Fentanyl and the danger of buying and taking street drugs

Brittany Peters, MD

Psychiatry

Street versions of drugs such as Ativan, Xanax and Adderall are easy to find online, but these (and other) illegal drugs are causing an increasing number of overdoses and deaths. Psychiatrist Brittany Peters, MD, explained why substances like fentanyl make it even more dangerous to buy and use illicit drugs, whether they’re bought online or on the street.

What are some of the most common illicit drugs causing overdoses?

According to the Centers for Disease Control and Prevention (CDC), overdoses are caused by a variety of drugs and combinations of drugs. Some of the more common include:

• Cocaine – A stimulant that is involved in nearly 1 in 5 overdose deaths.
• Psychostimulants – These include illegal drugs such as methamphetamines and ecstasy, as well as prescription drugs such as those used to treat ADHD and depression.
• Marijuana – Dried flowers and leaves of the cannabis plant.
• Fentanyl – A man-made opioid (pain killer) that is 50 times more potent than heroin and 100 times more potent than morphine.

“There are also newer substances, which we call ‘designer drugs,’ that are similar to opioids or sedatives such as Ativan and Xanax, but they’re not what you would get at the pharmacy,” Dr. Peters said. These ‘designer drugs’ are manufactured illegally and then are often added into other drugs, so you believe you are purchasing a specific drug but in truth, you don’t really know what you’re getting.”

Often these drugs are contaminated with fentanyl, leading to an increase in overdoses and death.

What exactly is fentanyl and why is it deadly?

Fentanyl is a pain medication typically prescribed after surgery or for advanced stage cancer. However, illicitly manufactured fentanyl is being added into other illegal drugs because it makes those drugs more powerful and cheaper. These drugs can be deadly, even in small doses. It’s also hard to detect.

“Fentanyl is a tricky drug, in terms of drugs found on the streets, because it’s one that folks will change into a different kind of substance,” Dr. Peters explained. “‘Designer fentanyl’ is sort of like fentanyl but not exactly, which makes it hard to pick up on. Some people try to detect it in their drugs using special test strips. They think the drug is safe because they used a fentanyl test strip and didn’t find any fentanyl in the drug. However, these designer fentanyl pills are not detected by those test strips.”

Every day, more than 150 people die from overdoses related to fentanyl.

How can you tell if someone is overdosing on fentanyl and what should you do?

According to the CDC, signs of overdose include:

• Small “pinpoint” pupils
• Losing consciousness
• Slow, weak or no breathing
• Choking or gurgling sounds
• Limp body
• Cold or clammy skin
• Discolored skin, especially the lips and nails

If you think someone is overdosing, call 911 immediately, try to keep the person awake and breathing, lay them on their side to prevent choking, and stay with them until emergency assistance arrives.

If you have it, administer Narcan (naloxone), a safe medicine that can reverse an overdose from opioids such as fentanyl.