Law enforcement seizures of fentanyl-laced pills increased by 834% in the United States between January 2018 and December 2021, according to an NYU Grossman School of Medicine study published in late March. The study also found that the U.S. Drug Enforcement Administration confiscated 1.8 million pills containing fentanyl in the last three months of 2021.

The percentage of all pill seizures that contained fentanyl more than doubled between 2018 and 2021, from 13.8% to 29.2%. In recent years, fentanyl — the synthetic opioid used in pain management treatments — has been increasingly found mixed with heroin to increase its potency.

Joseph Palamar, an NYU Grossman professor and the lead investigator of the study, said that there are safety concerns for those who purchase drugs illegally because of the potential presence of fentanyl in other drugs.

“The drug market is being flooded with fentanyl,” Palmar said. “It clearly does not belong in pills that look like Xanax, does not belong in cocaine or meth or ketamine, but it’s popping up in those drugs.”

Palmar said that because fentanyl has been mixed with the supply of other drugs, people are now seeking fentanyl directly. He said there needs to be greater awareness of overdoses caused by drugs that have been laced with fentanyl.

“There have been clusters of overdoses involving cocaine right here in New York City,” Palmar said. “You get a whole bunch of people who got a bad batch. They were drinking, did a bump of coke in the bathroom, and then they wake up in the hospital revived with Naloxone.”

Amanda Bunting, an assistant professor at Grossman and a researcher in the school’s population health department, said that while heroin users have become more accustomed to checking for fentanyl in their supply of drugs, users of other drugs are less aware. The sharp increase in instances of fentanyl being found in different drugs, whose users are uninformed of the possible presence of the substance, is particularly dangerous.

“Folks who use heroin, for example, have been aware and have known about and dealt with fentanyl in their drug supply for quite some time,” Bunting said. “Compared to, you know, for folks who use and are buying benzodiazepines or ecstasy, you may not really be expecting it, or even be aware of it at all.”

Bunting, who has also conducted research on online communities centered around drug use, said that people who use drugs socially may be less ingrained in online communities created to share harm reduction information. Those who consume ecstasy, for example, are often infrequent drug users, she said. As such, people who only occasionally use drugs are less likely to be tuned in to community information about tainted batches.

Overdose deaths in the United States have continued to increase every year, according to Centers for Disease Control and Prevention data, only exacerbating what has already been officially declared a public health emergency. Synthetic opioids, such as fentanyl, contributed to nearly 73% of all opioid-related deaths in 2019, the latest year with published data. 

Bunting said that anyone can help prevent overdoses by carrying Naloxone, a drug that can be used to treat opioid overdoses. She said that she takes the drug with her when she goes out and is trained in its administration.

“You don’t have to be a person who uses drugs to carry Naloxone, you can just be a concerned person of your community,” Bunting said. “And then there are fentanyl test strips, which have some caveats, but in general, are pretty helpful.”

Palamar has other ideas about what can be done to help alleviate the risks of drug use. He said he believes a systematic, nationwide drug purity testing program — where users can send their drugs to be tested for harmful elements — would be most effective in reducing fentanyl related deaths.

Contact Tori Morales at [email protected].