For some, fentanyl is a miracle drug used to dampen extreme physical pain from a devastating injury, surgery, or cancer treatment.
For others, it is a cheap, highly addictive mental escape hatch. Fast acting, inexpensive, and more powerful than morphine and heroin, it can bring death in moments.
The synthetic painkiller has been around since the 1960s, but a recent surge in overdose deaths linked to fentanyl has prompted congressional hearings, a CDC network-wide health alert, and a national conversation about prescription drug addiction.
For many, Thursday’s confirmation that Prince died after an accidental fentanyl overdose makes a national health crisis feel somehow personal.
Fentanyl is sometime used used in “lollipop” form to treat military personnel who suffer devastating injuries on the battlefield and is also prescribed to cancer patients in patches or lozenges.
Now, according to a CNN report, an “illicit version of the drug is flooding into communities across America.”
Casual users are taking fentanyl in a pill or powder form. Others are using it to “cut” heroin or are buying patches from recovering cancer patients. The painkiller, which looks like heroin, is so inexpensive and so prevalent that is now being peddled as a stand-alone.
The high is quick and potent. And sometimes, even in small amounts, fentanyl can be deadly.
As I wrote for the The Daily Beast in March, drug counselors say that with heroin there is at least a chance for recovery after a relapse. But fentanyl can kill within moments. The high takes off even before the injection is complete. That explains why addicts, like my friend Queenie, are so often found lifeless with the syringe still dangling from their arm.
Fentanyl can be up to 100 times more potent than morphine and 50 times stronger than pharmaceutical grade heroin. Incidences of seizures or deaths related to its abuse have soared in some states. The drug is so strong that law enforcement officers wear hazmat suits during search and seizure operations.
According to CNN, “It first showed up in deadly doses on the streets in 2007,” and the DEA was able to trace it to “a single lab in Mexico.” Even though that lab was shut down and drug seizures subsided for a time, in 2014 public health officials began tallying increases in at least 10 states.
Last March, President Obama addressed a conference on prescription drug abuse in Atlanta where he urged us to focus our collective attention on prioritizing treatment over criminalization. His proposal included a request for $1.1 billion in new funding for drug treatments that would go directly to the states and training for health providers and drug prescribers.
First responders around the country have been trained to used naloxone, the so-called save shot. But because fentanyl moves so quickly, the damage is often done before medical personnel can arrive. It is suspected that naloxone was used to save Prince, after his flight crew made an emergency landing in Moline, Illinois, in mid-April. He died a week later.
Prince, we now know, was found in an elevator at his Paisley Park estate. He had been dead at least seven hours. Authorities did not say how the chart-topping artist obtained the drug or how he administered the deadly dose.
What we do know is that fentanyl does not care about fame. It does not care about wealth, age, or color. It has no preference for gender, politics or religion. It does not care who you love, who loves you, or that you love at all.
Fentanyl is prolific and efficient.