Fentanyls

• Fentanyl is a synthetic opioid which acts as an analgesic. The drug is similar to morphine; however, it is 50 to 100 times more potent. Prescription/medical Fentanyl comes in patches, pills, tablets, lozenges, injectable solution.
• Many similar drugs (analogues) of fentanyl have been developed both legitimately for use in medicine and other ones illicitly for use as street drugs. These are commonly referred to as fentanyls. The potency of the various fentanyls varies considerably and can be much higher than that of fentanyl.
• Illegally made fentanyls are sold in power form, impregnated in blotting paper, as tablets and has been found as an adulterant in a number of street drugs. This has led to a huge increase in overdose deaths in the U.S and Canada, although at present fentanyl as either a street drug of choice or as an adulterant in heroin is relatively rare in the UK.

Desired Effects:

• Intense high
• Euphoria
• Relaxation
• Pain relief

Side Effects:

• Drowsiness
• Confusion
• Sedation
• Sweating
• Itching
• Nausea

• Don’t use alone.
• Always have naloxone available. Fentanyl is an opioid. Naloxone reverses the effect of an opioid overdose.
• Use slow/less. Because fentanyl is so strong, a little goes a long way (compared to heroin!) and overdoses can occur quickly, sometimes before you’ve finished injecting the dose.
• Try snorting or smoking instead of injecting. Injecting carries the highest risk for overdose, so shifting to snorting or smoking may help reduce risk. You can still OD by smoking/ snorting, especially with fentanyl, so start slow.

• Use a test strip on your heroin or other street drugs (these are available from drug services).
• Don’t use alone.
• Always have naloxone with you. You may need more naloxone to recover from a fentanyl overdose than you would from heroin.
• Smoke a small amount on foil before attempting to inject. You are less likely to die from smoking adulterated heroin because you would usually fall unconscious before inhaling a lethal amount.
• If you’re injecting, start with a dose that is a quarter of what you usually use.
• Don’t ‘slam’ your hit. Depress the plunger slowly, pausing to allow the familiar dose to take effect. If you feel it is unusually strong or sedating, pull it out.
• Be aware of the signs of overdose and make sure anyone you live with or use with knows them too. In case of emergency, use naloxone and ring for an ambulance.

Long term risks:

Short term risks:

• Injecting related injuries and infections (Hepatitis B, C and HIV, septicaemia).
• Overdose: Fentanyls are more likely to lead to overdose death than heroin.