Dangers of Mixing Fentanyl With Other Drugs

Fentanyl misuse can lead to several adverse health issues and increase the risk of addiction and overdose. Mixing fentanyl with other drugs may increase some of these risks.¹

Keep reading to learn more about the dangers of mixing fentanyl with different substances, and how to find fentanyl addiction treatment if you or a loved one is struggling with fentanyl use.

What Is Fentanyl?

Fentanyl is a powerfully addictive synthetic opioid with 50 to 100 times more potent opioid effects than other drugs like morphine and heroin. Pharmaceutical fentanyl can be legally prescribed to treat severe pain, such as pain after surgery, but illicitly manufactured sources of the drug are increasingly involved in the current epidemic of opioid overdose deaths.^1,2

Various sources of illicitly manufactured fentanyl (IMF) may be available in either liquid or powdered form, the latter sometimes being pressed into counterfeit pills (made to look like prescription opioid medications). These illicitly manufactured sources of fentanyl have been driving more recent surges in fatal opioid overdoses across the United States.^1,2

Fentanyl can have several adverse effects, including drowsiness, nausea, confusion, constipation, and slowed breathing. People who misuse fentanyl may also be at risk of developing drug addiction, which refers to a compulsive and uncontrollable pattern of ongoing substance use despite the negative consequences.¹

Why Is Fentanyl So Dangerous?

Fentanyl is so dangerous because of its high potency and rapid onset of effects—the U.S. Drug Enforcement Administration warns that just a tiny amount of fentanyl, around 2 mg, which is the equivalent of 10–15 grains of table salt, can be a deadly dose for some people.^3,4

Fentanyl is a leading contributor to the opioid overdose epidemic in America. According to the Centers for Disease Control and Prevention (CDC), over 150 people die every day from overdoses involving synthetic opioids like fentanyl.^1,2

In 2022, the majority (68%) of the reported 107,081 drug overdose deaths in the U.S. involved synthetic opioids other than methadone, mainly illicitly manufactured fentanyls.⁵

Powdered forms of illicitly manufactured fentanyl are sometimes mixed with other drugs, such as cocaine, methamphetamine, or other opioids like heroin. Fentanyl cannot be seen, smelled, or tasted, so people who use street drugs may be unaware that the substance they’re using is contaminated with it, unless they use fentanyl test strips.²

Mixing Fentanyl With Other Drugs

Polysubstance use with fentanyl can be intentional, meaning people use fentanyl and other substances to obtain desired effects, or unintentional, meaning the person is unaware that the substance they’re using contains fentanyl.⁶

Fentanyl and Other Opioids

Fentanyl in combination with other opioids, like heroin or prescription painkillers (e.g., morphine, codeine, oxycodone, or hydrocodone), can increase the risk of opioid overdose and fatal respiratory depression (i.e., slowed or stopped breathing).^7,8

Studies have indicated that fentanyl may synergize some of heroin’s already dangerous potential for respiratory depression-related brain hypoxia and hypothermia in overdose, further increasing the risk of death with this particular combination.⁹

Fentanyl and Stimulants (Meth, Cocaine)

Overdose deaths that involve the co-use of fentanyl and stimulants, like cocaine or methamphetamine, have been on the rise in the United States. According to one study, stimulants were the most common drug class found in fentanyl-involved overdoses in every U.S. state in 2021.¹⁰

The intentional combination of stimulants and opioids—a practice sometimes referred to as “speedballing” or “goofballing”—may take place as a means of altering or enhancing the effects of either substance or to balance out their different effects.^10,11

Regardless of the motivation or situation in which such co-use occurs, stimulant-involved polysubstance use, such as fentanyl and amphetamines or other stimulants, is associated with several adverse effects, including an increased risk of fatal overdose, worsened physical and mental health, and hospitalizations for infectious complications.^10,11

Fentanyl and Alcohol

Using fentanyl and alcohol together can increase the risk of side effects and overdose. As with other substances that depress the central nervous system, the primary risk is dangerously slowed or stopped breathing, because alcohol can have additive effects that further compound the risks already associated with opioids like fentanyl.^8,12

Alcohol is one of the most frequently used substances alongside opioids like fentanyl. For example, a recent study in Maryland found that alcohol was the second most common substance involved in the state’s fentanyl-related overdose deaths.^8,13

Overdose Risk from Mixing Fentanyl With Other Drugs

The risk of overdose from fentanyl alone is very high, but research has shown that mixing fentanyl with other substances, such as stimulants, other opioids, or alcohol, can increase the risk of overdose and death.^2,8

The signs and symptoms of fentanyl overdose are similar to other types of opioid overdoses and can include:²

• Small, constricted pinpoint pupils.
• Falling asleep or losing consciousness.
• Slowed or stopped breathing.
• Choking or gurgling sounds.
• Limp body.
• Cold and/or clammy skin.
• Discolored or bluish skin, especially in the lips and nails.

In the event of an overdose involving opioids and stimulants, the effects of the stimulant may mask certain signs of opioid overdose. This can make it difficult to tell if someone is overdosing, which may prevent the likelihood of a bystander seeking immediate assistance.¹⁴

Fentanyl Addiction Treatment in Orange County, CA

If you or someone you care about is struggling with fentanyl use and ready to begin the path to recovery, treatment is available. It’s never too late to seek help, no matter how things might seem right now.

Laguna Treatment Hospital, our Orange County rehab, offers different levels of addiction rehab and personalized treatment plans designed to meet each patient’s individual needs.

You can start the rehab admissions process today. Call to speak with one of our caring admissions navigators about your treatment options. You can also get more information about using insurance to pay for rehab or other ways to pay for rehab and  right away.