Fentanyl is a synthetic (man-made) opioid that is 50-100 times more potent than morphine. It can cause extreme happiness, drowsiness, nausea, confusion, constipation, sedation, problems breathing, unconsciousness, and even death, especially in high doses or when mixed with other substances. There is no “safe” dose of illicit/illegal Fentanyl as it is completely unregulated.

Medical Fentanyl is prescribed by doctors for (extreme) pain management, typically in controlled environments like hospitals. Illegal/illicit Fentanyl is manufactured in unregulated settings (like someone’s basement or garage), leading to varying strengths and increased risk of overdose. Illegal Fentanyl is entirely inconsistent and tiny, undetectable amounts can kill.

Medical grade/prescription fentanyl comes in multiple forms and brand names. They include: Actiq - Typically used for cancer patients in the form of lozenges/lollipops; Duragesic - Fentanyl patches applied to the skin; Fentora - used when cancer patients become resistant to other pain relievers, and prescribed as a small dissolvable pill. Lazanda - a nasal spray for cancer patients who experience extreme pain that comes and goes. Onsolis - For cancer pain, Onsolis is a dissolvable film that sticks to the side of your cheek and melts away in 30 minutes. Sublimaze - an IV or shot prescribed after surgery. Subsys - used for cancer patients who have become resistant to other pain relievers, Subsys is a liquid sprayed under the tongue.

Names for street Fentanyl include Apache, China Girl, China White, Dance Fever, Fenty, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango & Cash. It’s important to remember that Fentanyl is often used to cut other drugs or disguised to look like other drugs such as prescription pills (examples: Percocet, Oxycodone, Xanax, and Adderall), methamphetamine, cocaine, and heroin can be found in virtually any illicit drug.

Legally, Fentanyl is produced through complex chemical synthesis by pharmaceutical companies, in safe, controlled, regulated environments. Illegally, it can be synthesized in secret “labs” such as someone’s basement, garage or kitchen, resulting in unpredictable and very dangerous products.

Pharmaceutical Fentanyl can come as patches, lozenges, pills, or injections. Illicit Fentanyl is usually found as a fine white to off-white powder, which can be mistaken for and easily mixed into or passed off for other drugs like cocaine or heroin. It’s important to remember that Fentanyl is often used to cut other drugs or disguised to look like other drugs such as prescription pills (examples: Percocet, ,Oxycodone, Xanax, and Adderall), methamphetamine, cocaine, heroin, and can be found in virtually any illicit drug. It is undetectable in those forms; you can’t see, taste, or smell it and tiny amounts are deadly.

Fentanyl is highly potent because it binds very strongly to the body's opioid receptors, which are involved in pain relief, pleasure, and control of reward and addiction pathways. A lethal amount will cause a user to stop breathing.

Fentanyl is extremely dangerous due to its high potency, in tiny, undetectable amounts, often resulting in accidental overdose/drug poisoning, especially when mixed with other drugs and the user doesn’t know they are taking it.

Availability issues may stem from a lack of awareness, funding, or regulatory barriers. However, many regions are working to increase accessibility due to the rise in opioid overdoses.

Most people are unaware they are taking Fentanyl when it's mixed with other drugs. Some may use it for its powerful opioid effects, seeking relief from pain or pursuing a high. Addiction also plays a significant role.

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