What is fentanyl? Understanding the dangers, uses, and harm reduction

While fentanyl is not as prevalent in Australia as it is in North America, recent trends indicate a troubling rise in both prescribed and illicit use.

What is fentanyl?

Fentanyl is a powerful synthetic opioid that’s been used in medicine for over 50 years to manage severe pain. When used as prescribed fentanyl can assist with managing pain associated with surgery, major trauma, cancer, or nerve damage.

The rise of fentanyl appearing outside of medical settings raises concerns due to its strength and risk of overdose. Especially when users are unaware of its presence within other substances.

Why is fentanyl so dangerous?

Fentanyl is approximately 100 times stronger than morphine and 50 times stronger than heroin. This means that the difference between a dose that alleviates pain and one that causes an overdose is extremely small.

Illegally made fentanyl is also risky as it can be difficult to measure the same amount as the potency can vary batch to batch.

While illicit fentanyl is currently rare in Australia its presence is increasing, often being sold as heroin, counterfeit medications, or contaminating other drugs such as cocaine or MDMA.

What does fentanyl look like?

Pharmaceutical fentanyl comes in a variety of forms including:

• Skin patches
• Losengers
• Sublingual tablets
• Nasal Sprays
• Injections

Illegally made fentanyl is typically a white, grey, or tan powder. This may be sold on its own, mixed in with other substances or found in fake pharmaceutical products like oxycodone.

How fentanyl affects the body

Like other opioids, fentanyl works by attaching to opioid receptors in the brain to block pain and produce feelings of pleasure or euphoria. These effects vary based on a variety of factors including:

• Someone’s size, weight, and overall health
• Whether they are used to opioids
• Whether there are other drugs also being used
• Form and strength of the fentanyl

Common effects include:

• Pain relief and relaxation
• Intense happiness or euphoria
• Drowsiness & confusion
• Nausea, constipation, & vomiting
• Dizziness and impaired coordination
• Slurred speech & slow pulse

Serious risks include:

• Difficulty breathing
• Unconsciousness
• Coma
• Death

If you or someone else shows signs of overdose, call triple zero (000) immediately. Emergency services are there to help and can guide you through what to do.

Reducing the harm of fentanyl

Because of the potency of fentanyl, especially when it’s not prescribed, harm reduction is critical.

Always carry naloxone: a medicine that temporarily reverses the effects of opioids. Harm Reduction Victoria provides free online training on how to respond using naloxone.

Be aware: fentanyl may be hiding in other drugs. Where possible use drug-checking services or fentanyl test strips.

Don’t mix: never mix opioids with other depressants like alcohol, benzodiazepines, or GHB. This can increase the risk of overdose.

Fentanyl addiction and withdrawal

Fentanyl can be highly addictive, especially with long-term or repeated use. Over time users may develop tolerance and dependence.

Withdrawal symptoms can begin within 12 hours of the last dose and may include:

• Chills, sweating, & goosebumps
• Vomiting, diarrhea, & stomach cramps
• Insomnia & irritability
• Muscle pain and general weakness
• Depression & anxiety

If you’re thinking about stopping fentanyl it is advised that you speak with a healthcare professional first, and may be advised to use a detox program.

Whether you’re prescribed fentanyl, using opioids recreationally, or supporting someone who does, staying informed is key. Know the risks, carry naloxone, and access harm reduction services where possible.

Help is available. Please call our friendly and supportive team. Reaching out can make all the difference.