Dangers of Mixing Fentanyl With Other Substances

Fentanyl is a powerful opioid prescription pain reliever that helps manage surgical and cancer-related pain or sometimes chronic pain in people who are tolerant to other opioid drugs.¹

However, fentanyl carries a high potential for misuse and is often produced and sold illegally.¹

Fentanyl can be risky when it’s misused by itself. When fentanyl is mixed with other drugs, whether intentionally or not, it can be even more dangerous. This page will provide a brief overview of some of the dangers of mixing fentanyl with other substances.

Why Is Fentanyl So Dangerous to Mix?

Fentanyl is a synthetic (manmade) opioid drug that is 50-100 times more potent than morphine and is lethal in very small doses.¹ On its own, fentanyl misuse can cause:^1,2

• Anxiety.
• Difficulty sleeping.
• Irritable moods.
• Drowsiness.
• Itchiness.
• Fatigue.
• Confusion.
• Overdose.

Illicitly manufactured fentanyl (IMF) is relatively cheap to make and takes only a small amount to cause a powerful high, making fentanyl a common additive in other illicit drugs.^1,3

For example, fentanyl is often added to drugs including other opioids, cocaine, and benzodiazepines.^1,3 As a result, people who use these drugs may take fentanyl unknowingly, and risk experiencing a fentanyl overdose.¹

When fentanyl is mixed with other drugs, it presents new risks due to the coinciding interactions of these mixed drugs and their effects on the brain and body.

Repeatedly being exposed to substances mixed with fentanyl can lead to dependence because over time, the brain and body become reliant on fentanyl. When dependence occurs, the individual is at risk of withdrawal.

Fentanyl withdrawal symptoms occur when fentanyl use is suddenly decreased or stopped. The associated symptoms can be complicated or worsened when fentanyl is mixed with other substances.⁴

Another danger of mixing fentanyl with other substances is that it can also complicate fentanyl addiction treatment since the individual may have to be treated for multiple substance use disorders.⁴

Dangers of Mixing Fentanyl and Heroin

Heroin and fentanyl are both opioids that have similar methods of action on the brain and body. They both bind to opioid receptors in the brain.^1,5

When used in combination, they not only increase the feeling of euphoria but can heighten the dangerous signs and symptoms of misuse and can also increase the potential for overdose.

Fentanyl misuse includes:⁶

• Taking higher dosages of fentanyl than prescribed.
• Taking fentanyl more frequently than prescribed.
• Taking fentanyl for other purposes that prescribed (euphoria).
• Taking someone else’s fentanyl prescription.
• Using illicit fentanyl that is produced or sold illegally.
• Mixing fentanyl with other substances.

Fentanyl is made in a lab, whereas heroin is a semi-synthetic opioid meaning that it is derived from morphine. Morphine is a naturally occurring (extracted from the opium poppy plant) and therefore must be cultivated and then harvested before it is made into heroin. Therefore, fentanyl is often easier and much cheaper to make.^3,5

Fentanyl is sometimes laced into heroin without any knowledge to the person using it. As a result, the individual is unknowingly using a much stronger opioid (fentanyl) when expecting heroin (a less potent opioid).^1,3

Fentanyl can be lethal in even the tiniest doses, even to someone who regularly uses heroin and has a high tolerance to opioids.^1,3

Risks of Mixing Cocaine and Fentanyl

Cocaine may be laced with fentanyl to elicit a stronger high and increase cocaine profits.³ Fentanyl is much cheaper than cocaine so when fentanyl is mixed with cocaine without the user knowing, the dealer can sell a smaller amount of cocaine for the original price, since fentanyl is added.

This practice has become so common that several state, city, and federal health and law enforcement departments have issued official warnings regarding the possibility of cocaine containing fentanyl.^7,8,9

Cocaine is an illicit stimulant that speeds up the body system functions. Fentanyl and other opioids slow the body systems down. These two substances act in opposite ways, potentially creating serious harm to the body and brain. Even when used independently from each other, cocaine and opioids, including fentanyl, can result in serious complications and even lethal overdose.¹⁰

When fentanyl is mixed with cocaine intentionally, it is often known as “speedballing”. Generally, speedballing involves both substances being injected into the bloodstream, but they are sometimes snorted nasally together as well.¹²

These interactions may lead to heart, lung, and brain complications that can quickly become life-threatening. The dangers of mixing cocaine and fentanyl or other opioids include:¹²

• Confusion.
• Paranoia.
• Insomnia.
• Uncontrollable movements.
• Heart attack.
• Stroke.
• Respiratory failure.
• Increased risk of a brain aneurysm.

When fentanyl is mixed with cocaine, the risk of overdose increases. This is most likely because the individual has zero tolerance to opioids, and the smallest dose of fentanyl can result in an overdose.¹³

Data compiled by the Centers for Disease Control and Prevention (CDC) have identified synthetic opioids (mostly fentanyl) as the primary cause of cocaine-involved overdoses.¹³

Dangers of Mixing Fentanyl With Prescription Medications

Mixing fentanyl with prescription drugs is also extremely dangerous, even if the individual is using these prescription drugs for valid medical conditions.

Using fentanyl and a medication that already contains a weaker opioid (such as codeine) heightens the risk of overdose in the same way fentanyl-laced heroin does.

The combination of benzodiazepines (e.g., Xanax, Klonopin) and fentanyl is also very dangerous, accounting for 16% of opioid-involved overdoses in 2019. Benzodiazepines and opioids slow the functioning of the central nervous system, causing sedation and slowed breathing.¹⁴

Fentanyl is sometimes found in counterfeit prescription medications made to look like benzodiazepines (e.g., Xanax, Valium, etc.), less-potent opioids (OxyContin, Vicodin, Norco, etc.), or other prescription medications.¹⁵

According to the Drug Enforcement Administration (DEA), approximately 26% of tablets seized by law enforcement contained a potentially lethal dose of fentanyl.³

Fentanyl Addiction Treatment in Oxford, MS

While fentanyl addiction—also known as fentanyl use disorder (FUD)—is a serious and potentially devastating chronic illness, it is treatable.¹⁶ There are evidence-based treatment methods that help individuals withdraw from fentanyl safely and comfortably, and also build the skills necessary to remain in long-term recovery.^16,17

Addiction treatment is covered by most employer-based, government-funded, or Affordable Care Act (ACA) marketplace health plans and many addiction treatment centers offer multiple ways to pay for rehab.¹⁸

Within minutes, you can find out whether your health insurance plan covers treatment at Oxford Treatment Center by using the or calling an rehab admissions navigator at .

Oxford Treatment Center, American Addiction Centers’ drug and alcohol rehab center in Mississippi, is ready to help you get the addiction treatment you need today.