. Once contacted, stay with the overdosing person until emergency help arrives.

Getting Treatment For A Fentanyl Addiction

Fentanyl addiction is serious and potentially life-threatening, but help is available in the form of evidence-based treatments available at a rehab center.

Medical Detox

The first step in treating fentanyl misuse is by entering a medically monitored detox program. Here, clinicians can help people manage withdrawal symptoms as they slowly taper off fentanyl.

Detoxification may last up to a week depending on the severity of the opioid use disorder.

Replacement drugs such as buprenorphine or naltrexone are commonly used during detox to alleviate post-acute withdrawal cravings.

Evidence-Based Treatments

After the detox process, people may transition into a residential or outpatient recovery program where they will continue their journey to sobriety.

Treatment options may include:

• individual, family, or group therapy
• medication-assisted treatment (MAT)
• dual diagnosis treatment for co-occurring mental health disorders
• cognitive behavioral therapy (CBT)
• motivational interviewing
• case management and wellness programs
• aftercare services
• intensive outpatient programs (IOP)

Recovery from fentanyl addiction looks different for everyone, but with the right combination of treatment and support, lasting sobriety is possible.