Need to Know

Learn about fentanyl – the facts, risks, and how it impacts communities across Colorado.

Fentanyl Facts

Common questions and answers about fentanyl.

  • Fentanyl is a powerful, synthetic opioid medication that health care professionals have used to treat pain since the 1970s. When fentanyl is used without a prescription – whether that use is occasional, social, recreational, or experimental – it can be dangerous.

  • Non-medical fentanyl shows up in the drug supply across Colorado. Non-medical fentanyl can be made cheaply and illegally from chemicals and can be found in many other drugs like heroin, meth, cocaine, molly/MDMA, and counterfeit pills made to look like real medications such as Adderall, Xanax, Percocet, and Oxycontin. Illicit fentanyl comes in a powder form and can be injected, smoked, or snorted.

  • Fentanyl is a very strong drug. It is 50 times stronger than heroin and 100 times stronger than morphine. Fentanyl can be harmful, even in very small amounts, especially if someone has no tolerance to opioids. Since there’s no reliable way to determine how much fentanyl is in an illicit substance, potency often varies, increasing the risk of overdose.

    Fentanyl can be found in many recreational drugs like heroin, meth, cocaine, molly/MDMA, and counterfeit pills that look like real medications, such as Adderall, Xanax, Percocet, and Oxycontin. Fentanyl comes in a powder form, which allows it to be added to or mixed in with other drugs. It is very hard for people to know if the drugs they use contain fentanyl because you cannot see it, smell it, or taste it, which can make anyone vulnerable to an overdose.

  • Because fentanyl is very strong, even very small amounts of fentanyl can cause an overdose, especially if someone has no tolerance to opioids or is using multiple drugs at once. It can be very hard for people to know if there is fentanyl in the substances they are using, which increases the risk of overdose.

    Fentanyl is a synthetic opioid that works by binding to the opioid receptors in the brain that control pain. (source) If someone overdoses on fentanyl or any other opioid, their breathing can get very slow or stop, which is very dangerous.

  • It can be difficult to know if a substance has fentanyl in it. Fentanyl is very strong, so even small amounts can be dangerous. Fentanyl has no taste or smell, and you cannot see if a substance has fentanyl in it. Many people who use illicit substances can take a drug containing fentanyl without realizing it. Fentanyl test strips can show if there is fentanyl mixed into a substance, but you won’t be able to tell how much. Read about how to use fentanyl test strips here, or watch this video.

    Fentanyl test strips are legal in Colorado. You can find test strips online, at syringe access programs, and Denver residents can order them from Denver County.

  • No, touching or accidentally coming into contact with fentanyl will not hurt you. (source) Fentanyl must be introduced into the bloodstream or a mucus membrane (like the inside of your nose) in order for it to affect you. Health care professionals use fentanyl skin patches to treat pain. Fentanyl skin patches include multiple different chemical layers that help fentanyl absorb into the skin, and they are different from illicit fentanyl. (source)

    If you are with someone who is using fentanyl or someone who overdoses after using fentanyl, you will not get hurt by helping or touching them. Staying with that person, calling for help, and giving them naloxone could save their life.

  • Fentanyl is very strong and can be made very cheaply. People who make and deal drugs mix fentanyl into other substances like heroin, meth, cocaine, molly/MDMA, and counterfeit prescription pills to stretch their supply, increase the potency of the drug, and increase profit.

    Because even a very small amount of fentanyl can cause an overdose, people who make and deal drugs might accidentally mix in too much fentanyl into each dose. While some individuals use fentanyl knowingly, others may not know it’s in their drug, increasing risk of overdose.

  • Naloxone is a medication that quickly and safely reverses opioid overdose, including ones caused by fentanyl. Emergency responders and health care professionals use naloxone to help someone with an overdose, and so can you. Naloxone is 100% safe, and it will not hurt someone even if their symptoms are not caused by an opioid, like fentanyl.

    The most common form of naloxone — and the easiest to use — is a nasal spray, and brand names include Narcan and Kloxxado. Naloxone can be purchased or ordered from any pharmacy in Colorado or online, and you can check your insurance coverage to see what you have to pay. If you are with a non profit community organization or a health care facility, you may be able to access naloxone for free or at a discounted price.

    Anyone in Colorado can help someone who might be experiencing an overdose. Learn more about how to use naloxone and save a life here.

    Naloxone is very effective in helping someone experiencing fentanyl or other opioid overdose. No type of fentanyl or other opioid is naloxone-resistant; that is a myth. If someone is having overdose symptoms, naloxone will not hurt them, and it can possibly save their life.

    As naloxone is an opioid antagonist, it will only work to reverse the effects of an opioid overdose. However, it does not cause harm if administered in a non-opioid overdose event. Individuals are encouraged to administer naloxone if they encounter an individual who is unresponsive, experiencing respiratory depression, and/or displaying other opioid overdose symptoms. Third Party Naloxone, C.R.S. §18-1-712 and 911 Good Samaritan Law, C.R.S. §18-1-711 extend immunity to an individual "who acts in good faith to administer naloxone to another person whom the person believes to be suffering an opiate-related drug overdose."

  • Naloxone is an opioid receptor antagonist, which means that it binds to opioid receptors in the brain and reverses or blocks the effects of other opioids, like fentanyl. Giving someone naloxone rapidly reverses the effects of an opioid overdose and can help them start to breathe normally again. Sometimes with strong opioids like fentanyl, another dose of naloxone may be used. If there is no effect two to three minutes after administering the first dose of naloxone, a second dose may be needed. Since slowed or stopped breathing is a symptom of an overdose, it’s important to provide rescue breathing to an individual while you’re waiting for the naloxone to take effect.

  • Yes. Anyone can buy, have, and use naloxone without a prescription in the state of Colorado. Many pharmacies have naloxone in stock, and almost all can order it for you and get it to you within a couple of days. Many insurance plans, including Medicaid and Medicare, cover naloxone. Visit your local pharmacy and ask your pharmacist about naloxone.

    Anyone who uses opioids or has them in their home should get naloxone. If you or someone you care about uses opioids, either with a prescription or without, or has an opioid use disorder, you can help them by talking to them about naloxone and having it at home, just in case. You can even carry naloxone with you if you encounter someone who might be overdosing.

Fentanyl Risks

Fentanyl is a very strong drug.

Fentanyl is a very strong drug. It is 50 times stronger than heroin and 100 times stronger than morphine. While fentanyl has been utilized in medical settings for many years, illicit fentanyl can be harmful, even in very small amounts, especially if someone has no tolerance to opioids. Since there’s no reliable way to determine how much fentanyl is in an illicit substance, potency often varies, increasing the risk of overdose.

Many people who use other drugs may be exposed to dangerous amounts of fentanyl.

Fentanyl can be found in many other drugs like heroin, meth, cocaine, MDMA (also known as molly or ecstasy), and counterfeit pills made to look like real medications like Adderall, OxyContin, Percocet, and Xanax. Because some people who make and deal drugs add fentanyl to their drugs in order to stretch their supply, and cross contamination can occur during distribution, it is very hard for people to know if the other drugs they use contain fentanyl. You cannot see, smell, or taste fentanyl if it is added to other drugs. Not knowing how much fentanyl you might be exposed to when you use drugs can make anyone vulnerable to an overdose.

Illegally made fake medications may have dangerous amounts of fentanyl in them.

People who make and sell drugs sometimes add fentanyl to counterfeit pills that look like real medications like Adderall, OxyContin, Percocet, Xanax, and other drugs. It is also possible for cross-contamination to occur. It is often very difficult or impossible to tell the difference between real and fake medication, so don’t take pills from people you don’t know or friends, even if they say they are real. Taking medications that are prescribed to you by a health care professional and filled through a pharmacy is the only way to ensure that you know what’s in a substance. It is recommended to consult a health care provider when beginning medication for a medical condition. Resources such as Quality Health Care is Your Right by the National Harm Reduction Coalition can provide helpful guidance for accessing affirming care.

Taking small amounts of fentanyl can cause an overdose.

Because fentanyl is so strong, even very small amounts of fentanyl can cause an overdose. Unless you take a medication prescribed by a health care professional and filled at a pharmacy, it can be very hard to know if there is fentanyl in the drugs you are using, which increases the risk of overdose.

Fentanyl in Colorado

  • The drug overdose death rate in Colorado in which fentanyl was involved increased from 0.8 per 100,000 in 2015 to 15.6 per 100,000 in 2022.

  • This equates to an increase from 41 overdose deaths involving fentanyl in 2015 to 920 deaths in 2022.

  • In Colorado, the age adjusted rates of overdose deaths involving any opioid increased from 8.3 per 100,000 in 2020 to 19.5 per 100,000 in 2021.

  • This equates to an increase from 472 overdose deaths involving any form of opioid in 2015 to 1,160 deaths in 2022. This continued upward trend of overdose deaths is largely driven by fentanyl-involved deaths.

The Naloxone Bulk Purchase Fund provided nearly 125,000 doses of naloxone at no cost to 229 overdose prevention partners across the state in the 2021-22 fiscal year. That is an increase from the 51,631 doses of naloxone distributed through the Bulk Fund in FY 2020-21.

CDPHE harm reduction efforts focus on ensuring that people who use drugs are able to reduce the health risks associated with drug use. Evidence-based harm reduction strategies, such as the use of fentanyl test strips, are vital in preventing death and injury associated with both legal and illegal drug use.

The Harm Reduction Grant Fund is the first dedicated state funding of its kind, and has allowed six organizations that work with people who use drugs to implement diversion programs, stigma prevention campaigns, community naloxone distribution and education, and harm reduction services for individuals most impacted by the overdose epidemic. Due to additional funding through the American Rescue Plan Act, seven additional grantees will be funded to provide harm reduction services across the state.

CDPHE’s coroner mini-grant program has helped 16 coroners’ offices across the state conduct more advanced toxicology testing to determine the cause of death. This data provides important information on which areas are being impacted by fentanyl overdose and allows CDPHE also to stay attuned to emerging substances in the illicit drug supply.

The CDPHE Overdose Prevention Unit regularly provides training and technical assistance to community partners to increase evidence-based knowledge related to fentanyl, overdose, and harm reduction.

CDPHE received funds for fentanyl test strip purchasing as part of the Fentanyl Prevention and Accountability Act. We identified local health departments as the most effective entities to support the statewide distribution of fentanyl test strips at no cost to our communities. The health departments are able to distribute the tool to any interested individual or program in their county. This program has proven to be an essential partnership with the Naloxone Bulk Fund Program in efforts to expand overdose prevention access across Colorado.