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Important update: Sept. 21, 2023

Boulder County Public Health (BCPH) is urging caution following the discovery of a powdered form of fentanyl circulating in the county’s illicit drug market.

Colorado has seen an increase in fentanyl overdoses over the past year. Here are five things everyone should know about fentanyl.

What is fentanyl?

Fentanyl is a synthetic opioid that is 50 to 100 times more potent than heroin or morphine.

Drug traffickers often mix fentanyl into other drugs because it is cheap to manufacture and a small amount goes a long way.

Why is fentanyl dangerous?

Fentanyl is often mixed into other substances or marketed as substances other than fentanyl, such as prescription medications. This can be dangerous because individuals often consume fentanyl without knowing it or meaning to, which can result in accidental overdoses or death.

Fentanyl is often added to:

• Powders (like cocaine)
• Capsules
• Pressed pills meant to look like prescription medications (like Xanax or Oxy/M30s)
• … and much more!

Experts consider 2 mg of fentanyl to be lethal, but many counterfeit pills contain up to 5 mg (more than twice the lethal dose). This amount is incredibly small. Check out the image to the side for scale to see what 2 mg of fentanyl looks like. 

Important: While these drugs have tested positive for fentanyl by public health agencies, it’s important to remember that any pill or drug sold on the internet, on the streets or by a person you know could contain a potentially lethal dose of fentanyl.

How common is fentanyl?

Fentanyl may be more common than you think.

Colorado authorities have seen a large influx of fentanyl over the past year and are expecting to see an increase in overdoses in the coming months. In fact, the CDC announced that fentanyl is now the leading cause of death among adults 18 to 45 in the United States. 

Additionally, according to the U.S. Drug Enforcement Administration (DEA), nearly half of all counterfeit pills tested contained a lethal dose of fentanyl. This figure is particularly alarming because it can be difficult to distinguish genuine pills from fake or counterfeit versions. Check out the examples below to see how counterfeit pills can be designed to look just like genuine pharmaceuticals.

How common is fentanyl?

Fentanyl may be more common than you think.

Colorado authorities have seen a large influx of fentanyl over the past year and are expecting to see an increase in overdoses in the coming months. In fact, the CDC announced that fentanyl is now the leading cause of death among adults 18 to 45 in the United States. 

Additionally, according to the U.S. Drug Enforcement Administration (DEA), nearly half of all counterfeit pills tested contained a lethal dose of fentanyl. This figure is particularly alarming because it can be difficult to distinguish genuine pills from fake or counterfeit versions.

Tips for staying safe

While fentanyl can be lethal, there are things you can do to help protect yourself and your friends. Here are some tips and strategies you can use to prevent accidental overdoses.

 Please note: Due to the unpredictability of fentanyl, there is no foolproof way to eliminate the risk of overdose. 

Know what you’re getting into

Assume that any pill or drug not purchased directly from a pharmacy could contain fentanyl. This includes illicit drugs (cocaine, heroin, meth, etc.) as well as prescription medications (Xanax, Oxycodone, etc.).

Have naloxone on hand

Carry naloxone and make sure you know how to use it. 

Naloxone is an FDA-approved medication that can be used to temporarily reverse opioid overdoses. Naloxone is typically administered through a nasal spray, but it also comes in an injectable from. This medication help can temporarily reverse opioid overdoses, but it can wear off quickly or require additional doses for fentanyl.

All CU Boulder students, staff and faculty can pick up free naloxone from Health Promotion on the third floor of Wardenburg Health Center.

Learn more about naloxone and how to use it

Watch this video on when and how to use naloxone

[video:https://www.youtube.com/shorts/d7LjUz3RvV8]

Be prepared to call for help

Look for these signs:

• Pinpoint (small) pupils
• Shallow or no breathing
• Blue or grayish lips/fingernails
• No response to stimulus (i.e. being pinched)
• Gurgling/heavy wheezing or snoring sound

If signs of an overdose are present:

• Ask if the person is alright and look for a response
• Make a fist, and use your knuckles to apply downward pressure to their sternum (do not hit them); this is a test to see if they respond to the pain stimulus

If they do not respond:

• Call 911
• Administer naloxone if available
• Start CPR

Naloxone will not harm someone who is not overdosing—when in doubt use it!

Important policies to know

CU Boulder Amnesty Policy

Calling for help in an alcohol- or drug-related emergency means neither the person who calls for help nor the person who needs help will be subject to formal disciplinary sanctions by the university (i.e., probation, suspension, expulsion).   

To be covered by the Amnesty Policy, a student must:  

• Call for help (911 or university staff). 
• Stay with the individual until help arrives. 
• Cooperate with staff and emergency responders. 

The 911 Good Samaritan Law states that a person is immune from criminal prosecution for an offense when the person reports, in good faith, an emergency drug or alcohol overdose even to a law enforcement officer, to the 911 system or to a medical provider.  

This same immunity applies to persons who remain at the scene of the event until a law enforcement officer, or an emergency medical responder arrives, or if the person remains at the facilities of the medical provider until a law enforcement officer, emergency medical responder or medical provider arrives. The immunity described above also extends to the person who suffered the emergency drug or alcohol overdose event. 

Avoid using substances alone

If you can’t be in the company of someone else who is sober, plan to have someone check in on you in case you need help. If you are with friends who are also using, have someone else check in on all of you. It’s also important to have naloxone on hand. Ensure that everyone knows where to access it and how to use it in case of an emergency.

Start small and go slow 

Start with a very small dose every time you use something that could be contaminated with fentanyl. Because fentanyl is often mixed in with other substances in large batches, the amount present in a single pill or drug can vary widely. One pill may be fine, and the next may not be.

Test for fentanyl

There are a number of test strips you can use to test for fentanyl. However, it’s important to know that a negative result does not mean there is no fentanyl present. It is possible for fentanyl to exist in an untested area of a pill or for the pill to contain a different synthetic opioid product.

Sobriety can reduce tolerance 

If you’ve used fentanyl or other substances in the past and have recently experienced a period of sobriety, your tolerance for the drug has likely decreased. If you choose to use again, be mindful of potential changes in drug potency and start with a smaller dose than you might have used in the past. These strategies can help you avoid an accidental overdose or other unwanted experiences.

What resources are available?

Campus resources

There are resources available to support students, staff, faculty and families at CU Boulder.

• Resources for students
  • Learn how to connect with campus resources for undergraduate and graduate students.
• Resources for staff and faculty
  • Learn how to find support for yourself, a student or a colleague.
• Resources for families
  • Learn how you can support your student.
• General information
  • Learn about prevention, harm reduction and substance use at CU Boulder.

Community resources

Students, staff, faculty and community members can also access resources outside the university.

• • The Works Program is a free, legal and anonymous harm reduction program that provides free supplies, disposal programs and referrals. Their goal is to reduce the rsiks of disease and overdose deaths across Boulder County communities.
• • There is a fatal overdose in Colorado every 4 hours, 45 minutes and 9 seconds. Stop the Clock connects community members with pharmacies and other sites that offer naloxone.
• • The Substance Use Advisory Group is working toward preventing fatal overdoses, destigmatizing substance use disorders (SUDs), promoting harm reduction and supporting affected individuals into treatment and recovery.
• • The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a free, confidential, 24/7 treatment referral and information hotline for individuals and families facing mental health and/or substance use disorders.