How long does fentanyl stay in your system?

Fentanyl – The Most Dangerous Drug Ever?

What is Fentanyl?

Fentanyl is a synthetic opioid that is approximately 100 times more potent than morphine and 50 times stronger than heroin. First developed in 1959 by Belgian chemist Dr. Paul Janssen, fentanyl was approved for medical use in the United States in 1968. As a pain reliever and anesthetic, fentanyl is commonly used in surgeries and to treat patients dealing with severe chronic pain who have developed tolerance to other opioid drugs. The drug was initially delivered intravenously, but over the years, pharmaceutical companies developed other methods, including patches, lollipops, lozenges, tablets and sprays.

How Long Does Fentanyl Stay in Your System?

Drug tests can detect fentanyl in urine up to 72 hours after use. Traces of the drug can be found in blood samples up to 48 hours after use and in hair for up to three months. (source: Drugs.com)

What Does Fentanyl Do?

Fentanyl can cause a short-term high similar to other opioids, resulting in euphoria, deep relaxation, pain relief, happiness, etc. But that high comes with a steep price – in the form of extreme addiction and often death. Two milligrams – an amount that fits on the tip of a pencil – is enough to cause an overdose. Fentanyl is frequently cut into other drugs, including heroin, cocaine, oxycodone pills, meth, and MDMA, as a cheap way to up the potency and increase profits. Because of this, people often take it unintentionally, and due to its extreme potency, they end up overdosing.   

Fentanyl and Overdose Deaths

The National Safety Council has an interactive chart that allows viewers to compare the fatality statistics of various drugs. Opioids that include fentanyl were responsible for 409 overdose deaths in 1999. By 2020, that number rose to 53,480. In 2021, that number grew to 71,238.

Narcan Opioid Overdose Medication

A Brief History of Fentanyl Misuse

According to the article, Fentanyl: where did it all go wrong?, in the publication Pharmaceutical Technology, cases of misuse began in the mid-seventies, but the public health crisis we’re in today didn’t really get started until the mid-90s and early 2000’s when there began to be an uptick in “off-label” prescribing. The article states that around this time, 80% of prescriptions for the fentanyl lollipop, which was created primarily for cancer patients, were going to people who did not have cancer. During this period, evidence of illicit use (and manufacturing) of opioids like oxycodone, hydrocodone, morphine and methadone began to grow in tandem within the larger crisis of addiction to the prescribed drugs. In hindsight, this is what the National Institute for Healthcare Management (NIHCM) calls, the “first wave” of addiction. 

Beginning around 1996, this wave of addiction was initially fueled by misused opioid prescriptions handed out by doctors and pharmacies to the degree that is now largely understood as criminal. (Efforts to hold many pharmacies and the drug makers themselves accountable have resulted in billion-dollar lawsuits. The television miniseries, Dopesick chronicles the DEA’s efforts to hold Purdue Pharma– maker of Oxycontin – and its owners, the Sackler family, accountable for their role in pushing out the highly addictive drug for profit without regard to the extreme harm it was doing.) 

Crackdowns on prescriptions led to a drop in the street-level availability of opioids and, in turn, drove many opioid addicts to heroin – one of the most addictive substances in existence. This is considered the second wave of the crisis, resulting in an uptick in heroin overdoses that lasted from between 2010 until about 2013.

Homeless encampment

Meanwhile, the illegal manufacturing of synthetic opioids began ramping up, leading to the third wave, in which synthetic opioids, including fentanyl, began overtaking heroin as the drug responsible for the most overdose deaths. According to the article from the NIHCM, “[b]y 2018, 68 percent of all opioid deaths involved a synthetic product.” 

A report from the Congressional Budget Office, says we are likely now in a fourth wave, where fentanyl is regularly mixed with other substances, including cocaine and methamphetamine. These mixtures are leading to large numbers of overdoses, as well as exacerbating problems, including homelessness. Author, and subject matter expert Benjamin Hart, wrote in a recent article for Intelligencer, about the extremely pure and, thus, extremely potent meth that is now being manufactured in Mexico and how it, in combination with fentanyl, has contributed to the homeless crisis we are now experiencing across the United States. He discusses how these drugs, in particular, are extremely addictive and how their ability to “hijack our instinct for self-preservation” is unprecedented. The article explains that fentanyl has virtually taken over the heroin market in the United States, to the point that it is actually quite difficult to find heroin in illegal US drug markets. He describes the impact that this change has had on individuals as follows:

Both of those drugs, together and alone, make it so that people will literally refuse treatment, will literally refuse housing even when they’re living in tent encampments, even when they’re living in feces, in lethal temperatures, beaten, pimped out, because they do such a masterful job in potency and in supply of keeping, of thwarting that instinct to self-preservation.
Person on a gurney in emergency room

With Fentanyl Tainting the Nation’s Illegal Drug Supply, the Risk of Fatal Overdose is Not Worth the High

A recent Public Safety Alert from the DEA has announced that, according to its lab tests, more than half (6 in 10) of the fake prescription pill supply in circulation in 2022 contained lethal levels of fentanyl. Meanwhile, another alarming combination of drugs posing as prescription opioids called “tranq dope” has been found in 39 states, Washington DC and Puerto Rico. According to a November 2022 Vice article on the topic, tranq dope is a mixture of fentanyl and the animal tranquilizer xylazine. It has been linked to painful and incredibly drawn-out detox periods and has caused users to suffer from skin lesions, ulcers and limb amputations. 

Anecdotal testimony of the drug’s effect indicates there isn’t even a high associated with it – only hours of unconsciousness, followed by extreme withdrawal symptoms. Further, because it’s such a new threat, xylazine doesn’t show up on drug test strips, so there is no way of knowing whether or not it is present in a drug batch until it’s too late. People in detox who have unknowingly taken it experience anxiety, restlessness, sweats and problems sleeping that are not alleviated with medications such as methadone.

Man sitting on a bench looking at a forested view

For Former Addicts, Maintaining Recovery is More Important Than Ever

The bottom line is that the nation’s illicit and recreational drug supply is tainted with fentanyl and other drugs that are not to be trifled with. These drugs are highly addictive killers, and the hard truth is that to use drugs recreationally is to play Russian roulette – and if the DEA alert is to believed, unlike Russian roulette, where only one chamber houses a bullet, more than half of the chambers are full.  

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