What Does Fentanyl Look Like?
In This Article
What is Fentanyl?
Fentanyl is a synthetic opioid used to treat extreme and chronic pain. It is 50 times more potent than heroin and 100 times stronger than morphine.
Fentanyl is available by prescription as a Schedule II drug. Its use must be closely monitored due to its high potential for addiction.1, 2, 3, 4
Fentanyl can be produced illegally for a low cost. Drug dealers are able to mix it with other prescription opioids or illicit drugs to maximize profits.
However, people taking drugs who are unaware that the drug has fentanyl, may accidentally overdose due to the unexpected potency.
In the U.S., fentanyl and other synthetic opioids are the most common drugs associated with overdose deaths. In 2017, fentanyl caused 59.8 percent of opioid-related deaths.2, 3
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What Does Fentanyl Look Like?
Pharmaceutical fentanyl is available as injectables, skin patches, nasal sprays, or milky-colored lozenges.1, 3
Illicitly manufactured fentanyl can be in powder or tablet form.
Fentanyl powder is placed on blotter paper, nasal sprays, or eye droppers. Color varies from off-white to light brown, similar to other illicit drugs like heroin and cocaine.2, 3
Fentanyl can also be found in counterfeit pills that look like real prescription opioids.3, 4, 5
What Does Fentanyl Taste and Smell Like?
Fentanyl has no distinctive taste or smell, making it difficult to identify.2
Effects & Dangers of Fentanyl
Like other opioids, fentanyl binds to opioid receptors in the brain. These receptors regulate pain and people may experience:
- Relief from pain
Not all effects of fentanyl are desirable. People taking fentanyl may also experience adverse effects like:4
- Breathing problems
Because fentanyl is more potent than other opioids, its risk of overdose is also higher.
For comparison, heroin’s lethal dose is 30 mg. For fentanyl, it’s only 3 mg.7
Drug dealers’ practice of mixing fentanyl with other drugs further increases the risk of overdose as people may be unaware that the drug has fentanyl.
Some signs of fentanyl overdose include:
- Slow, weak, or no breathing
- Slow or weak heart rate
- Limp body
- Pale, blue lips and nails
- Cold, clammy skin
- Choking or gurgling sounds
- Small, constricted pupils
When a person’s breathing or heart rate slows or stops, the amount of oxygen that reaches the brain decreases. This can lead to coma, permanent brain damage, or death.2
Frequent use of fentanyl causes the brain to adapt to the drug. A person taking fentanyl can experience withdrawal symptoms when the drug is stopped. This is known as dependence.
Severe withdrawal symptoms include:
- Muscle and bone pain
- Uncontrollable leg movements
- Cold flashes and goosebumps
- Sleep problems
- Severe cravings
People will often continue using fentanyl to avoid uncomfortable symptoms. This is why some find it hard to quit.3, 4
Treating Fentanyl Overdose
Call 911 if someone overdoses on fentanyl.
Naloxone is a life-saving medication that reverses fentanyl’s effects. It’s available as an injectable or a nasal spray.
Administer naloxone while waiting for help. Multiple doses may be needed due to fentanyl’s high potency.
After administering naloxone, it is important to monitor the person for two more hours to ensure their breathing doesn’t slow down or stop.3
Treating Fentanyl Addiction
Treating fentanyl addiction is similar to that of other opioid addictions. Treatment approaches include:3
- Medications: Buprenorphine and methadone bind to opioid receptors to reduce fentanyl cravings and withdrawal symptoms. Naltrexone blocks opioid receptors to prevent fentanyl from taking effect.
- Counseling: Methods include cognitive behavioral therapy (CBT), contingency management, and motivational interviewing. These approaches are proven to be effective, especially when combined with medications.
How to Avoid Ingesting Fentanyl
Fentanyl has no specific color, taste, or smell. This makes detection difficult, especially when mixed with or substituted for other drugs.
To avoid accidental ingestion of fentanyl, do the following:
Check the Appearance
Fentanyl powder can easily be mistaken for other drugs like heroin and cocaine.
However, when fentanyl is mixed with other powders, it tends to create an off-brown color. This can help identify drugs laced with fentanyl, but it is not reliable.
Pills containing fentanyl are also sold as fake prescription opioids. To check whether your medication is real, look for any unusual color, texture, or numbering. Remember, counterfeit pressed pills and capsules may look like prescription drugs.
Use a Fentanyl Test Strip
Fentanyl test strips are the safest and most reliable way to check for the presence of drug.2
To use a fentanyl test strip, follow these steps:
- Mix the crushed pill or powder with water
- Dip the strip into the solution for 15 seconds
- Wait up to 5 minutes
- Read the results (one red line means the drug has fentanyl, two lines means it doesn’t)
Overdose Prevention Tips
The safest way to avoid fentanyl overdose is to avoid using the substance at all.
Although the risk of fatal overdose remains, people can implement the following harm reduction measures:
- Use less of the substance
- Go slow
- Do not use alone
- Have naloxone available
Call to find out how much your insurance will cover
- Stanley, Theodore. “The Fentanyl Story.” The Journal of Pain vol 15, 12 : 1215-1226.
- “Fentanyl Facts.” Centers for Disease Control and Prevention, 2 Nov., 2021.
- “What is Fentanyl?” National Institute on Drug Abuse, Jun. 2021.
- “Drug Fact Sheet: Fentanyl.” Drug Enforcement Administration, Apr. 2020.
- Ostrov, Barbara Feder. “Counterfeit Opioid Poisonings Spread To Bay Area.” California Healthline, 27 Apr., 2016.
- Ciccarone, Daniel, Jeff Ondocsin, and Sarah Mars. “Heroin uncertainties: Exploring users' perceptions of fentanyl-adulterated and -substituted 'heroin'.” The International Journal on Drug Policy vol. 46 : 146-155.
- Bond, Allison. “Why fentanyl is deadlier than heroin, in a single photo.” STAT, 29 Sept., 2016.