What you need to know about fentanyl.

Facts on fentanyl from official groups and agencies.

This page contains downloadable copies of each of the most important factsheets on fentanyl, from the U.S. Drug Enforcement Administration (DEA), the U.S Centers for Disease Control and Prevention (CDC) and other official organizations.


Many of the most important facts about fentanyl are also excerpted here for ease of reading.


Facts and figures published after these sheets were issued can be found in our NewsBriefs.

What Parents Need to Know About Fake Pills

U.S. Drug Enforcement Administration

“Fake pills are made to look like OxyContin®, Xanax®, Adderall®, and other pharmaceuticals. These fake pills contain no legitimate medicine. Fentanyl is also made in a rainbow of colors so it looks like candy.” – U.S. DEA

“DEA lab testing reveals that six out of every ten fake pills with fentanyl contain a potentially lethal dose.” – U.S. DEA

“It only takes a very small dose of fentanyl—2 milligrams—to be lethal, such as the amount found on the tip of a pencil.” – U.S. DEA

“The drug landscape is dramatically different from when you grew up, or even from just a few years ago. All parents and caregivers need to be educated on current drug threats to be able to have informed talks with their kids.” – U.S. DEA

“Drug traffickers are using social media to advertise drugs and conduct sales. If you have a smartphone and a social media account, then a drug trafficker can find you. This also means they are finding your kids who have social media accounts.” – U.S. DEA

Tips for Parents and Caregivers

— Encourage open and honest communication
— Explain what fentanyl is and why it is so dangerous
— Stress not to take any pills that were not prescribed to you from a doctor
— No pill purchased on social media is safe
— Make sure they know fentanyl has been found in most illegal drugs
— Create an “exit plan” to help your child know what to do if they’re pressured to take a pill or use drugs. – U.S. DEA

Parents’ Perspective

Fake pills took real lives: Their children were victims of fentanyl poisoning. They thought it was Xanax, Percocet, Oxycodone, or Adderall. It wasn't.

These factsheets contain what too many parents wish they'd known sooner. Please do yourself the favor of reading at least the key excerpts provided.

Counterfeit Pills Fact Sheet

U.S. Drug Enforcement Administration

“Criminal drug networks are mass-producing fake pills and falsely marketing them as legitimate prescription pills to deceive the American public.” – U.S. DEA

“Many counterfeit pills are made to look like prescription opioids such as oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®); or stimulants like amphetamines (Adderall®).” – U.S. DEA

“Fake prescription pills are easily accessible and often sold on social media and e-commerce platforms—making them available to anyone with a smartphone, including teens and young adults.” – U.S. DEA

“Counterfeit pills often contain fentanyl and are more lethal than ever before. DEA lab testing reveals that 2 out of every 5 pills with fentanyl contain a potentially lethal dose.” – U.S. DEA


[Note: The ratio of potentially fatal fake pills has since increased from 2 out of 5 [or 4 out of 10] to 6 out of 10 fake pills with fentanyl now containing a potentially lethal dose of it.]

“The only safe medications are ones that come from licensed and accredited medical professionals. DEA warns that pills purchased outside of a licensed pharmacy are illegal, dangerous, and potentially lethal. – U.S. DEA

Social Media Drug Trafficking

U.S. Drug Enforcement Administration

“Criminal drug networks are abusing social media to expand their reach, create new markets, and target new clientele. This includes by selling deadly fake fentanyl and methamphetamine pills, often to unsuspecting teenagers, young adults, and older Americans, who think they are buying the real thing.” – U.S. DEA

“Drug traffickers have turned smartphones into a one-stop shop to market, sell, buy, and deliver deadly, fake prescription pills and other dangerous drugs. In just three steps, deadly drugs can be purchased and delivered to your home just like any other good or service.” – U.S. DEA

“Drug traffickers advertise on social media platforms like Facebook, Instagram, Snapchat, TikTok, Twitter and YouTube. These advertisements are in disappearing, 24-hour stories and in posts, which are promptly posted and removed.” – U.S. DEA

“Posts and stories are often accompanied by known code words and emojis that are used to market and sell illicit and deadly drugs on social media. These code words and emojis are designed to evade detection by law enforcement and by the preset algorithms used by social media platforms.” – U.S. DEA

“Once contact is made, drug traffickers and potential buyers often move to an encrypted communications app like WhatsApp, Signal, and Telegram. Drug traffickers typically switch to these encrypted communications apps to arrange drug deals with prospective buyers.” – U.S. DEA

“After a deal is made, drug traffickers request payment using one-click apps like Venmo, Zelle, Cash App, and Remitly.” – U.S. DEA

Decoding Drug Emojis

U.S. Drug Enforcement Administration

According to the U.S. DEA, drug dealers on social media use code words and emojis to indicate that they have certain drugs available. These include Percocet, Xanax, Adderall, Meth, Heroin, Cocaine, MDMA, Mollies, Mushrooms, Cough Syrup, and Marijuana, among others. These fake pills may actually contain fentanyl and not even the dealer may know this.

“Fake prescription pills, commonly laced with deadly fentanyl and methamphetamine, are often sold on social media and e-commerce platforms – making them available to anyone with a smartphone.” – U.S. DEA

“These emojis reflect common examples found in DEA investigations. This list is not all–inclusive, and the images…are a representative sample.” – U.S. DEA

The Facts About Fentanyl

U.S. Centers for Disease Control & Prevention (CDC)

“Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and nonfatal overdoses in the U.S.” – U.S. CDC

“[Fentanyl] is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous.” – U.S. CDC

“Illicitly manufactured fentanyl (IMF) is available on the drug market in different forms, including liquid and powder. Fentanyl-laced drugs are extremely dangerous, and many people may be unaware that their drugs are laced with fentanyl.” – U.S. CDC

“Drugs may contain deadly levels of fentanyl, and you wouldn’t be able to see it, taste it, or smell it. It is nearly impossible to tell if drugs have been laced with fentanyl unless you test your drugs with fentanyl testing strips.” – U.S. CDC


Please note that testing strips are useless and inaccurate when used on pills. A pill would have to crushed and dissolved for proper testing, and, “Even if the test is negative, caution should be taken as test strips might not detect more potent fentanyl-like drugs, like carfentanil”

“Recognizing the signs of opioid overdose can save a life. Here are some things to look for:
— Small, constricted “pinpoint pupils”
— Falling asleep or losing consciousness
— Slow, weak, or no breathing
—Choking or gurgling sounds
— Limp body
— Cold, clammy, and/or discolored skin.” – U.S. CDC

“It may be hard to tell whether a person is high or experiencing an overdose. If you aren’t sure, it’s best to treat the situation like an overdose—you could save a life.

What to do if you think someone is overdosing:

1. Call 911 immediately.

2. Administer naloxone, if available.

3. Try to keep the person awake and breathing.

4. Lay the person on their side to prevent choking.

5. Stay with them until emergency workers arrive.” – U.S. CDC

Fentanyl: DEA, DOJ Drug Fact Sheet

U.S Department of Justice / DEA (October 2022)

“Fentanyl can be injected, snorted/sniffed, smoked, taken orally by pill or tablet, and spiked onto blotter paper. Illicitly produced fentanyl is sold alone or in combination with heroin and other substances and has been identified in fake pills, mimicking pharmaceutical drugs such as oxycodone.” – U.S. DEA

“Fentanyl, similar to other  commonly used opioid  analgesics (e.g., morphine), produces effects such as relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.” – U.S. DEA

“Overdose may result in stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of triad of symptoms such as coma, pinpoint pupils, and respiratory depression are strongly suggestive of opioid poisoning.” – U.S. DEA

“From 2011 through 2021, both fatal overdoses associated with abuse of clandestinely produced fentanyl and fentanyl analogs, and law enforcement encounters increased markedly…. These overdose deaths involving synthetic opioids is primarily driven by illicitly manufactured fentanyl, including fentanyl analogs.” – U.S. DEA

Common street names include:
— Apache

— China Girl

— China Town

— Dance Fever

— Friend

— Goodfellas

— Great Bear

— He-Man

— Jackpot

— King Ivory

— Murder 8

— Tango & Cash.” – U.S. DEA

Counterfeit Pills: DEA, DOJ Drug Fact Sheet

U.S Department of Justice / DEA

“Counterfeit pills are fake medications that have different ingredients than the actual medication. They may contain no active ingredient, the wrong active ingredient, or have the right ingredient but in an incorrect quantity.


“Counterfeit pills may contain lethal amounts of fentanyl or methamphetamine and are extremely dangerous because they often appear identical to legitimate prescription pills, and the user is likely unaware of how lethal they can be.” – U.S. DEA

“Mexican and domestic drug trafficking organizations operating in the U.S. produce counterfeit pills with pre-made chemicals and drugs from China and/or Mexico. They are usually produced in substandard conditions, labeled incorrectly, and may include dangerous, unapproved substances. There are no quality control mechanisms in the illicit labs producing counterfeit pills to ensure dosing is not lethal.” – U.S. DEA

“Online sales via internet marketplaces and social media are the major sources for obtaining counterfeit pills. A significant number of high school and college students purchase Adderall and Xanax from dark web drug markets and/or through social media referrals, which market deadly versions of these drugs tainted with fentanyl and/or methamphetamine.” – U.S. DEA

“Counterfeit pills are nearly identical to actual prescription medications. The majority of counterfeit pills resemble oxycodone 30mg pills (M30s), but can also mimic hydrocodone, alprazolam (Xanax), Adderall, and other medications. There are indications that drug trafficking organizations are specifically targeting kids and teens by creating counterfeit pills in a variety of shapes and bright colors to appeal to that age group. Counterfeit M30 pills can vary in color from white to blue.” – U.S. DEA

“The best way to avoid counterfeit medication is to take only medications prescribed by a licensed medical professional and dispensed by a registered pharmacist.” – U.S. DEA

“Counterfeit pills that contain fentanyl can be deadly. A lethal dose of fentanyl is about two milligrams, equivalent in size to a few grains of salt.

“Synthetic opioids, such as illicit fentanyl, remain the primary driver of the increase in overdose deaths, accounting for 80 percent of all deaths  involving an opioid.” – U.S. DEA

Briefing Guide for First Responders

U.S Department of Justice; Drug Enforcement Administration

“…due to the elevated potency of fentanyl over traditional opioid drugs (i.e., heroin), criminal organizations can use one kilogram of fentanyl to produce approximately 1 million (1 milligram) counterfeit pills, resulting in potentially 10- 20 million dollars in revenue.” – U.S. Department of Justice

“As matter of reference it has been determined that it would only take 2-3 milligrams of fentanyl to induce respiratory depression, arrest and possibly death (see photo of penny). When visually compared, 2 to 3 milligrams of fentanyl is about the same as five to seven individual grains of table salt.” – U.S. Department of Justice

“Fentanyl-related substances are designed to be absorbed into the body by all means, including injection, oral ingestion, contact with mucous membranes, inhalation, and via transdermal transmission (through the skin). As such, accidental exposure by first responders is a real danger.” – U.S. Department of Justice

“Do NOT use hand sanitizer. Hand sanitizers may contain alcohol, a skin penetrant, which may increase the absorption of fentanyl through the skin.”


“To limit the potential for exposure, personnel should refrain from eating, drinking, or smoking while in the presence of any suspected fentanyl-related substance.” – U.S. Department of Justice


Please study the Briefing Guide, available below, and other written and visual material in full. These excerpts are intended only to highlight some of the information available in this guide.


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