This is a national public health crisis. People, especially young people, are ingesting illicitly manufactured fentanyl without knowing it and dying at alarming rates as a result.

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Fentanyl is very cheap and extremely addictive. Drug dealers are dangerously mixing illicitly manufactured fentanyl w​​ith, and disguising it as, other common drugs like Oxy, Percocet and Xanax to increase profits. It has also been found in party drugs like cocaine and MDMA. This production process is not regulated and does not undergo any kind of quality control. Users have no way of knowing what they are getting in these street drugs, putting them at significant risk of poisoning and overdose – and as little as two milligrams of fentanyl (two grains of sand) can kill a person.

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The practice of cutting drugs with fentanyl is relatively new, so public awareness is low.

Educating the public about this crisis is the first step to reversing the tragic outcomes. Teach yourself and your community about the facts. Tips for communication from Fentanyl Awareness Day include:

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• If you are a parent, don’t avoid the topic. Initiate an open dialogue with your family about fentanyl to understand their knowledge of the issue and if they’re aware of fake pills.
  

• If you’re an educator, start the conversation in the classroom. Check out some classroom resources here.
  

• Don’t stigmatize drug use. Emphasize the high risks of encountering illicitly manufactured fentanyl and how individuals can protect themselves and their community.

Above all else, keep in mind that any pill or powder drug not prescribed by a doctor may contain fentanyl. Learn how to respond accordingly:

• Know the signs of an overdose: Loss of consciousness, unresponsiveness, irregular breathing, and inability to speak are a few of the signs to look out for.
  

• Carry naloxone: Naloxone (also referred to as Narcan) is a life-saving opioid reversal medication. It commonly comes in the form of a nasal spray. Some states and cities are making it available for free. Find naloxone near you and learn how to administer it.
  

• Test the product: Some cities and states are making fentanyl test strips available. Caution: There is no such thing as a pill that has been tested for fentanyl, since the test strips require that you fully dissolve each and every entire pill in water. Test strips also do not test for every fentanyl analog.
  

• Be prepared to call for help: If you witness someone experiencing the symptoms of an overdose/poisoning, call 911 and request emergency medical services. All 50 states and D.C. have enacted Good Samaritan laws, which typically provide immunity to those who call emergency services when experiencing or witnessing an overdose.

Illicit fentanyl is an ideal raw material for drug dealers. It is cheap to get and extremely potent. Because it is potent, only a tiny amount of powder is needed to make large quantities of drugs, making it easy to hide from law enforcement and extremely profitable to sell. Money is the biggest driver of illicit drug sales. Trying to get real prescription pills from the pharmacy to the street is difficult and risky. Pressing out a fake oxy is easy and costs the maker just pennies per pill. If an oxy sells for 40 bucks on the street, almost 100% of that goes in the dealers’ pockets. Apply that math to a batch of 5,000 or 10,000 pills and you can see there is A LOT of money to be made by the dealers up and down the supply chain.

Let’s look more closely at how these pills get into the buyer’s hands. The people making the pills usually sell them to other dealers, who sell them to other dealers, and so on, many times before the deadly pills are sold to the buyer. Whether the pills are made in Mexico or in the U.S., it is highly unlikely that the people making the fentanyl powder and fentapills, or the higher-level dealers, even know that their product has killed someone. They have made their money and moved on. Buyer beware: even a trusted friend does not know what is in the drugs they are giving you; they cannot test the dosages of their pills and have no way of backing their claim that the pills they are offering are safe.

Not all fentapills contain a lethal dose, so many people take a fake pill, assume it was real and then get comfortable taking another. This creates demand, especially since fentanyl is so addictive. This is another feature that dealers like – dependent customers are repeat customers, and that market segment is growing.