Opiate addicts north of the border are rummaging through dumpsters, hoping to score tiny drug patches containing a narcotic called Fentanyl. If they’re lucky, there’ll be enough of the drug left on the strip to scrape off or suck on, guaranteeing a euphoric high reminiscent off the morphine dial. If they’re really lucky, they won’t die.

But it doesn’t always break that way.

The super-opioid, which is 80 times as potent as morphine and packs hundreds of times the analgesic punch of heroin, has already been responsible for thousands of deaths across the U.S. and Canada. But bad is headed in the direction of worse. Earlier this year, a string of Fentanyl-related deaths in New Hampshire, New Jersey, Rhode Island, and Pennsylvania led the DEA to issue a nationwide alert against the drug, calling it a threat to public safety. The DEA isn’t just worried about the hardcore drug fiends digging through the trash. Fentanyl, in its pill form, is getting into the hands of casual drug users, the kind that’ll pop an OxyContin for fun on a Friday night. It’s lazy experimentation — people just assuming the two are equivalent — that poses a major threat.

Like OxyContin, Fentanyl is legally prescribed as a painkiller, most often to patients undergoing excruciating treatments for cancer. It’s so powerful that patients need to develop a tolerance to the drug, training their bodies to tolerate increasing opiate doses by starting off with Fentanyl’s less potent cousins, morphine and oxycodone. Teaching the body to tolerate Fentanyl’s strength takes time and careful dosage control. Without enough lead time, a dose as small as 0.25 mg is enough to kill an otherwise healthy adult.

The CDC lists Fentanyl as an “incapacitating agent” that’s even more dangerous when mixed with other drugs. The characteristic drowsy, floating feeling that comes from taking the drug comes from a rapid drop in heart rate and dramatically slowed breathing. Add alcohol or other nervous system depressants to the mix and you’ve got a potentially fatal situation not unlike the one that recently killed a young Canadian couple toasting the new home they’d bought for their toddler. Avoiding mixed drug overdoses won’t be easy, especially considering Fentanyl has also been found mixed into street heroin.

Drug enforcement authorities dealt with over 1000 Fentanyl deaths back in 2005, but back then, it was a relatively simple problem to fix: One Mexican laboratory was responsible for most of the available illegal drugs. This time around, however, there are multiple clandestine labs to deal with and the drug is also being stolen from pharmacies, prescribed illegally by physicians and nurses, and distributed by patients.

While authorities figure out how to get Fentanyl off the streets, figuring out how to keep it from killing users — both serious and recreational — is crucial. In an attempt to prevent used patches from being recycled, cities like Windsor, north of the Detroit border, have implemented a “patch-for-patch” program, which offers users the chance to trade in used strips for new ones. Naloxone, a drug that can reverse opioid overdoses if administered in time, has also been made available over-the-counter in some states in an attempt to limit the death toll.

But Fentanyl, deadly as it is, is just part of the illegal opioid buffet responsible for killing 100 Americans daily. It’s a horrifying drug but it might also represent a sort of horrifying cure. It is forcing policymakers and medical professionals to act.


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