What is fentanyl and how can you recognize it?

(KRON) — Even though the Covid-19 pandemic has subsided, the fentanyl pandemic rages on in the Bay Area.

The synthetic drug, 50 times stronger than heroin and 100 times stronger than morphine, is often mixed into other drugs to make them cheaper, stronger and more addictive, and then sold on the street. And it has become more and more prevalent.

In 2022, the leading cause of drug overdose in San Francisco was fentanyl with a total of 456 deaths, according to data collected by KRON4. In second was meth, with a total of 355.

KRON4’s statistics from 2021 show:

San Mateo County: 84 opioid overdoses in 2021
Santa Clara County: 154 opioid overdoses in 2021
Alameda County: 203 opioid overdoses in 2021
Contra Costa County: 183 opioid overdoses in 2021
Marin County: 47 opioid overdoses in 2021
Napa County: 14 opioid overdoses in 2021
Sonoma County: 122 opioid overdoses in 2021
Solano County: 58 opioid overdoses in 2021

In California, there were 7,175 opioid overdoses in 2021, 5,961 of which were related specifically related to fentanyl, data showed.

San Francisco Supervisor Matt Dorsey said just in San Francisco, police officers seized enough fentanyl to kill every adult in California, when he proposed legislation that would exclude undocumented immigrants who have been arrested for dealing fentanyl from the city’s sanctuary city policy.

Over 21 pounds of fentanyl and $28,000 in cash were recovered by SFFD officers on Feb. 1, 2023 after serving a search warrant at two Oakland residences (San Francisco Police Department).

So, what is fentanyl?

There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl.

Both are synthetic opioids. But one, pharmaceutical fentanyl, is used in hospitals to treat pain and prescribed by doctors. The other–illicitly manufactured fentanyl–is what street drugs are being laced with.

Fentanyl affects the brain by binding to opioid receptors found in areas that regulate pain and emotion. The more times it has been taken, the more the brain adapts to the drug, making its effects less potent and becoming very addictive since the brain has a harder time finding pleasure anywhere else but the drug. It can also impede a person’s reaction to pain, which is why it is sometimes used to treat chronic or severe pain, especially after surgery, when prescribed by doctors.

Fentanyl use can cause extreme happiness, drowsiness, nausea, confusion, constipation, sedation, problems breathing and/or unconsciousness.

Even a small amount can increase the likelihood of fatal overdose.

A fatal dose of fentanyl compared with a penny. (California Department of Public Health)

And how can you recognize it?

Pharmaceutical fentanyl usually goes by names including Actiq^®, Duragesic^® and Sublimaze^® when prescribed by a doctor. It can be prescribed by a healthcare professional as a shot, a patch that is put on a person’s skin or as lozenges that are sucked like cough drops.

Illicitly manufactured fentanyl has been found in many drugs including heroin, methamphetamine, counterfeit pills and cocaine. It can also be found in liquid forms like nasal sprays or eye drops, and forms resembling candy or sidewalk chalk called “rainbow” fentanyl.

It is nearly impossible to tell if a street drug has been laced with fentanyl without testing specifically for it. But you can purchase test strips which can give results in about five minutes. Results should be taken with caution as one portion of the drug sample may not contain fentanyl while another portion of the sample may.

Street names for illicitly manufactured fentanyl include: