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Mixing Fentanyl with Other Substances

Drug and substance abuse continues to be a significant problem in the United States today. This menace continues as the number of deaths from drug abuse rises each year. According to the CDC's National Center for Health Statistics, about 100,306 deaths resulted from drug overdoses between 2020 and 2021. 


CDC reports that this number has risen to 28.5% from the previous period, which reported 78,056 deaths. Overdose deaths from opioids increased to 75,643 during the 12 months ending in April 2021. Overdose deaths from synthetic opioids, primarily fentanyl, also increased simultaneously.


These shocking statistics make you wonder why so many deaths are involved and the associated risk factors. The worst part is that people who use fentanyl or other drugs know they have a problem yet fail to take the necessary precautions. Though most people begin using fentanyl as a doctor's prescription, most end up addicted to the drug.

What is Fentanyl?

Fentanyl falls under a group of drugs called opioids that occur naturally from the opium poppy plant. Manufacturers produce some opioids directly from the plant, while others, like fentanyl, are manufactured by scientists in labs. 


Fentanyl might be similar to morphine, but it exceeds its power to a potency of 50 to 100 times more. Though the drug is a synthetic opioid and may be legally prescribed by a doctor, most people use it illegally. Like morphine, it treats patients with severe pain, especially in advanced cancer cases or after major surgery.


At other times, doctors use fentanyl to help treat patients with tolerance to other opioids or chronic pain. Fentanyl is also known by other names such as:


  • Duragesic®

  • Actiq®

  • Sublimaze®.


Most doctors prescribe fentanyl as a patch on people's skin, shot, or as lozenges sucked like cough drops. Illegal fentanyl is associated with recent overdoses and is manufactured in labs. 

This synthetic fentanyl is often illegally found as a powder, made into pills similar to other prescription opioids, put in nasal sprays and eye droppers, or dropped onto a blotter paper.

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Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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Why Do People Mix Fentanyl and Other Substances?

Some drug dealers mix fentanyl with other drugs, such as cocaine, heroin, methamphetamine, MDMA, and more. Most drug dealers prefer fentanyl mixed with other substances because they offer a cheaper option and higher potency than other drugs. This is because it only takes a small amount of fentanyl to produce a more potent high; hence a profitable venture for the seller. 

However, mixing fentanyl and other substances is risky because it exposes a user to the effects of both drugs, especially since fentanyl is powerful and dangerously addictive. Users taking other drugs mixed with fentanyl might not know they are using a more potent opioid and are more likely to overdose. Mixing different types of opioids also puts users at increased risks of addiction and overdose and has constituted the fentanyl crisis we see today.

Risks Involved with Mixing Fentanyl and Other Substances

The following are the risks involved with mixing fentanyl and other substances:


Fentanyl and Heroin

Fentanyl and heroin are two highly potent, harmful, and addictive opioids. While heroin is manufactured from the resin of the poppy plant and refined from morphine, it becomes a psychoactive drug that may be smoked, sniffed, injected, or snorted. Fentanyl, on the other hand, is an additional booster that escalates the mixture's effects and strength.


Heroin mixed with fentanyl has a chance of killing its victims in minutes without even showing any signs of an overdose. Though heroin might prompt a user to overdose, mixing fentanyl eliminates such an outcome. While it is hard to notice fentanyl mixed with heroin since both have similar appearances, fentanyl is primarily white while heroin is yellow.


Fentanyl and Cocaine

Cocaine stimulates the central nervous system and increases feelings of alertness, euphoria, and well-being. The drug also increases blood pressure, body temperature, heart rate, and oxygen needs. Using cocaine alone is dangerous since it strains your heart from the increased respiratory rate and blood pressure.


Vital organs such as the brain receive low blood levels from the constricted blood flow, increasing the high risk of strokes from a cocaine overdose. Fentanyl combined with cocaine has a much more lethal effect on these functions than cocaine alone.


Fentanyl and Other Medical Prescriptions

A doctor prescribing fentanyl and other medications risk exposing a patient to severe effects of fentanyl and other prescribed medications. Combining opioids and fentanyl is risky and becomes even more dangerous when mixing fentanyl and other drugs that impact brain activity like benzodiazepines.


Fentanyl Overdose

Using drugs like benzodiazepines is already dangerous on its own due to the effect they have on the GABA receptors in your brain. However, mixing such drugs and fentanyl is lethal since fentanyl will slow down the respiratory system leading to an overdose that might cause death.


Someone who suffers from a fentanyl overdose might experience the following symptoms:


  • Pinpoint pupils.

  • Difficulty breathing, walking and speaking due to Central Nervous System depression

  • A prolonged heart rate may lead to a cardiac arrest when not treated fast enough

  • Severe respiratory depression

  • Cardiovascular issues 

  • Low blood pressure

  • Drowsiness

  • Dizziness

  • Nausea and vomiting

  • Limp body

  • Changes in pupillary size

  • Clammy and cold skin

  • Blue-colored fingernails and lips(cyanosis)

  • Stopped or slowed breathing

  • Decreased heart rate

  • Loss of or reduced consciousness

  • Coma

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Fentanyl Addiction

All opioids activate pleasure regions of the brain and quickly lead to addiction. Most individuals begin using fentanyl because it has a more substantial effect, unlike any other opioid. However, mixing fentanyl with other drugs is highly dangerous since it affects brain activity, slowing it down faster. 

Fentanyl addiction is twice as much as any opiate, leading to tolerance just as quickly. You find you can't go on without using the drug within a short period. You might be addicted to fentanyl when you experience withdrawal symptoms when not using fentanyl, you need more of the drug to feel high, and you can't quit using fentanyl even if it causes you problems.


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The Bottom Line

Remember that you don't have a quick fix if you are addicted to fentanyl. Bouncing back does not happen overnight. The treatment administered to opioid dependency generally may take time.


It seems like a long time, and be sure that it gets more challenging, uncomfortable, and painful- especially when you develop withdrawal symptoms. During these times, you might want to brace yourself and prepare. But, the best part is that you do not have to face recovery alone. Get in touch with your loved ones or friends because they are the support system you will need in recovery. Get professional help too!

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What is fentanyl
Why do people mix fentanyl with other substances?
Risks involved with mixing fentanyl with other substances 
Fentanyl addiction
The bottom line
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