Today on Plain English, we’re talking about fentanyl, the substance that’s stalking the illegal drug market
Lesson summary
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Coming up today: fentanyl is an opioid drug. It can be taken on its own, but it’s most common for it to be mixed into other drugs like heroin or cocaine. And it’s behind an alarming increase in drug overdose deaths in the U.S.
In the second half of the lesson, I’ll show you how to use the phrasal verb “mix in.” And it’s different—slightly different—than the word “mix.” So if you don’t know the difference between “mix” and “mix in,” then stay listening in the second half of the lesson.
Ready? Let’s get started.
Fentanyl: the substance behind the alarming increase in drug overdose deaths
It’s more than car crashes, more than suicides, more even than influenza in a typical year: In 2021, over 100,000 Americans died from drug overdoses, an all-time record . Two-thirds died from opioids, most of them from just one substance: fentanyl.
Fentanyl is a very potent painkiller. In a hospital, physicians can prescribe fentanyl when patients need immediate, powerful pain relief. This might be for cancer patients or for patients recovering from surgery. In its legal form, fentanyl can be administered as a shot, as a patch that goes on your skin, or as a lozenge, like a cough drop.
Illegal fentanyl is different. In the illegal market, fentanyl is a powder that’s mixed into other drugs.
Fentanyl became popular for two reasons: it’s extremely potent and it’s cheap to make. For example, it’s estimated to be about 50 times stronger than heroin and 100 times stronger than morphine. It’s also cheaper to make than heroin, since its ingredients are commonly-available chemicals.
By mixing a little cheap fentanyl into expensive heroin, a supplier could lower costs. And because the effects of heroin and fentanyl are similar, the end consumers often didn’t know that they were taking heroin laced with fentanyl.
Users say fentanyl causes feelings of euphoria, relaxation, and drowsiness. The problem, though, is that while fentanyl feels similar, its effects are not exactly the same. For one thing, the highs it provides don’t last as long. So users of fentanyl will seek out more of the drug more often, like every few hours, making it harder to hold down a job. For another, it’s much more powerful, and more addictive.
If a heroin user gets hooked on a supply with a high concentration of fentanyl, it can be hard or impossible to go back to normal heroin. Withdrawal from fentanyl is similar to withdrawal from heroin: patients experience anxiety, vomiting, chills, pain, and sweating for days. Many fentanyl users have stopped feeling the positive effects of the drug; now they only take it to avoid the withdrawal.
The strategy of mixing fentanyl into heroin was such a success for drug suppliers that they started doing this with other drugs. Fentanyl was later added to cocaine, methamphetamine, and even counterfeit versions of prescription drugs. People buying fake Adderall, fake Xanax, and fake Percocet off the internet and from unregulated sources have unknowingly been taking fentanyl.
And this is not just here or there . In 2017, ten percent of the fake prescription drugs seized by American drug authorities were laced with a potentially lethal dose of fentanyl. In 2022—listen to this—in 2022, sixty percent of seized counterfeit pills contained fentanyl.
In New York City, in 2020, there were 980 cocaine overdose deaths. Eighty-one percent involved fentanyl. This substance is everywhere. But mixing fentanyl into other drugs is a dangerous game: only a few grains of fentanyl can be the difference between a normal dose and a lethal dose.
The drug Naloxone is an effective antidote, which can be used in the case of an overdose. Testing is also an option: users can test their drugs for fentanyl before taking them.
Casual drug users—people who might use cocaine or methamphetamine occasionally on a night out—they’re starting to take notice. It’s now common for partygoers to test their drugs with new fentanyl detection strips before going out for the night.
Scary risks
This is so scary. I mean, people know—or they think they know—the risks of cocaine. They know the risks of taking counterfeit Adderall. But then they take counterfeit Adderall, and it turns out it’s actually laced with fentanyl, and now they’re addicted to a drug 50 times worse than heroin. Sheesh.
I was reading this article about testing strips—and testing strips are illegal in the U.S.
There is some logic to this—but not helpful logic. Cocaine is an illegal drug. So anything used to test the purity of cocaine is classified as illegal drug paraphernalia. That means, it’s something used in association with illegal drugs. Testing strips can save lives if they’re used to detect fentanyl mixed into cocaine. But the testing strips are illegal, so it’s hard for people to get them. And four out of five cocaine overdose deaths in New York were due to fentanyl, which it’s illegal to test for.
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