Ask an Expert: Is There a Way to Know if Fentanyl is in My Drugs?

By Anna Lembke 11/03/17

Small amounts of fentanyl can kill even a highly tolerant opioid user.

Image: 
Baggie and white powder.

I'm scared to death of fentanyl, mostly because I don't know of any way to tell if the heroin or pills I buy have any in it. Is there any way to know?

Anna Lembke:

Dear “Scared-To-Death,"

You should be. There is no way to tell if heroin powder or a pill contains fentanyl. Fentanyl is 50 to 100 times more potent than heroin, depending on the purity. For example, if you ingest a “bag of heroin,” which is typically 100 mg of heroin, and that bag contains 20% pure fentanyl in place of heroin, you will be ingesting the rough equivalent of 2,000 mg of heroin, enough to kill even a highly tolerant user.

Even if you knew what you had was pure fentanyl powder, it is impossible to differentiate a lethal dose from a non-lethal dose with the naked eye. Advanced scientific equipment is needed to measure fentanyl accurately.

Don’t play with your life. It’s not worth the high. If you do use opioids recreationally—there are better ways to the top of that mountain—do it with a buddy to help you stay safe, use clean needles, and always have naloxone nearby to reverse an accidental overdose. Some pharmacies now sell naloxone without a prescription.

If you are addicted and want help stopping, good treatment for addiction—especially opioid addiction—exists. Go get treatment. It’s never too late to turn your life around.

Anna Lembke, MD, is on the faculty of the Stanford University School of Medicine, a diplomate of the American Board of Psychiatry and Neurology, and a diplomate of the American Board of Addiction Medicine. Full bio.

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