China White. Dance Fever. Goodfella. Tango and Cash.
Have you heard these names?
No, we’re not talking Hollywood blockbusters.
These are street names for fentanyl, an incredibly powerful drug that’s growing in popularity for its intense, short-lived highs.
Even tiny amounts of the drug — equivalent to a few grains of salt — can be lethal. According to a fascinating documentary project from Fusion titled “Death by Fentanyl,” an amount the size of three grains of sugar can kill an adult. It’s changing the face of America’s drug problem, and it’s changing the ways that police are dealing with it.
As with other opioid drugs, it’s used in hospitals to treat chronic pain or to manage post-surgery pain.
Like heroin and morphine, fentanyl binds to the body’s opioid receptors, which are located in the brain’s pain- and emotion-control centers. This binding can drive up dopamine levels in the reward areas of the brain, resulting in a state of euphoria and relaxation.
But of course, euphoria and relaxation aren’t all you get. The effects of fentanyl are similar to those produced by heroin, including drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma and death.
It can be prescribed and then diverted for illegal use, but it’s also being manufactured on the street. A large amount of the drug and its analogs, or similar compounds, comes into the U.S. from Mexico, where it’s made with components acquired from China. It’s often mixed with or disguised as white-powder heroin, and it’s also sold spiked on blotter paper or as tablets. It also can be injected. Acquired from a pharmacy, it might come as a lozenge, lollipop or transdermal patch.
Because fentanyl is so potent, it’s ridiculously easy to overdose, especially when taken unawares. As mentioned earlier, even tiny amounts can be deadly. According to the NIDA, opioid receptors are also found in the areas of the brain that control breathing rate, and thus high doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely.
Thus far, the drug has primarily been appearing in the eastern United States, but it has been growing in popularity. From 2013 to 2014, national seizures of fentanyl increased almost 400 percent. One silver lining, though, is that the growing threat of fentanyl is not going unnoticed. For the past couple of years, the U.S. Drug Enforcement Administration has been issuing instructions to law enforcement on how to deal with the issue.