Fentanyl Education
Facts. Language. Prevention. Proctection. Harm Reduction.
What Is Fentanyl?
Fentanyl is a synthetic opioid with two very different realities.
Understanding this distinction is essential for prevention, policy, and public safety.
The fentanyl driving today’s crisis is unregulated, unpredictable, and often hidden. It is frequently mixed into other substances without a person’s knowledge or consent — including counterfeit pills and non-opioid drugs.
Illicit fentanyl is different.
Illicit Fentanyl vs. Medical Fentanyl
Medicinal (Pharmaceutical) Fentanyl
Medical fentanyl is a medication with legitimate medical uses when it is
Prescribed by a licensed healthcare provider
Correctly dosed
Administered in controlled medical settings.
Dosage is known and monitored
People are not dying from prescribed medical fentanyl when it is taken as directed.
This difference matters.
Illicit Fentanyl
The fentanyl driving the current crisis is illicit fentanyl.
Illicit fentanyl:
Is manufactured and distributed illegally
Has no quality control
Varies widely in potency
Is often mixed into other substances without the user’s knowledge or consent
This unregulated fentanyl is responsible for the majority of fentanyl-related deaths today.
Fentanyl Poisoning vs. Overdose
Many deaths are currently labeled as “overdoses” are more accurately understood as:
FENTANYL POISONINGS
Fentanyl poisoning refers to exposure to an unknown or unintended substance, rather than overuse of a known drug.
People may believe they are taking:
• A prescription pill (such as pills sold as oxycodone, Percocet, or Xanax)
• A familiar substance such as Cocaine, Methamphetamine, or Heroin
• Something they have taken safely before
But instead, they are exposed to hidden fentanyl.
Language Matters.
When we name poisoning accurately, we
Reduce stigma
Improve prevention
Support more effective public safety responses
Conflating medical fentanyl with illicit fentanyl obscures the real source of risk and delays solutions that could save lives.
Naming this distinction matters — for prevention, policy, medical response, and family support.
Many of these deaths are better understood as fentanyl poisoning — exposure to an unknown, unexpected, or misrepresented substance — rather than overdose from a known drug.
A Public Safety Issue —
Not Just an Addiction Issue
Fentanyl exposure does not require:
• A substance use disorder
• Regular drug use
• Identifying as a “drug user”
People at risk include:
• First-time or infrequent users
• People taking pills they believed were legitimate prescriptions
• Teens and young adults
• People with and without substance use disorder
• Families and children exposed accidentally
Hidden fentanyl is a public safety crisis.
When Something Doesn’t Feel Right
These warning signs may include:
Saying a pill or substance “didn’t feel right”
Sudden changes in mood after taking something
New or worsening depression or anxiety
Inability to sleep
Physical discomfort that doesn’t make sense
Expressing fear, confusion, or concern about a substance
Thoughts of self harm or sudden suicidal ideation that feels new, intense, or uncharacteristic
Some people experience intense withdrawl-like symtoms after a single exposure, especially when fentanyl was unexpected
Without language of testing, this can be mistaken for sudden mental health crisis
These experiences can be frightening-especially when they appear suddenly or without a clear cause
When someone voices concern, that moment matters. fentanyl is a medication with legitimate medical uses when prescribed, dosed, and administered by healthcare professionals in controlled settings.Prescribed and administered in controlled medical setting
People are not dying from prescribed medical fentanyl taken as directed.
They are dying from unpredictable illicit fentanyl contamination in the unregulated drug supply.
Many of these deaths are better understood as fentanyl poisonings — exposure to an unknown or unintended substance — rather than overdose from a known drug.
Naming this distinction matters for prevention, policy, public safety, and understanding.
Conflating medical fentanyl with illicit fentanyl obscures the real source of risk and delays effective public safety responses.
This difference matters.
Many people harmed by illicit fentanyl did not ignore danger.
They noticed something was wrong — but lacked the language, information, or support to understand what was happening in time.
That gap between exposure and understanding is where prevention can save lives.
When Something
Doesn’t Feel Right
Many people who are later harmed by hidden fentanyl noticed early warning signs- but did not yet have the language or information to understand what was happening.
These warning signs include:
Saying a pill or substance “didn’t feel right”
Sudden changes in mood after taking something
New or worsening depression or anxiety
Inability to sleep
Physical discomfort that doesn’t make sense
Expressing fear, confusion, suicidal thoughts, or concern about a substance
Thoughts of self harm or sudden suicidal ideation that feels new, intense, or uncharacteristic
Some people experience intense withdrawal-like symptoms after a single exposure, especially when fentanyl was unexpected.
Without language or testing, this can be mistaken for sudden mental health crisis
These experiences can be frightening — especially when they appear suddenly or without a clear cause.
Sudden mental health crises can be a sign of toxic exposure, withdrawal-like effects, or nervous system disruption — not a personal failure.When someone voices concern, that moment matters.
When someone voices concern, that moment matters.
Listening can save a life.
Responses Can Increase or Reduce Risk
Sometimes, when someone shares concern about a substance, the response they receive unintentionally increases danger.
This can look like:
Minimizing the concern
Normalizing symptoms
Encouraging continued use
Treating distress as “just mental health” without asking why it suddenly appeared
This is not always malicious.
But it can delay care and silence warning signs.
Social Responses Can Increase or Reduce Risk
Sometimes, when someone shares concern about a substance, the response they receive unintentionally increases danger.
This can look like:
Minimizing the concern
Normalizing symptoms
Encouraging continued use
Treating distress as “just mental health” without asking why it suddenly appeared
This is not always malicious.
But it can delay care and silence warning signs.
How to Advocate for
Each Other
If someone you care about says:
“Something feels wrong”
“I can’t sleep”
“I feel unlike myself”
“This pill didn’t feel right”
“I’m suddenly depressed or panicked”
“I don’t want to be here anymore” or “I’m scared of my thoughts”
Take it seriously.
Helpful responses include:
Encouraging immediate medical or emergency care when safety is at risk
Asking about recent substance exposure — without judgment
Naming that hidden fentanyl exposure is common
Treating sudden suicidal thoughts as a medical emergency, not a character issue
Staying with the person and reducing isolation
Talks about not wanting to live or being disconnected from themselves
You do not need to diagnose.
You do not need to accuse.
You only need to slow things down and prioritize safety.
Responding quickly and compassionately can save a life — even if the cause is not yet clear.If someone you care about says
Take it seriously.
You do not need certainty to prioritize safety.
Exposure does not always look like immediate collapse.
Possible warning signs may include:
• Sudden or severe depression
• Confusion or disorientation
• Inability to sleep
• Leg cramps or body pain
• Extreme anxiety or fear
• Feeling “not right” after taking a pill or substance
If someone experiences unexpected symptoms after taking a substance — even once — it is important to seek medical care and advocate clearly for fentanyl testing.
You can also use fentanyl test strips to check for fentanyl exposure.
About Drug Testing & Hospitals
Standard drug panels have not always included fentanyl unless specifically ordered.
This gap has led to missed diagnoses, confusion, and delayed care.
We believe fentanyl testing should be:
• Routinely available
• Clearly explained
• Nonjudgmental
• Focused on safety, not punishment
Lack of testing is not a personal failure — it is a systems issue.
About Fentanyl Test Strips
Fentanyl test strips can be one harm reduction tool, but they have important limitations.
Important facts:
Fentanyl test strips were originally validated for urine testing, which can help detect exposure after use
Some people use test strips to test substances directly, but this method has limitations
Illicit drugs may contain fentanyl unevenly (“chocolate chip cookie effect”)
A negative test does not guarantee safety
Accurate substance testing requires fully dissolving the drug
Testing urine after unexpected symptoms can help identify fentanyl exposure — especially when symptoms are sudden, severe, or unexplained.
However, many people do not test because they do not believe they are at risk.
Education must reach everyone — not only those who already identify as using drugs.Many people do not know they need to test — because they do not believe they are at risk
Testing for Possible Exposure
Fentanyl test strips were originally validated for urine testing.
In some situations, urine testing may help confirm fentanyl exposure after symptoms begin, support medical advocacy, and guide people to seek immediate care when something feels wrong.
A positive test does not explain timing or dose — but it can provide critical information when symptoms are confusing or dismissed.
Education must reach everyone.
Test strips are one tool- not a guarantee.
Education and access must work together.
Testing does not replace medical evaluation.
It is one tool to support understanding and safety.
Naloxone (Narcan)
Saves Lives
Naloxone reverses opioid poisoning and is safe to carry.
We encourage:
• Every household to carry naloxone
• Friends, families, and communities to learn the signs of opioid poisoning
• Removing stigma around carrying or using naloxone
You do not need to identify as someone who uses drugs to carry naloxone.
If You Think Someone Has Been Exposed
• Call emergency services immediately
• Administer naloxone if available
• Stay until help arrives
• Advocate clearly and calmly
Asking for help is an act of care — not a confession.
What to Say / What Not to Say
Helpful response
“I’m glad you told me.”
“Let’s slow down and make sure you’re safe.”
“Hidden fentanyl is common — this could matter.”
“We don’t have to figure this out alone.”
Responses that can increase risk
“You’re overthinking it.”
“That happens to everyone.”
“It’s probably just anxiety.”
“You’ll be fine.”
Your response can create safety — or silence.
Our Commitment
Never Alone Nick exists to:
• Name hidden fentanyl exposure honestly
• Support families left without language or recognition
• Expand harm reduction to include everyone
• Reduce preventable loss through education, compassion, and truth
Closing the gap between and exposure and understanding-throughlanguage, testing, and compassionate response- is central to Nick’s Law and to preventing future loss.
You are not alone.
And this did not happen because you failed.