Condition Basics

What is fentanyl?

Fentanyl is a powerful pain medicine made in a lab (synthetic opioid). Doctors may prescribe it to treat severe pain. Illegal fentanyl is often mixed into street drugs like heroin, cocaine, and meth. Or it may be added to fake pills made to look like prescription medicines.

Fentanyl is up to 50 times stronger than heroin and up to 100 times stronger than morphine. This means that even a small amount can lead to an overdose or poisoning, which could be deadly. Illegal fentanyl has added to the rise in poisoning deaths in Canada.

Unregulated fentanyl often comes as a powder or pressed into a pill. It can also be a liquid. A poisoning can occur if you swallow, snort, smoke, bump, or inject fentanyl. You can’t get a drug poisoning just by touching fentanyl.

Why is fentanyl so dangerous?

Fentanyl is fast-acting and very strong. It's also fairly cheap and easy to make. That's why it's often used as a filler in fake prescription pills or street drugs. If you use street drugs or fake pills, you may take fentanyl without knowing it. This could quickly lead to a deadly poisoning.

What are the signs of fentanyl poisoning?

A person who has been poisoned by fentanyl may be very sleepy or pass out (lose consciousness). You may notice other signs such as:

• Slow or shallow breathing, or not breathing.
• Very small (pinpoint) pupils in their eyes.
• Gurgling or choking noises.
• Cold, clammy skin.
• Blue or purple lips and nails.
• A limp body.
• A slow or weak pulse.

A fentanyl poisoning is an emergency. Call for help right away.

What can you do if someone has fentanyl poisoning?

• Check for a response: Speak loudly. Rub your fist hard on the middle of their chest. If no response, call for help. Stay with the person until help arrives.
• Check for breathing. Perform rescue breathing as needed.
• Call 911 or other emergency services right away.
• If you have naloxone, give it as quickly as possible. This medicine can reverse the effects of a poisoning if it's given soon enough after the poisoning. Follow the instructions that come with the medicine. You may need to give a second dose. (You can give naloxone even if you're not sure the person has a fentanyl poisoning. It won't hurt them.)
• If you need to leave the person at any time, or they start breathing again, place the person on their side. This can help prevent choking.

How can you help prevent a poisoning?

If you or someone you're close to uses opioids or street drugs, these ideas may help protect them.

• Know the signs of a poisoning and act fast. For example, a person who is experiencing a poisoning will often be very sleepy and breathe slowly. The pupils of their eyes may be very small. They may pass out or stop breathing. Quick action could save a life.
• Always have a naloxone kit on hand. Naloxone can reverse a fentanyl poisoning if it's given soon enough.
  • You can get a naloxone kit without a prescription at most drugstores or through a community-based Naloxone program.
  • Make sure that others know that you have a kit and that they know how to use it. For instructions go to: Naloxone Kit Instruction Insert.
• Be careful about the medicines you take. Only take medicines that were prescribed for you and that come from licensed pharmacies. Avoid pills sold through social media or apps. Products sold online as medicines like Adderall, OxyContin, or Xanax are often fakes. And many are tainted with fentanyl.
• If you use drugs, take extra care to stay safe.
  • Try not to use alone. If you do use alone, ask someone to check on you.
  • If you're using in a group, take turns. Get one person to stay alert and have naloxone on hand.
  • Go to a supervised consumption service. This is a place where you can safely use drugs in the presence of trained medical staff. Go to Supervised consumption sites to find a site near you.
  • Be cautious. Use smaller amounts, and take more time between doses. And be extra careful if you're using in a new setting, a new batch of drugs, or from a new supplier.
  • Do your best not to combine substances. This includes alcohol, opioids, non-opioid sedatives (sleeping pills), and stimulants. Combining substances can increase your risk of poisoning.
  • Test drugs before you use them if you can. You may be able to test your drugs through an outreach agency depending on where you are in Alberta. There are test strips that can find fentanyl in a small sample of a drug. Some clinics, drugstores, and outreach programs provide these test strips for free. You may also be able to buy them. These testing strips are not approved or tested by Health Canada. No test is completely effective at detecting all potentially dangerous substances in unregulated drugs.

5 Things to Know About Fentanyl, video

How and When to Give Naloxone, video