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Fentanyl & Fentanyl Analogs: Worsening the Opioid Epidemic

April 26, 2021
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fentanyl, fentanyl analogs

The United States has been struggling with an opioid epidemic that has been increasing in severity for several decades. According to the CDC, over 70% of the drug overdose deaths in 2019 involved an opioid of some kind.

Fentanyl is an opioid that is prescribed as a pain medication for intense chronic pain. However, illicitly manufactured fentanyl has been increasingly circulating in the US. This has led to an increase in recreational fentanyl abuse and overdoses.

But what exactly is fentanyl? And what can be done to overcome this crisis?

What Is Fentanyl?

Fentanyl is a synthetic opioid and is legally produced and prescribed in order to treat severe pain. It typically comes in the form of transdermal patches when prescribed by a doctor.

Fentanyl is about 50 times stronger than heroin and about 100 times more potent than morphine. Fentanyl analogs, structurally related to but different from fentanyl, can be up to 10,000 times stronger than morphine.

Because of its strength and ability to be transported easier than heroin, it is often mixed with heroin to create a stronger, more desirable product for addicts. Though, these opioid users are not always aware that the substance they are using contains fentanyl.

With this trend, fentanyl analogs have also made their way into street drugs marketed as heroin. They have been detected in a number of overdose autopsies across the country.

Below are a few of the most commonly detected fentanyl analogs.


This analog of fentanyl is 10,000 times as potent as morphine, 5,000 times as potent as heroin, and 100 times as potent as fentanyl.

Carfentanil was first sold as an ingredient in a tranquilizing agent for large mammals like elephants and elk in 1986.

This analog was responsible for approximately 350 overdose deaths in the state of Ohio as of 2016. Additional data points to carfentanil behind overdose deaths in a number of other states, including New Hampshire and Kentucky.

Furanyl Fentanyl

Roughly one-fifth of the potency of fentanyl, furanyl fentanyl is sold as a designer opioid drug.

There has been an increase in deaths in the last several years that are due to the presence of this analog. Sold on the black market, it is reported that the presence of furanyl fentanyl has been detected in crack cocaine and other illicit drugs.

Acetyl Fentanyl

This analog is about 15 times more potent than morphine. Acetyl fentanyl was responsible for 14 overdose deaths in the state of Rhode Island in the spring of 2013. There were also five overdoses in one county in Pennsylvania that involved this fentanyl analog.

The Fentanyl Crisis: Deaths Involving Synthetic Opioids Are on the Rise

Between 2018 and 2019, there was a 16% increase in overdose deaths that involved synthetic opioids other than methadone. These overdoses have included both fentanyl and fentanyl analogs.

Synthetic opioid-related overdose deaths were almost 12 times higher in 2019 than they were in 2013. During 2019 alone, there were more than 36,000 overdose deaths that involved synthetic opioids.

It is too early to have complete data on the 2020 synthetic opioid overdose deaths. However, provisional overdose data suggests that, during the COVID 19 pandemic, there was an acceleration of overdose deaths.

Across the country, many counties are struggling with a rise in opioid-related deaths. You can read our article on the fentanyl crisis in Sonoma County here.

What Can Be Done About the Fentanyl Epidemic?

One of the terrifying aspects of the fentanyl epidemic is that it is often added to other illicit drugs without the knowledge of the user.

Fentanyl and its analogs are incredibly potent. This means that people can unknowingly take a very high dose of this drug when they expect it to be another popular street drug, such as cocaine or heroin.

According to the CDC, there are a number of steps that are necessary to fight this epidemic.

Since there has been such an increase in overdose deaths that involve synthetic opioids in the last several years, it’s important that people who are most at risk have access to care. Additionally, it is necessary to expand both response activities and prevention activities.

A Health Alert Network (HAN) Advisory was issued to public health professionals and medical professionals, as well as harm reduction organizations, first responders, and other community partners.

In this advisory, they recommended a number of steps:

1. Expand access to treatment, availability of treatment, and awareness of treatment for substance use disorders
2. Expand the distribution of overdose prevention education as well as naloxone
3. Improve detection of outbreaks of overdoses in order to respond more effectively
4. Practice early intervention with individuals who are at high risk for opioid overdose

The CDC states that there have been three waves of opioid overdose deaths in the United States between 1999 and 2019.

The first resulted from the increasing rate at which prescription opioids were leading to overdose deaths beginning around 1999.

The second occurred when the number of heroin overdose deaths began increasing around 2010.

The third wave is where the crisis currently stands. Starting around 2013, there was a notable rise in deaths due to synthetic opioids.

Today in 2021, the risk that other illegal drugs are contaminated with fentanyl is a growing concern. This drug can be mixed with counterfeit opioid pills, cocaine, methamphetamine, and heroin. It is likely that the rise in illicitly manufactured fentanyl is contributing to the deaths that involved these other substances as well.

Are You Suffering From an Opiate Addiction?

Opiate addiction is a disease that ruins lives. While these drugs are highly addictive, it doesn’t mean that you can’t turn your life around.

The fentanyl crisis has exacerbated an already troubling pattern in the US relating to drug overdose deaths. Understanding what fentanyl is as well as its most common analogs is an important step in realizing just what is at risk when you are addicted to opioids.

Are you suffering from opioid addiction, or is someone you love struggling with a substance abuse problem? If so, there is help! Contact us today to start getting the help you need




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