In his book Fentanyl, Inc.: How Rogue Chemists Created the Deadliest Wave of the Opioid Epidemic, journalist Ben Westhoff spent years diving into the international fentanyl trade and uncovering how the substance exploded into an urgent crisis. His reporting took him across the country and around the world, meeting those responsible for the fentanyl epidemic and those whose lives have been damaged by it.  

In recognition of National Fentanyl Awareness Day, we gathered the three key takeaways from Fentanyl, Inc.:  

1. Fentanyl can be mixed into any substance, and it’s hard to detect.   

Fentanyl has existed since 1959 and has been used for decades as prescription pain medicine. It did not begin to become the crisis we know today until cartels and drug dealers realized they could save money and keep customers coming back by mixing fentanyl with other substances, like heroin and prescription pain pills. Now, fentanyl is frequently found in almost any street-sold substance and in almost any formulation.  

Even more frightening, fentanyl is impossible to detect by the human eye once it has been mixed with other substances. The only way to detect its presence is through thorough testing. A user typically does not know they’ve used a substance containing fentanyl until it is too late.  

As Westhoff said in his keynote speech at the 2023 Champions for Youth Summit, “The most important message that we can tell kids, that we can tell parents, is that any pill or any powder from the black market can and does have fentanyl in it.”  

2. Fentanyl is extremely potent, and dosing is inconsistent. 

Many people do not fully comprehend how powerful fentanyl is – even those who use and sell it. Westhoff met an anonymous man who sold fentanyl over the internet, and he described turning it into a nasal spray with only “tiny crumbs of the drug, 0.001 grams per milliliter of water.”  

This incredible potency becomes even more of a threat when fentanyl is mixed into other substances without the user’s knowledge. Cartels and manufacturers of illicit drugs are not precise in their methods, so one dose of a substance might contain almost no fentanyl while the next could have enough to be fatal.  

“Other than those who cut up the original product, nobody knows how much pure fentanyl is in the powders and pills being sold on the street… This lack of dosage information, at root, is the primary cause for the fentanyl overdose crisis, the reason so many people are dying,” Westhoff writes.  

3. Fentanyl is exceptionally hard to police.  

The global fentanyl trade relies on precursors, chemicals that are the essential ingredients to producing a particular substance. Modern science has made it possible for drug manufacturers to discover fentanyl precursors quicker than governments can find and schedule them. This legal limbo makes it possible for cartels and illicit drug manufacturers to buy and sell the components of fentanyl without prosecution.  

Fentanyl is also difficult to monitor because its high potency makes it easier to hide and transport. “It’s near impossible to stop these drugs, because they are so easy to smuggle in shipping containers,” said one expert Westhoff consulted.  

Despite all the sobering facts shared in Fentanyl, Inc., the book ends on a hopeful note. Westhoff explores harm reduction efforts in the United States and around the world, concluding, “Solving this crisis will require us to change some of our basic assumptions about how we perceive drug abuse. We need to treat it as a disease, not a crime, and understand what causes it, rather than simply trying to eradicate it.” 

Looking for a way to help keep youth safe from fentanyl? VFHY developed a free lesson plan to help youth understand the dangers of fentanyl.  

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