Fentanyl (fent-in-al) is a synthetic opiate used to manage severe, chronic pain. In medicine, it is administered by sticking a patch to the skin. It can also be found as a fine, white powder. Fentanyl is extremely potent and reports estimate it to be 20-50 times stronger than heroin.

There are many analogues of fentanyl including acrylfentanyl and carfentanyl. Carfentanyl is estimated to be 2000-5000 times stronger than heroin with a lethal dose in the milligram range. In veterinary medicine it is used to tranquillize large mammals but its non-clinical use in humans is extremely risky.

Fentanyl is a quick acting, analgesic (pain relieving) drug which can make you feel calm, relaxed and deeply secure. It also lowers your heart rate and breathing and causes drowsiness. People taking it can feel cut off from physical and emotional pain and may experience a feeling of well-being and euphoria although is reported to be less intense than the effect from heroin. Other effects include nausea, sedation, feeling withdrawn, itching and respiratory depression (reduced/slowed breathing).

As this drug reduces heart rate and breathing, it increase the chances of an overdose. Take care with doses, dose low and go slow. Avoid mixing with other drugs especially other opiates such as heroin, tramadol, methadone and other depressants such as alcohol, GHB and benzodiazepines. It is usually only medically administered to someone who has a tolerance to opiates but even if you do have a tolerance please be extremely careful with doses.

In medicine it can come as a liquid or as a patch. In the illegal drugs market it will normally come as an off-white to light brown powder. It can be smoked by heating on foil and inhaling (chasing/burning).

It can also be injected but this is very risky and only a tiny amount is required to get the desired effect.

Purity often varies making it difficult to judge dose and dependency can happen quickly. Regular users will need larger doses to get the same effect and may begin to experience withdrawal symptoms and cravings.

People who don’t take opiates for a while will have a reduced tolerance and are at a higher risk of overdose.

What you need to know

If you choose to take fentanyl:

– Smoking fentanyl is still risky but reduces the risk of getting blood borne viruses including HIV, hepatitis B and hepatitis C. You may also find it easier to control doses. One or two inhales is normally enough to get the desired effect.
– Avoid sharing equipment – foil and injecting equipment are available from needle exchanges.
– Use scales to measure dose and be aware that only a tiny amount is needed.
– Avoid taking it alone. Make sure you are with other people who have naloxone and can call an ambulance in the case of an overdose.
– If injecting: use the smallest needle possible, rotate your sites, wash injecting sites/ hands and never share equipment!
– Avoid other downers like alcohol, methadone, benzos or sleeping tablets as this will increase your risk of overdose.
– Naloxone can reverse an opiate overdose – speak to your local drug service to find out more. Or visit: http://www.naloxone.org.uk. Be aware that it may take multiple doses of naloxone to reverse a fentanyl overdose.
– Fentanyl test kits can be bought online, but their use does not guarantee safety.
– Fentanyl has been found cut into other drugs such as heroin and cocaine. Even if you have taken the drug before and buy it from the same source, always take a test dose first i.e. a matchstick head size, and wait to see what the effects are. If the effects are different to what you expect then avoid taking more.