What Is the Fentanyl Crisis?

Street fentanyl causing many overdose deaths

A pill bottle spilled over with fentanyl tablets. San Diego Health Magazine

Street fentanyl causing many overdose deaths

Fentanyl is a synthetic opioid that’s estimated to be 50 times stronger than heroin and 100 times stronger than morphine. It’s linked to more than 150 overdose deaths each day in the United States.


According to the US Drug Enforcement Administration, fentanyl overdose is the leading cause of death among Americans between the ages 18 and 45. 


Fentanyl abuse is on the rise in San Diego and across the country and health officials are issuing a warning: one pill can kill. 


Opioids are a class of pain medications that includes oxycodone, hydrocodone, morphine and heroin. Morphine and heroin are examples of natural opioids that are extracted from plants, while synthetic opioids like fentanyl are manufactured in a laboratory. 

What is illicit fentanyl?

There are two types of fentanyl. Pharmaceutical-grade fentanyl may be safely prescribed by physicians for patients in severe pain. Illicit fentanyl is produced in foreign labs and smuggled into the country illegally. Illicit fentanyl is often contaminated with other chemicals, so its actual ingredients are unknown, making it even more dangerous


The powder form of illegal fentanyl can easily be mixed into other drugs, such as methamphetamine or cocaine. Fentanyl tablets can be formed to look like authentic medication, such as anti-anxiety medication or less potent painkillers, and marketed on social media as legitimate prescription medications. Buyers of these potentially fatal drugs are none the wiser. 


“There’s fake everything, and even experts sometimes cannot tell a real tablet from a fake one. A college student who is studying for finals and thinks they’re getting an Adderall tablet may get something that just has fentanyl and various contaminants,” says Roneet Lev, MD, director of emergency department operations at Scripps Mercy Hospital. “That’s not what they meant to buy. It’s a mistake they made and often a deadly one.” 


In San Diego County, fentanyl overdose is considered an epidemic, causing nine out of 10 opioid-related deaths. Fentanyl paralyzes your ability to breathe, so someone overdosing on the drug will be unresponsive despite efforts to wake them. Without medical intervention, they will likely die. 

Preventing overdose deaths

If you see somebody showing fentanyl overdose symptoms, call 911 immediately. Additionally, it’s crucial to give an opioid reversal agent called naloxone as soon as possible. Naloxone blocks opioid receptors and can quickly restore normal breathing to someone suffering an opioid overdose. Naloxone is available by prescription or sold over the counter as Narcan. 


The best way to reduce the risk of fentanyl overdose is to avoid street drugs and use only medications prescribed to you by a physician. 


“There’s no safe drug supply, none, unless it is prescribed to you by your doctor and purchased from a reputable US pharmacy,” says Dr. Lev. “Don’t get them from a friend and don’t get them illegally, because you could die.” 


Dr. Lev also encourages parents to start having age-appropriate conversations with kids about the dangers of drugs even before middle school, which is when drug use often begins. 


If you or someone you know needs help, call the Suicide & Crisis Lifeline at 988. 

Scripps’ role preventing opioid abuse

In 2018, Scripps launched the Opioid Stewardship Program with the goal of reducing opioid use to help prevent patient overdose or addiction. Led by a multidisciplinary group of physicians, pharmacists, nurses, substance-use navigators and other health care professionals, the program has been recognized for its work educating patients and health care providers about opioid use, addiction and the benefits of non-opioid approaches to pain management. 

San Diego Health Magazine Winter 2023 Cover

This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.

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