Pharmaceutical fentanyl vs. illegal fentanyl: What’s the difference?

NEW ORLEANS ( WGNO ) — Fentanyl has become synonymous with the crisis of opioid addiction in America. It’s easy to produce and readily available on the black market.

In 2022, Opioid Help Louisiana reported that 1,400 people in the state died with opioids to blame. Of that, over 1,200 were because of synthetic opioids like fentanyl. The CDC says fentanyl remains the deadliest drug threat in the U.S.

But, it does have a medical use – providing relief to millions of people suffering from chronic pain.

Dr. Catherine Oliver with Clinical Pharmacy Services at Ochsner says fentanyl is used in the hospital to control pain and is far more potent than most opioids.

“We can give it to you in surgery, we can give it to you in the ICU when we are trying to keep you comfortable when you’re critically ill,” said Oliver. “There are also some compounding pharmacies that will make it in forms like lozenges so for patients who can maybe not swallow they’ll use that or lollipops.”

But like any opioid, it carries the risk of addiction, and when you take to the streets to get your fix you never truly know what you’re getting.

“We do see that laced with other illicit or street medications and that’s where we see the devastating effects because it is so much more potent than other opioids if you aren’t aware of what it is or what is being used that’s when we see unexpected or unintended overdoses,” said Oliver.

“These are typically chemicals that are sourced in one country, brought to a second country outside the U.S., they’re produced into an illegal lab and then they’re smuggled into the United States,” explained Dr. Daniel Sessions. He’s the Chief of Medical Toxicology at Ochsner.

He says every few hours a person comes into an Oschner Emergency Room overdosing on fentanyl. A lot of the time those using don’t even realize they’re taking the drug.

“People are taking these fentanyl chemicals and the fentanyl itself – they’re making them into pills and the pills are usually disguised to look like other medications that people are trying to use or misused or abused,” said Sessions. “If you have a pill that you think contains 30mg of oxycodone, 60% of the time it doesn’t contain that oxycodone, it contains a lethal dose of fentanyl.”

Since the Covid-19 pandemic, nationwide the use of synthetic opioids, primarily fentanyl, has skyrocketed. That’s according to research from the CDC .

“We’ve seen an increase in those fentanyl exposure, unfortunately,” said Sessions. “That was probably exasperated by the COVID pandemic and kind of the stress by that.”

If you find yourself struggling with addiction, Sessions has some advice for you.

“If you’re really at the end of your rope, don’t know what to do, you can always go to the emergency department,” explained Sessions. “There’s a lot of groups in New Orleans like Metro Human Services and Behavioral Health Group who are very good about very short-term addiction treatment even if you don’t have financial resources.”

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