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Fentanyl: RX for a Deadly Overdose

The DEA reported that hundreds of thousands of counterfeit prescription pills cut with fentanyl have already infiltrated the United States drug market and the problem is anticipated to get worse. These counterfeit pills are manufactured with pharmacy-grade machines that make them nearly indistinguishable from the real thing. First synthesized in 1959, fentanyl is a powerful opioid analgesic that can be lethal in very small doses. It’s similar to morphine but is up to 50-to-100 times more powerful. Due to its potency, even a few extra grains of fentanyl can mean the difference between life or death.

What Is Fentanyl?

The drug is used to treat patients with severe pain or to manage their pain after surgery. In some cases, it’s prescribed for chronic pain to patients who have become physically tolerant to other opioids. Some prescription medications that contain fentanyl are Actiq, Duragesic and Sublimaze [1]
A graphic detailing fentanyl's status as a schedule 2 drug. According to the United States Controlled Substance Act, fentanyl is a schedule II prescription drug, meaning it has high potential for abuse and has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Its classification also states that fentanyl abuse may lead to severe psychological or physical dependence. [2]


A professional can sometimes recognize whether a pill is counterfeit due to its markings, but in most cases, pills that are suspected to be counterfeit must be tested in a laboratory to be able to tell the difference.

Pick Your Poison

4.3 million people in the United States admitted to using to have used painkillers for non-medical purposes in 2014, and that number has only grown. According to the Centers for Disease Control and Prevention, approximately 80 people died every day in 2014 from opioid overdoses, with fentanyl playing a large role in those deaths.


Another surge in fentanyl use took place in the Midwest in 2006. The drug was mixed with heroin to create a more potent high, which resulted in more than 1,000 deaths by overdose. Most of those overdoses were accounted for by heroin users who were unfamiliar with fentanyl and weren’t even aware that they were putting it into their bodies. Aside from the Midwest, the Northeast was also a heavily affected area during that time, particularly states such as Delaware, Massachusetts and Rhode Island. [3]
A picture of a skull and crossbones


Due to the high potency and low price of fentanyl, the drug has been making its way into a wide variety of knockoff prescription pills such as the anxiety medication Xanax and the painkiller Norco. Between January and April of 2016, there were 19 deadly overdoses from pills laced with fentanyl, nine in Florida from counterfeit Xanax pills and 10 in Sacramento, CA from counterfeit Norco pills. Some other variations of fentanyl-laced pills are marketed as knockoff Oxycodone, a powerful painkiller, but nowhere near as powerful as fentanyl, resulting in further overdoses.


Many customers of the illegal drug trade do not participate in it by choice but rather by necessity. In an attempt to crackdown on high opioid use across the country, which often leads to addiction followed by illegal opioid use, the government has set strict federal regulations on the prescribing of powerful painkillers. Tragically, these regulations are too austere and often prevent patients who have a justified claim to refill their prescriptions from doing so. This only provides the counterfeit prescription pill market with more customers, achieving the opposite of the government’s intended effect.


Even worse, the counterfeit pills sold on the street vastly differ from the pharmaceutical grade pills that legitimate patients are accustomed to, which only serves to exacerbate the fentanyl-induced public health crisis.

Vicious Cycle

Due to the nature of the illegal drug market, dealers will put anything in their pills to increase their profit margins. Unfortunately, this almost always results in counterfeit pills being even more dangerous to those who take them.


A chart detailing the different profit margins between selling heroin or fentanyl. In many cases, buyers are not aware that the pills they are taking are laced with fentanyl. Even if they were aware, many might choose to continue taking them due to there being no other recourse to deal with their severe, chronic pain. Additionally, fentanyl can be absorbed through the skin, meaning that many people are not only unwittingly dosing themselves with fentanyl, they are also doing so unwillingly.


Fentanyl’s potency as a painkiller makes it very cheap so its illegal sale is extremely profitable. The DEA estimates that 666,666 pills can be made per kilogram, and that the counterfeit pills are being sold for $10 or $20 a pop. Do the math – these kind of profits are irresistible to those with the means to manufacture fentanyl-laced pills, which is a huge factor to fentanyl popping up in all types of counterfeit prescription medication. [3]


The profit margin for selling fentanyl is significantly higher than that of heroin. Due to the strength of fentanyl, drug dealers can make between $1-2 million from a single kilogram of fentanyl whereas they only make about $80,000 from a kilogram of heroin. [4]

Help Is Available

If you or someone you know is currently having trouble with prescription pills, counterfeit or otherwise, consider seeking help. Fentanyl is an extremely dangerous drug and its manufacturers have zero qualms about selling deadly pills laced with fentanyl to their unsuspecting customers. The fentanyl crisis in the United States is going to get worse before it gets better so now is the best time to seek help.


Behavioral Health Centers is a recovery center located in North Palm Beach, FL that specializes in treatment for all types of addiction as well as mental health issues. The professionals at Behavioral Health Centers are available to help you or your loved ones through what could become a deadly habit if left unchecked. Please call us today at 772-774-3872.


  1. https://www.drugabuse.gov/drugs-abuse/fentanyl
  2. https://en.wikipedia.org/wiki/List_of_Schedule_II_drugs_(US)
  3. https://www.theguardian.com/us-news/2016/jul/24/counterfeit-prescription-pills-laced-deadly-opioid-fentanyl
  4. https://www.painnewsnetwork.org/stories/2016/6/23/us-inundated-with-fake-fentanyl-pills
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