According to the Centers for Disease Control and Prevention, more than 932,000 people have died from drug overdoses in the United States since 1999. In 2020 alone, nearly 100,000 people died from overdoses. The main cause ? Synthetic opioids – especially fentanyl.
This sharp increase in opioid-related overdoses in recent years includes nearly 69,000 deaths in 2020. Of those deaths, 82.3% involved synthetic opioids, which are artificially produced. But what makes synthetic opioids so deadly?
Fentanyl and synthetic opioids
Fentanyl is a synthetic opioid about 100 times more potent than morphine and 50 times more potent than heroin in its effects on the body, according to the Ministry of Justice/Drug Enforcement Administration.
Although it has become a household name in recent years, fentanyl has been around since its inception in 1959 and was introduced in the 1960s as an intravenous anesthetic for pain relief.
But today, the increase in the illegal trafficking of fentanyl and other synthetic opioids has led to soaring numbers of drug overdoses in the United States and beyond. These overdoses often occur when people use a drug, such as heroin, that has fentanyl added.
Because a person is unaware of the presence of fentanyl, they do not know that they are taking a potentially fatal dose. Once injected into the body, the drug travels to the brain, where it binds to certain opioid receptors, called mu-opioid receptors. These receptors are found in the part of the brain that handles pain and emotions, which is why these drugs provide extreme pain relief.
Why are these synthetic opioids so deadly?
Synthetic opioids, especially fentanyl, are deadlier than more natural opioids for one main reason: they bind more effectively to mu-opioid receptors.
When an opioid enters the brain and binds to these opioid receptors, an excessive amount of binding can cause drowsiness, disrupt the body’s breathing process, and possibly lead to unconsciousness.
According to a 2021 study published in Nature, fentanyl can adopt different binding patterns in the brain, which may explain why fentanyl is so deadly in such small doses. However, the researchers admit that more research is needed to understand how fentanyl works in the brain.
“Surprisingly little is known about the signaling mechanism of fentanyl and how it interacts with [mu-opioid receptors] to an illicit analgesic response,” the researchers write in the study. “It is conceivable that fentanyl and its analogs bind and activate [mu-opioid receptors] in the same way as the morphinan compounds; however, the structural basis is still lacking.