ETA (edited to add)- what’s the margin of error between a pain killing dose and a just plain killing dose?
In: Biology
The dosage of fentanyl is extremely small. It’s measured in micrograms. To give you perspective, there are 1000 micrograms in a milligram. Think of an regular strength Tylenol. It’s usually 200 milligrams of acetametaphine. The normal dose of fentanyl is like 25-100 micrograms.
The margin of error for such a small amount of medication is incredibly small.
[removed]
Hospitals prescribe Fentanyl in *extremely* controlled doses. That kind of precision may not be used when people cut other drugs with fentanyl. A lot of people don’t even know there’s fentanyl in the drug they are taking, so they take too much.
Because in the hospital they give you such a tiny amount of it. They know how much to give you. Drug dealers have no clue and people who try it do not realize how strong it is.
So SOME drug dealers my have no clue but thats not the case for all.
there are several major issues with fent in street drugs
1. while x amount spread across the entire amount in a batch of pills/bag/rock ect might be a safe dose. often times the product is not evenly mixed. This is fairly common but it didnt used to be fatal when they were cutting with inert things, you would just have a variety of strengths in across the single bag/rock.
Dealers are cutting the actual product with both fillers and fent, with the intent of making more product without sacrificing the strength of the heroine or w/e they are cutting.
1. as a side note to this one. testing. if product is not mixed fully, you could run some of the product through a test kit and it come up pure, but then a chunk on the other side of the bag might have a pocket of unmixed fent.
2. even in a case where things are mixed perfected. lets say they put 1/5 of a lethal dose of fent, in a dose of the product in question. and generally you only expect the person to do 1-2 doses because thats the usual, but what if someone knows that its nonfatal to take 10 doses at once if the product they bought was pure. and decide they want to go hard tonight. whelp you do the math.
3. with mdma back in the 90s it was common for dealers to make custom cuts for batches of pills. they would have mdma, but also other things like meth or heroin mixed in. part of the reason for this was to give their product a special high to try to make it worth coming back to the same dealer instead of getting the product where ever they can find it. it was also because these products have significantly greater withdrawal effects and addictive qualities.
4. People are finding fent on substances they wouldnt expect to be cut with anything let alone a potentially deadly pain killer.
1. this is sometimes caused by residue left on scale between different products. sometimes on purpose :/
5. Relapsing heroin junkies often od because they do the dose they were doing before they quit, but they were only able to handle that dose because their body had built op a tolerance requiring more to get where they want to get.
so we know its already difficult for people doing heroin to correctly measure out the correct dose for them, now add in the wild card of the chance of fent, and beyond that inconsistent strength/presence at all of it thought-out a bag.
6. Double cutting. Where a dealer assumes the product they were given is pure and then cuts it to try to increase their profit margin, not knowing that someone before them in the chain already cut it.
I routinely prescribe fentanyl in the emergency department. The answer to your question is very precise dosing. A normal dose of fentanyl is 25-100 micrograms, which is an incredibly tiny amount. At that dose you may feel a bit drowsy but it’s very unlikely anything bad will happen.
It’s easy to reliably give the right dose when you have drugs that are manufactured to strict standards and tested at multiple steps during production. When you’re mixing up drugs for street distribution, quality control gets pretty loose. A variation of a few milligrams (a few thousand micrograms) one way or another is no big deal for many drugs, but would be lethal with fentanyl.
Another important factor is that patients receiving IV opioids are generally in a monitored setting so we know if their breathing slows down too much and can give them oxygen or even narcan. If you’re using recreational drugs alone or with a group of similarly intoxicated people, nobody will know you overdosed until too late.
A typical dose of fentanyl in the hospital is 0.000025 g. That is an unfathomably small amount. When actual drug companies are making pills or patches, they have the right equipment, quality control, and ~100% pure fentanyl to start with, to produce doses that are like 0.000025 +- 0.000005 g.
When drug dealers are adding fentanyl to spike their product, there is no way in hell they can measure quantities that accurately, mix them thoroughly enough, or even know the purity of the fentanyl they’re adding to begin with.
Like, I worked in a lab with a digital scale that cost like $8,000 and it *might* have been accurate enough. It weighed to 4 decimal places (+-0.0001 g) so the lightest amount of fent it could weigh would be enough for hundreds of doses, so you’d have to mix them all up together in a big bowl. So you’re adding hundreds of desired-doses worth of fentanyl (aka dozens of fatal doses) into a bowl, then stirring or using a kitchen mixer, then scooping it into baggies or pressing into pills and just hoping you’ve mixed enough that no single baggie / pill has more than 0.00001 g or whatever. It’s essentially impossible to mix well enough. Oh and you’re guessing at the purity of the fent you’re adding to start with. If you assume 100%, then your stuff is weak, because odds are it’s not. Guess the starting fent strength too low and now *lots* of your baggies have lethal doses.
The difference between a fent dose you can barely feel and a dose that kills you is barely visible. People have died from traces left on a scale used to weigh fent before the thing they weighed. Hospitals and drug companies are equipped to handle chemicals with that level of precision, illegal drug labs (even very very good ones) are not.
There was a documentary on Netflix called “Dope” it followed different drugs in different cities, users, dealers and cops. There was one on heroin, shows a dealer cutting it with Fen. He says he keeps adding fen till it starts killing users- then the users want it more cause it’s so strong it kills people.
On the street fentanyl concentrations very wildly, from batch to batch, week to week. What it’s cut with, is it veterinary dewormer or shit crystal, some benzos or maybe some baby powder …anyone’s guess.
One week you get a weak batch and you have to up your dose. Next week that same dose stops your respiratory drive and you turn purple and die.
Although these days everyone and their dog carries Narcan. We have guys just sleeping on a bench get x4 doses up their Nose from concerned bystanders.
In the hosp, they know your weight , they have stable concentrations of the drug and the medical staff are pros who know their dosing .
So speaking from some experience, an old friend used to stomp his heroin with fentanyl purchased as a “research drug” from China and shipped to a drop house. He was 100% an addict and the reason he was cutting was he was taking his “pure” heroin he received, holding a large percentage back for his own use, and selling the stomped on product as “pure.”
Problem was his supplier had the same ideas and used **carfentanil** to cut it before passing it down to be sold. My friend does his usual and shoots up a hero dose and the rest is in the obituary. [Picture](https://imgur.com/a/drk74iJ) reference for how small of an amount of these synthetic opioids is considered a lethal dose.
**Edit:** Because jesus, didn’t expect this to blow up.
To clarify, friend in question was my half brother, who unfortunately got me on drugs in the first place. I’ve personally been clean since 92. He started off slinging pot for the mexican mafia back in the late 70’s and branched off to coke and speed in the 80’s. The wake up call (for me) was when he got shot in the head during a bad deal and managed to live. (The bullet skidded off his skull and bounced around in his sinus cavity before exiting by his eye.)
I’d like to say he turned his life around at that point, but he didn’t. We fell out after he started using what he was supposed to sell. (Found this out when people showed up at my moms house and held a gun to her during a family dinner.) He pops up every 5-6 years “clean” and we catch-up just for him to disappear again. Last time he popped up around 2013 was when he tried to recruit me into his scheme and basically laid it all out. He was dead within the year.
Edit#2: As mentioned his H was white, he didn’t sling black tar or that brown shit from the middle east, his words; “My shits pure, I get it from the Asians.”
Define “trace amounts” ?
A study of drivers pulled over while under the effects of Fentanyl gave samples showing numbers generally higher than 7 ng/ml (of blood) but less than 20.
Some autopsies of overdoses show around 500 to 700 ng/ml, but generally any number over 20 is potentially fatal especially in smaller users
The famous case George Floyd supposedly had 11 ng/ml and was showing some very low amounts of norfentanyl, which means his body had just started to break the drug down, something not seen in overdoses as the drug generally kills before its decomposition starts. This is one of many factors that lead all the medical experts brought in for the trial of Chauvin to the conclusion that George Floyd did not die of overdose, that he was murdered.
Latest Answers