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What Is It?

Fentanyl is an opioid drug. It is a depressant that slows your body and mind. 

Some opioids – like heroin – are made directly from certain poppy plants, but synthetic opioids like fentanyl and similar drugs (e.g. carfentanil) are created in a lab by scientists and can be hundreds of times more powerful than other opioids or the drugs they are meant to be replacing. These are very strong and addictive drugs – a few grains of fentanyl can be enough to kill you. 

Fentanyl can be prescribed by doctors in pill, patch, or injection form for severe pain relief when necessary – for example in palliative or end-of-life cancer care. When taken as prescribed, opioids are useful pain relievers. These drugs can be very addictive and should be handled with care and safely stored. Carfentanil is used by veterinarians for very large animals like elephants – it is approximately 100 times more toxic than fentanyl and 10,000 times more toxic than morphine.

Fentanyl and similar drugs are available illegally on the streets in many forms and can be unknowingly mixed in with other illicit drugs. Fentanyl can go by many other names such as Apache, China girl, China town, China white, murder 8, jackpot, poison, TNT, tango and cash.

WARNING: Buyer Beware! Opioids sold on the streets (including in the NWT) can be a very dangerous mixture of more potent and potentially lethal opioids like carfentanil and other additives (e.g. benzodiazepines – which Naloxone does not work against in an overdose).

What Does It Look Like?

Fentanyl and similar drugs can take on many different forms. It is typically sold illegally as a powder or a pill, or is cut into (mixed with) drugs such as heroin or cocaine. It is often sold as another substance, so people might end up using it without realizing. Many accidental overdoses or drug poisonings have occurred because people did not know that what they were taking was contaminated with fentanyl and similar drugs.

WARNING: Buyer Beware! Street drugs can also look like prescription medication (ex. Percocet® or Oxycodone). Never take prescription drugs that have not been provided by a physician or pharmacist.

How Does It Work?

Fentanyl and similar drugs (e.g. carfentanil) work as extremely powerful and dangerous depressants. They slow your brain, heart, and respiratory systems down. They can block how your body processes pain, which makes them powerful painkillers. 

Why Is It Dangerous?

Fentanyl and similar drugs are addictive drugs that can have widespread effects on a person's life including physical, mental, and social harms. 

These are extremely powerful drugs that can easily cause a fatal overdose. They slow breathing and heart rate so much that a person may pass out and not get enough oxygen to their brain or body, and eventually die. 

These drugs may also cause: 

• Constipation
• Nausea and vomiting
• Confusion
• Inability to react or respond to danger
• Unconsciousness

Because people using illicit fentanyl do not know the actual strength of the drug or its true contents, they are at a high risk of overdose or death. Many other drugs are now being contaminated with fentanyl and carfentanil, which increases the danger of using illicit substances, since people are not aware of their presence or how much of these powerful and potentially deadly substances may be in their drugs. 

If a person tries to stop using opioids suddenly, they can be at high risk for relapse and overdose due to changes in tolerance. Avoid quitting “cold turkey” – talk to a health care provider about it first. 

What Does Opioid Toxicity Look Like?

Fentanyl is an opioid – signs of opioid overdose may include:  

• Slow, shallow breathing or no breathing
• Not moving and can’t be woken
• Blue lips and nails
• Person may be choking, making gurgling sounds, or snoring
• Cold, clammy skin
• Tiny pupils

If you suspect someone may have overdosed on opioids call 9-1-1 immediately and give Naloxone!  The Good Samaritan Drug Overdose Act protects you from drug possession charges when helping in an overdose situation.  

Learn more about how to respond to an opioid overdose:

• Responding to an opioid overdose
• Opioid overdose prevention
• Get a free Naloxone Kit, which can help save someone’s life during an Opioid overdose by temporarily reversing the effects 

Safer Use

If you are taking opioids that have been prescribed to you by a health care provider: 

• Only trust medicine that comes from the pharmacy directly. Pills can look like they are prescription, but they may be counterfeit.
• Store medications in a locked cabinet away from children, friends, and visitors. 
• Keep track of how much medicine is in the container. 
• Safely dispose of any leftover opioids as soon as you no longer need them by returning them to your pharmacy. Do not flush or throw your medication in the garbage.

There is no safe way to use fentanyl that is not prescribed to you. If you are using illicit fentanyl or similar drugs, here are some tips to decrease your risk: 

• Start low and go slow. Start with a “tester dose” and wait before taking more. Be aware that pausing or reducing use, even for a few days, can significantly lower tolerance – starting low and going slow can decrease the risk of a fatal overdose.
• Don’t use alone. If you are using alone, call NORS -- the National Overdose Response Service Hotline, at 1-888-688-NORS (6677) so you can get help if you need it.
• Don’t mix with other substances, including alcohol and prescription or over the counter medications. 
• Don’t share equipment! Sharing drug equipment like needles, pipes or spoons, increases risk of infection. Contaminated equipment can spread several serious diseases, such as HIV, hepatitis B, and hepatitis C.
• If smoking from a pipe, don’t use steel wool or Brillo as a filter. Use brass screens instead.
• Stay hydrated. Drink water and use lip balm. 
• Know the signs of an opioid overdose and act! Stay within cell range or have access to a satellite phone in case you need to call 9-1-1. Always carry Naloxone with you and know how to use it. Kits are available for free at locations across the NWT – make sure your kit doesn’t freeze! Find out about opioid overdose prevention here. 
• Take a photo of the drug before you use it. If you end up getting sick, this can help keep other people safe and makes it easier to help you.

See Safer Partying Tips for more tips and information. 

Need Help?

Help is always available. Reach out to your local health centre, community counsellor/mental health professional, or call 8-1-1. Visit Getting Help for more information.