Fentanyl Forms: What Types of Fentanyl Exist?

Fentanyl is an opioid drug that is about 50 to 100 times more potent than morphine, making it extremely dangerous and deadly. There are two main types of fentanyl: prescription fentanyl often used for severe, breakthrough cancer pain and illicit fentanyl made in labs. [4]

Within those categories, there are many fentanyl forms. For example, prescription fentanyl may be available as an oral pill, a transdermal patch, or an injectable medication.

Some dealers sell fentanyl products they’ve stolen from pharmacies and doctors. But others make fentanyl in clandestine labs, making products that look like almost any other substance someone might buy—this includes counterfeit oxycodone and hydrocodone, counterfeit Xanax, counterfeit Adderall and more.

The Centers for Disease Control and Prevention (CDC) says more than 150 people die every day from overdoses related to drugs like fentanyl. Many people are unaware their drugs are contaminated. Fentanyl’s potency means a dose that looks safe could be incredibly dangerous.

[5]

Street drugs are often contaminated with fentanyl. Research shows that there were over 70,600 overdose deaths involving synthetic opioids—like fentanyl—in 2021.[1]Knowing the various fentanyl forms can help you to understand how to identify this drug, how dealers often cut drugs with this deadly opioid, how this opioid works, the potential for fentanyl misuse, and more.

The Different Fentanyl Types

What Are the Different Forms of Fentanyl?

The Drug Enforcement Administration recognizes multiple types of fentanyl, both prescription and illicit.[2]

The CDC says most fentanyl-related overdoses are linked to illicit sources.[5] While the supply of tainted drugs is increasing, the prescription rate is dropping. Between 2010 and 2019, overall milligrams of fentanyl dispensed decreased by over 65%.[6]

While illicit fentanyl is more common, all forms of fentanyl can be misused, and all of them are potentially dangerous. Here’s what you need to know.

Prescription Fentanyl Forms

Pharmaceutical fentanyl has legitimate medical uses, such as for severe chronic pain and breakthrough cancer pain. Taking this medication exactly as prescribed is generally considered to be safe, as long as you follow your doctor’s instructions, avoid drug interactions, and communicate with your doctor regularly about your symptoms and pain.

Edibles

Fentanyl is pressed into lollipops and lozenges, sold under the brand name Actiq. Active ingredients move into your bloodstream very slowly.[2] If you enjoy the taste and don’t recognize how high you are, you could take too much and overdose. 

Edibles are also very dangerous for families with children. Your kids may believe the stash they found is candy, and they could eat it and overdose.

Tablets & Capsules

Fizzy tablets you place inside the cheek are sold under the brand name Fentora. [2]

Tablets you can put beneath the tongue are sold as Abstral. These products are dangerous, as they can be chewed for an immediate high or crushed and snorted for the same purpose.

Sprays

You can spray a liquid beneath your tongue (Subsys) or inside your nose (Lazanda). [2] These formulations deliver strong changes in seconds and can be very addictive because of this rapid onset of effects. However, if you take it as prescribed, it can be helpful in managing severe pain that doesn’t respond to other opioids.

Patches

A fentanyl-infused transdermal patch you can place on your skin (Duragesic) could be useful for people who can’t digest fentanyl or who need ongoing pain relief. However, these products can be dangerous as dosing is difficult. By the time you realize you’ve had too much, it could be too late. [2]

Discarding them safely is hard, as these patches retain their power even after someone has worn them for days. Children and pets could be exposed to fentanyl if they touch used patches. It is recommended to fold these patches on themselves and flush them down the toilet after use to prevent accidental exposure.

Injections

Generic forms of fentanyl are available to doctors for people in hospital environments. If you’re struggling with severe pain, these medications could be very helpful. Doctors may administer fentanyl injections epidurally, spinally, intramuscularly or intravenously.[2]

Types of Illicit Fentanyl

Powders

Dealers typically make fentanyl in powdered formats. They can mix this substance into powdered drugs like cocaine or heroin. You can’t smell, taste or see fentanyl powder. It’s almost impossible for people to understand if the drug they’re about to take is stronger than expected. Many people don’t even know they bought a drug that contains fentanyl, which greatly increases the risk of fatal overdose.

One form of harm reduction is fentanyl testing strips, which you can use to detect the presence of fentanyl in your drugs. They aren’t 100% accurate, especially if you only test a small part of your drugs, but they can still be helpful in preventing an overdose.

Counterfeit Pills

In addition to cutting other drugs with fentanyl, dealers may press this powder into tablets and pills they can sell as counterfeit drugs like:

• Xanax
• MDMA
• Adderall
• Percocet
• Vicodin
• OxyContin

Overdose Signs & Response

Knowing what an overdose looks like—and what to do if you spot one—could help you to save a life.

A typical fentanyl overdose causes the following symptoms:[5]

• Tiny pupils
• Slow or absent breathing
• Choking or gurgling sounds
• Unresponsiveness
• Cold or clammy skin
• Discolored lips and nails

It’s not always easy to determine if someone is high or overdosing. If you’re not sure, the CDC recommends following an overdose protocol anyway. You could save a life. Follow these steps:[5]

1. Call 911 and tell the operator where you are and what you’re seeing.
2. Administer the drug naloxone if you have it available.
3. If you can, keep the person awake and breathing.
4. If the person is unconscious, lay them on their side to prevent choking.
5. Stay with the person until help arrives.

Keeping naloxone on hand is a smart move for anyone using fentanyl. This life-saving medication is available in most states without a prescription.[5] Visit a local pharmacy and keep it with you. Better yet, train everyone around you to spot signs of an opioid overdose and treat it when needed.

Using Suboxone for Opioid Use Disorder

Fentanyl is a very powerful and addictive drug, and repeated misuse can lead to dependence and opioid use disorder (OUD). Overcoming that problem without help is often challenging.

Opioids like fentanyl change your brain chemistry, ensuring you feel sick when you quit using them. Flu-like withdrawal symptoms accompanied by severe drug cravings could make you take another dose even when you want to quit. 

If you work through withdrawal, your cravings could make you relapse. The brain changes that have come about from chronic drug use can make you feel like you’re incapable of living a healthy life without drugs.

Suboxone is a partial opioid agonist, capable of correcting these persistent chemical imbalances. Using the medication can help you to get sober without withdrawal symptoms, and the dose could help you stay sober over the long term. 

In one study of Suboxone’s efficacy, only 25% of people returned to using drugs within one year of starting the medication. By contrast, 100% of people returned to using drugs without Suboxone and only psychosocial support.[3] 

If you’ve tried to quit drugs like fentanyl and relapsed, consider Suboxone. Talk to your doctor to find out if this therapy is right for you. Here at Bicycle Health, we offer MAT with Suboxone. This life-saving treatment can help you stop misusing fentanyl and all opioids. Reach out today to learn more about how MAT can change your life.