Within the last decade, the word “fentanyl” has become synonymous with death.
Twice as potent than heroin and morphine, and wildly available, the synthetic opioid is often used by drug dealers as an inexpensive mixing agent. Those greatest affected by fentanyl’s horrors can be seen from the streets of Los Angeles to the Kensington neighborhood of Philadelphia, known nationally for its open air drug market and drug users “roaming the streets like zombies.”
Chicago’s Abid K. Nazeer, MD — a psychiatrist with board certification in addiction medicine — notes that despite all warnings surrounding the dangers of fentanyl, substance use persists due to the complex interplay of addiction, mental health struggles, and social dynamics.
“Addiction rewires the brain’s reward pathways, making rational decision-making about drug use extremely difficult,” says Nazeer. “For many, the immediate relief or euphoria outweighs perceived risks, even when those risks are life-threatening.”
In regards to fentanyl, two common scenarios exist, notes the doctor.
“The first is when the individual does not intend to use fentanyl and is unaware of its presence in whatever drug they are using,” says Nazeer. “Fentanyl is increasingly being added into drugs as way to increase their potency. This applies to not only other opioid drugs like heroin or oxycodone, but non-opioid drugs like cannabis, stimulants like amphetamines, cocaine, and anti-anxiety sedatives like Xanax.”
The other scenario is that someone using opioids has developed tolerance, which means that it takes more of the drug to get the desired effect. “If a larger amount of a less potent opioid is needed and then consumed, but with fentanyl cut into it, it can be a deadly situation.”
In 2023, Philadelphia had a total of 1,315 overdose deaths, according to the Pennsylvania Department of Health — almost 80% of those deaths included fentanyl.
One of the greatest threats of fentanyl is how the public lack a comprehensive understanding of what it is, how it affects individuals and communities, and what steps can be taken to prevent further tragedies.
Fentanyl detection and test strips
Ahmad Hussain, a Los Angeles-based entrepreneur with laboratory, medical diagnostic and toxicology experience in collaboration with various Southern California sheriff’s departments for COVID-19 testing, knows this tragedy first hand.
“Fentanyl came on my radar ten-years-ago as my cousin in Boston, a city that leads the country in the over-prescribing of opiates – he struggled with opiate addiction,” says Hussain. “He was clean for a while, but tried using one last time. That last time had fentanyl in it, and he had a fatal overdose.”
After hearing such stories with alarming frequency, Hussain founded his own medical company, DEFENT Diagnostics, and created a fentanyl testing apparatus, DEFENT ONE All-In-One Fentanyl Detection Device. Easy to use, simple to buy (Amazon sells it) and inexpensive ($9.99), the portable detection system can be used anywhere that drug users might go — parties, festivals, concerts, everywhere.
“It wasn’t a lightbulb moment. It’s was the realization of so many people being poisoned. This has been going on since 2017, a true public health crisis. We shut the world down for COVID, but nothing changes with fentanyl poisoning – the deaths get increasingly greater with each passing year. Everyday people who have no idea they’re coming in contact with fentanyl need tools to stay alive.”
Though fentanyl test strips exist — and Hussain’s DEFENT Diagnostics also made fentanyl test strips — these individually-packed kits haven’t changed much since they first went on the market.
“The strips are great at home, but what you need to best test for fentanyl when you buy a drug off the street is a ten-microgram measuring cup, a five-milligram measuring spoon – these are not things you’d bring to a party, a concert, or on-the-go” says Hussain. “You can’t risk false-negatives or false-positives when testing for fentanyl. Accuracy is crucial.
“What the mobile DEFENT ONE All-In-One Fentanyl Detection Device has when testing drugs in powder form is a built-in measuring scoop and all the tools necessary to tell you if the drug you bought contains fentanyl. With the scoop, expose as much of the drug as possible to the All-In-One. If it’s a pill, you must crush the pill, so we provide a bag to crush it in. You can use the All-In-One, easily, in a bathroom stall, a loud party in a dorm-room, or a concert festival.”
While Hussain states that “abstinence from drugs” is the only prevention from an overdose, and that Narcan is a great tool for harm reduction after the fact, the DEFENT ONE All-In-One Fentanyl Detection Device provides an accurate measurement before consumption to avoid an overdose before it happens.
“I hope that our product and other testing products on the market become the standard – like Uber did with cabs – and we put ourselves, and drug dealers, out of business,” Hussain says.
A deadly impact
Christopher Francis, President, CEO and Chief Clinical Officer of the Bensalem-based Livengrin Foundation, a Philadelphia-area rehabilitation and detox center, sees fentanyl’s living victims on a daily basis.
“The patient who presents themselves here is never aware of the fentanyl they’ve taken in,” notes Francis. “Very rarely do they know exactly what they took, or how fentanyl got in their system. They say, “We got Oxys or Xanax,” never knowing they were fentanyl-laced. Percosets and other drugs made in a pill press – items like that are the danger.
“It’s a difficult and dangerous detox, too,” Francis added. “I’ve been here 20 years, and one thing the incoming always wonder is why a drug dealer would want to kill them. ‘They want my money.’ The reality is drug dealers aren’t chemists, don’t want to poison you, but don’t know what they’re doing when it comes to mixing ratios of pharmaceuticals and such. When they’re mixing by blender or by hand, they don’t know how much fentanyl is going into that pill or whatever else they’re cutting.”
According to the CDC, synthetic opioids like fentanyl contribute to nearly 70% of overdose deaths — even in small doses, it can be deadly. And while testing with the All-in-One Device and similar items can be handy and helps save lives, Francis says it isn’t exactly the best medicine.
“I’ve been dealing with addicts and addiction my entire career,” he says. “Seeing products such as this go with the assumption that if somebody detects fentanyl, they’re not going to use — the reality of the situation is that they might be more likely to use because they think it is the good sh*t, something stronger. I understand the idea of testing, but most people won’t think it through – you can’t scare an addict.
“Abstinence and medical treatment such as Sublocade or Vivitrol — blockers with no intoxicating effects — are also effective avenues when it comes to this treatment. There are options.”
Where to get help
Local organizations such as Prevention Point Philadelphia offer resources to help those affected by addiction. The nonprofit provides training on how to use Narcan, as well as medical services, outreach and overdose prevention programs. For more information and a complete list of available resources, visit ppponline.org
There is also a 24/7 substance use treatment center located at 5th and Spring Garden streets, where people can receive treatment for opioids with medications for opioid use disorder. The center also helps people get further help.
The Philadelphia Department of Public Health also runs local resource hubs — located in five neighborhoods throughout the city — which offer free Narcan (naloxone) and Fentanyl test strips to Philadelphia residents.
A list of local resources can be found online at phila.gov/services
