Fentanyl

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Fentanyl  is a synthetic opioid that was originally developed as an analgesic – or painkiller – for surgery. It has a specific chemical structure with multiple areas that can be modified, often illicitly, to form related compounds with marked differences in potency.

For example, carfentanil, a fentanyl analog formed by substituting one chemical group for another, is 100 times more potent than its parent structure. Another analog, acetylfentanyl, is approximately three times less potent than fentanyl, but has still led to clusters of overdoses in several states.

Despite the number and diversity of its analogs, fentanyl itself continues to dominate the illicit opioid supply. Milligram per milligram, fentanyl is roughly 50 times more potent than heroin and 100 times more potent than morphine.