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When prescribed by a physician, fentanyl is usually administered via injection, transdermal patch, or lozenges. However, the fentanyl and fentanyl analogs associated with recent overdoses are produced in clandestine laboratories. This illicit fentanyl is sold in various forms: as a powder; laced on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids. Fentanyl can be ingested, snorted, or injected, or the blotter paper can be placed in the mouth for absorption through the mucous membrane.
Like heroin, morphine, and other opioid drugs, fentanyl operates by binding to the body’s opioid receptors, located in areas of the brain that regulate pain and emotions. When opioid drugs bind to these receptors, they can increase dopamine levels in the brain’s reward areas, inducing a state of euphoria and relaxation. Fentanyl's effects are similar to those of heroin and include euphoria, drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma, and death.
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