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How Does Fentanyl Kill You?

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Fentantyl has developed a sinister reputation in recent years as the leading cause of overdose in America. With its valuable medical usage in contrast with its damaging epidemic of illicit use, many have mixed emotions when thinking about this potent chemical compound. When you are able to understand the mechanisms of action behind fentanyl and how it affects the body, you will be better equipped to understand both why this substance is so useful for medical professionals as well as why so many have fallen victim to its deadly side effects.

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Fentanyl & Chemical Interactions in the Body

Fentanyl (1) quickly crosses the blood brain barrier binding with the brain’s opioid receptors. Because of this, it produces rapid onset pain relief to the user. It is used for this purpose in medical settings as an anesthetic or pain management option for patients who are undergoing a surgical procedure or are experiencing high levels of pain. Whether it is through an IV, a transdermal patch, or a sublingual tablet, fentanyl provides powerful pain relieving properties to those who it is prescribed to.

Common Side Effects of Fentanyl Use or Exposure

With its primary effects being positive in the context of pain relief, its side effects are potentially harmful and include vomiting, nausea, sedation, and respiratory depression. Though it slows the heart rate down less than other opioids, its potentially fatal side effect of respiratory depression has an extremely fast onset and requires medical intervention immediately.

How Much Fentanyl Does it Take to Kill?

Fentanyl is estimated to be 50 times more potent (2) than the common street drug heroin. In a healthy adult male, an estimated lethal dose of heroin would be approximately 30 milligrams. The amount of fentanyl required to overdose that same male would be less than 2 milligrams. This amount of fentanyl is approximately the size of Abraham Lincoln’s ear on the front of a penny. This means that one kilogram of fentanyl is potentially potent enough to kill 500,000 people.

Fentanyl Kills By Hypoxia & Respiratory Depression

Two of the side effects of fentanyl that have proven to be the most dangerous are Hypoxia and Respiratory Depression. Hypoxia (3) is a condition where there is an insufficient amount of oxygen in the bloodstream leading vital organs to function poorly or not at all. Though it is a medical condition on its own, hypoxia is directly related to the respiratory depression caused by the overuse of fentanyl. Respiratory depression is the slowing or shallowing of breathing. If this breathing is stunted enough, it will lead to a lack of oxygen in the blood (hypoxia) causing potentially fatal effects.

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How Long Does Fentanyl Take to Cause Death?

The onset of the effects of fentanyl depend on a variety of factors including tolerance, weight, and, most of all, route of administration. If a person ingests fentanyl orally, they will see a slower onset of the effects of fentanyl. Conversely, if a person injects the same amount of fentanyl they will see a rapid onset of both the negative and positive effects. In just a matter of minutes fentanyl’s respiratory depression can cause such a low amount of oxygen (4) in the bloodstream that the user can lose consciousness or even die.

Deaths Caused By Accidental Overdose

Often, the deaths related to fentanyl (5) are accidental. Other drugs are often “laced” or  “cut” with fentanyl by manufacturers. It was discovered that in 2021 42% of illegally manufactured pills confiscated by the Drug Enforcement Administration (DEA) contained 2 milligrams or more of fentanyl, a potentially lethal dose.

Fentanyl Can Be Undetectable By Drug Users

Due to such miniscule amounts of fentanyl having such dramatic effects, often users of other substances are unaware that fentanyl is present. Visually, fentanyl looks like any other white powder and is virtually undetectable to the naked eye. This compounded with the fact that a deadly amount of fentanyl can fit on the tip of a pencil, makes for an extremely difficult to detect additive in other illicit drugs.

Naloxone Use in the Prevention of Respiratory Failure

One widely used and often lifesaving medication administered to those experiencing a fentanyl overdose is naloxone. Naloxone is an opioid antagonist (6). This means that it attaches to opioid receptors and reverses and blocks the effects of other opioids. It is able to quickly restore breathing to normal in someone who has their breathing depressed during an overdose.

Naloxone is available in two forms. The first is a nasal spray. Often referred to by its brand name Narcan, this substance is sprayed into the nose of the person experiencing an overdose. It goes to work quickly blocking opioid receptors and halting the adverse effects of opioids.

The second available form of naloxone is the injectable form. Most often utilized by medical professionals responding to an overdose, this form is either injected into the muscle or the veins of the patient. It quickly disperses into the bloodstream counteracting the effects of fentanyl and other opioids.

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Seeking Treatment for Fentanyl Addiction

Fentanyl use disorder rampantly affects the lives of those who use as well as those around them. Now more than ever, high quality substance use treatment is needed to combat the high rates of overdose in America. Guardian Recovery understands this need and is here to help. With our staff of highly trained clinicians, you or your loved one will receive the help they need to overcome this potentially life controlling addiction. Call Guardian Recovery today to begin your journey to freedom.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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