30 Jun 2021 | Aaron Neville


Summary: The basics of Fentanyl

Fentanyl is a synthetic analog to opium. As a medication, fentanyl is considered 50–100 times stronger than morphine. Patients undergoing difficult surgeries and cancer treatments benefit from its effectiveness. Fentanyl is often compared to oxycodone for pain management, so it is helpful for recognizing how little is required to induce similar effects. Oxycodone doses range 5–60 milligrams (mg) while fentanyl dosages range 15–150 micrograms (mcg). Both dosages are minuscule, but the amount of fentanyl required is almost 1000 times smaller.

The problem started a while back. In the 1990s, pharmaceutical companies were given permission to market oxycodone (a timed release opiate) and similar drugs to doctors and patients. Pain was advertised as a disease to treat more than just a symptom. In the following decades, pain-management became a hundred billion dollar industry. To keep the competition alive, companies introduced new formulations of opiates, including fentanyl.

13 million US citizens were addicted to these medications by 2010 and our legislatures began to react. As a result of the body's natural ability to build tolerance to medication, each person with pain would need more and more medication to achieve the results needed to live their lives. Those addicted went to great lengths to obtain more. This helped create a black market built out of rogue pharmacies, etc. The public finally began to notice the destruction and a campaign to educate and create laws went in to effect.

The black market grew further when much of the 13 million people couldn't stop taking their medication overnight. Many began to seek out alternatives like heroin to fix their needs. Organized crime assisted in building a greater supply and in 2013 fentanyl became a major player. Much of the initial fentanyl was ordered from legal laboratories in China, India, and elsewhere in Asia. When sanctions by the US government penalized those countries, the Mexican cartels had already invested and so they made deals to produce fentanyl in Mexico while still ordering ingredients from countries in Asia.