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Fentanyl facts and statistics

Current fentanyl stats, overdose facts, and why it’s so dangerous when misused
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By | May 6, 2025 Medically reviewed by Gerardo Sison, Pharm.D.
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Fentanyl is a prescription medication used to manage severe pain, typically during and after surgery. It can be prescribed off-label for certain types of pain, especially severe acute pain or pain caused by cancer. However, outside of its prescribed uses, illegally made fentanyl (IMF) has become a major public health concern due to its potency and high potential for overdose. Read on to learn more about what fentanyl is, how it’s used, safety considerations, and key statistics about its impact.

What is fentanyl?

Fentanyl is a fast-acting medication in the opioid drug class. It’s a synthetic opioid, meaning it’s human-made rather than derived from natural sources. While its effects are similar to the painkiller morphine, fentanyl is approximately 50 to 100 times stronger.

Fentanyl prescribed by a licensed healthcare provider is not the same as fentanyl found on the street. Pharmaceutical fentanyl is made by manufacturers under strict regulations and is known by different brand names such as Sublimaze, Actiq, Fentora, and Duragesic. It’s available as a patch, a lozenge, or an injectable solution. 

Illegally made fentanyl, also known as illicit or illegally manufactured fentanyl, is made in unregulated facilities and is often mixed with other substances. IMF can be found pressed into pills, as a powder, or mixed in with other illicit drugs such as heroin, cocaine, methamphetamine, and MDMA, according to the Centers for Disease Control and Prevention (CDC). 

What is fentanyl used for? 

Pharmaceutical fentanyl can be used for pain management as an analgesic or as an anesthetic. As a prescription opioid, it has different approved uses based on the dosage form: 

  • Injectable fentanyl is used as a pain reliever during or after surgery or as an add-on to general or local anesthesia. For example, it might be used in an epidural injection during childbirth.
  • A fentanyl patch is prescribed for the management of persistent, moderate to severe chronic pain that can’t be managed by other medications.
  • Fentanyl lozenges, lollipops, nasal sprays, sublingual sprays, and sublingual tablets are used for pain management for people with cancer who don’t respond to other opioid medications.

Fentanyl lozenges, lollipops, nasal sprays, sublingual sprays, and sublingual tablets are products in a group of medications called transmucosal immediate-release fentanyl (TIRF). As of Sept. 30, 2024, TIRF manufacturers stopped production of these forms of medications.

Fentanyl may also be prescribed off-label, meaning for a purpose other than what the Food and Drug Administration (FDA) approved it for. For example, injectable fentanyl may be prescribed to manage cancer-related pain. 

Why is fentanyl so dangerous?

Fentanyl is dangerous because it’s a strong opioid medication with a high risk of overdose. “Fentanyl, in particular, is more dangerous than other opioids because it is very potent and works very quickly,” says Sylvie Stacy, MD, chief medical officer at Rehab.com. According to the Drug Enforcement Administration (DEA) and the CDC, fentanyl is 50 to 100 times stronger than morphine and 50 times stronger than heroin as a painkiller. “This means even a small amount can cause someone’s breathing to slow down or stop, especially if their body isn’t used to opioids,” Dr. Stacy explains. A potentially life-threatening dose is around 2 mg of fentanyl.

Fentanyl works by activating opioid receptors in the body to reduce the sensation of pain. Side effects of fentanyl include feeling “high” (euphoria), confusion, drowsiness, constipation, loss of consciousness, and breathing problems. Fatal overdoses on fentanyl can lead to severe sedation, clammy skin, respiratory depression, coma, and death.

When prescribed and administered under the guidance of a healthcare provider, fentanyl can be a safe and effective option for pain control. Most fentanyl overdoses occur with IMF or counterfeit pills mixed with other medications. In addition, pharmaceutical fentanyl that’s been obtained illegally and misused can also lead to an overdose.

Fentanyl facts 

Here are some facts about fentanyl you should know:

  • Fentanyl was first developed in 1959 and used in the 1960s as an injectable anesthetic. (DEA, 2024)
  • Fentanyl currently comes as an intravenous (IV) injection and a topical patch.
  • Fentanyl lozenges, lollipops, sublingual tablets, and nasal sprays are no longer produced as of September 30, 2024. (FDA, 2024)
  • Brand names of fentanyl include Sublimaze, Actiq, Fentora, and Duragesic.
  • Street names of fentanyl include Apache, China Town, Dance Fever, Goodfellas, King Ivory, and Poison. (DEA, 2024)
  • Common side effects of fentanyl include drowsiness, dizziness, constipation, nausea, and vomiting. (National Institute on Drug Abuse (NIDA), 2021)
  • It’s possible to develop an addiction to the drug, which may lead to an overdose or withdrawal symptoms. (NIDA, 2021)
  • Fentanyl overdoses can be treated with naloxone, an opioid antagonist available in a nasal spray or injection. (NIDA, 2021)
  • Treatment for fentanyl addiction may include medications such as methadone, buprenorphine, and naltrexone, in addition to behavioral therapy and supportive medical care. (NIDA, 2021)

Fentanyl statistics

Fentanyl overdose statistics

  • Overdose deaths from drugs like fentanyl rose sharply after 2013, reaching 22.2 deaths per 100,000 people in 2023. (CDC, 2024)
  • Overdose deaths due to synthetic opioids like fentanyl made up about 92% of all opioid-related overdose deaths in 2023. (CDC, 2024)
  • About 2 in 3 drug overdose deaths in 2023 were due to synthetic opioids such as fentanyl. (CDC, 2024) 
  • Between 2022 and 2023, the rate of drug overdose deaths increased among adults 55 and older, but adults 35 to 44 years old had the highest rate of drug overdose deaths. (CDC, 2024)
  • There’s a growing trend of illicitly manufactured fentanyl being mixed with xylazine, a tranquilizer, and the combination of the two has been increasingly linked to overdose deaths. (CDC, 2024)

The cost of fentanyl misuse

Although there aren’t specific numbers tied to fentanyl abuse, the cost of opioid abuse is significant. For example:

  • A 2021 study of U.S. emergency departments found that substance use disorders (SUD) cost more than $13 billion yearly in medical costs in hospitals, and opioid-related disorders were the second most expensive SUD after alcohol-related disorders. (JAMA Network Open, 2021)
  • A 2023 study of people with employer-sponsored insurance plans found that substance use disorders cost more than $15,000 per person annually to treat. (JAMA Network Open, 2023)
  • In total, the economic cost of opioid use disorder in the U.S. was over $1 trillion in 2017. (CDC, 2021)
  • A study of data from 2017 found that the reduced quality of life due to opioid use disorder cost an estimated $390 billion, and the cost associated with life lost due to opioid overdose was more than $480 billion. (Drug and Alcohol Dependence, 2022)

Preventing fentanyl misuse

Given the staggering impact of opioid abuse, preventing fentanyl misuse and overdose is key to saving lives and reducing healthcare costs. However, doing so requires a concerted effort from public health agencies, community health programs, and individuals. 

On the national level, the U.S. Department of Health and Human Services (HHS) has an overdose prevention strategy focused on research, harm reduction, treatment, and recovery from SUD. In response to the rising fentanyl misuse before and during the COVID-19 pandemic, the CDC issued recommendations to healthcare professionals and organizations, including:

  • Increasing access to naloxone and teaching people how to use it 
  • Helping more people learn about and get treatment for substance use problems 
  • Reaching out early to help people who are at higher risk of overdose 
  • Keeping a closer watch to identify and respond quickly to overdose outbreaks

Always take medications exactly as prescribed and safely dispose of unused doses at participating pharmacies. To lower the risk of fentanyl overdose, the CDC also advises:

  • Using fentanyl test strips to check for contamination in drugs.
  • Carrying naloxone and learning how to use it. Naloxone kits are available at local pharmacies and community-based programs in all 50 states. 
  • Practicing harm reduction strategies, such as avoiding drug mixing and monitoring your body’s reaction each time you take drugs.
  • Seeking treatment for substance use disorder by calling the SAMHSA helpline (1-800-662-HELP [4357]) or visiting FindTreatment.gov.

If you or someone you know is experiencing a medical emergency, call 911 right away. 

If you are experiencing a mental health crisis, call or text 988 to get help.

How to treat a fentanyl overdose

“Knowing how to recognize an overdose is the most important thing, and every overdose should prompt a call to 911 so that the patient can at least be assessed by healthcare professionals,” advises Ryan Marino, MD, medical toxicologist, addiction medicine specialist, and associate professor at the Case Western Reserve University School of Medicine in Cleveland, Ohio. 

Signs of fentanyl overdose include:

  • Very small pupils 
  • Slow, shallow, or no breathing 
  • Blue or purple lips or nails
  • Clammy skin
  • Severe drowsiness or loss of consciousness
  • Limp body
  • Choking or gurgling sounds

Naloxone, also known under the brand names Narcan or Kloxxado, is a medication used to reverse the effects of prescription opioids. “Naloxone is the antidote for a fentanyl overdose, and timely administration can be the difference between complete recovery and the worst possible outcomes. Naloxone comes in a nasal spray formulation that is available over the counter and very easy to use,” says Dr. Marino. Naloxone can be used for any opioid-related overdoses, such as overdoses on heroin, methadone, or fentanyl. 

Here’s what to do if you think someone has overdosed on fentanyl, according to the CDC:

  1. Call 911.
  2. Give naloxone as soon as possible.
  3. Try to keep the person awake and breathing.
  4. Lay the person on their side to prevent choking.
  5. Stay with the person until emergency workers arrive.

Naloxone is a short-acting medication and may need to be readministered depending on how much fentanyl was taken, according to the CDC. David Deyhimy, MD, an addiction medicine specialist and medical director at MYMATCLINIC in Laguna Hills, California, shares that naloxone can be given again every two to three minutes if the person’s breathing hasn’t improved. 

Fentanyl questions and answers

What does fentanyl look like?

Pharmaceutical fentanyl is produced as lollipops, tablets, sublingual tablets, nasal sprays, and sublingual sprays. It also comes in patches that you can apply to the skin. Pharmaceutical fentanyl typically comes with official labeled packaging and a medication guide.

IMF can come in powder, fake tablets, liquid, eye drops, and nasal sprays. It can also be dropped on blotter paper like small candies, according to NIDA. In many cases, you can’t tell whether other drugs have been mixed with fentanyl by look, smell, or taste, but you can use fentanyl test strips.

How long does fentanyl stay in your system?

According to its drug label, injectable fentanyl has a half-life of almost four hours (219 minutes). That is, after about four hours, there should be half as much fentanyl in your body as the original dose. However, it could take around four to five half-lives for a drug to be nearly eliminated from the body. 

How long fentanyl stays in your system can also vary by individual and dosage form, Dr. Stacy says. “Fentanyl is generally cleared from the bloodstream within about 12 hours. But precisely how long it stays in your system depends on how much was taken, how it was administered, and the person’s metabolism,” she shares.

Where does fentanyl come from?

Fentanyl is a synthetic drug, meaning it is not found in nature but is made in laboratories. Regulated companies produce pharmaceutical fentanyl and meet strict safety and quality standards. However, some fentanyl is made illegally in unregulated labs and sold on the street, which can be much more dangerous.

How much fentanyl can kill you?

According to the DEA, a 2 mg dose of fentanyl is a potentially fatal dose. Lethal doses of fentanyl require immediate medical attention to reverse the effects. 

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