Fentanyl's lethal toll continues. Nearly 10 million pills were seized last year

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A pill press machine seized by authorities is displayed during a news conference outside the Roybal Federal Building in February 2021 in Los Angeles. / AFP via Getty Images

American law enforcement is seizing fentanyl pills at a rate nearly 50 times greater than four years ago, according to a new study funded by the National Institute on Drug Abuse.

Fentanyl is 30 to 50 times stronger than heroin, and the study's authors raise the alarm over the danger that users will overdose, especially if they believe the pills are legitimate pharmaceutical products.

"Given that over a quarter of fentanyl seizures are now in pill form, people who obtain counterfeit pills such as those disguised as prescription opioids or benzodiazepines in particular are at risk for unintentional exposure to fentanyl," said the study, conducted by researchers from several universities who participate in the National Drug Early Warning System.

Other experts say the fentanyl pills have become so common in the drug market that most users have come to realize what's in them and seek them out because they contain fentanyl.

Caleb Banta-Green, principal research scientist at the Alcohol & Drug Abuse Institute (ADAI) at the University of Washington School of Medicine, said awareness of fentanyl pills has risen quickly among users. In a recent survey in Washington State, two-thirds of those who used fentanyl said they did so "on purpose." They said they consumed fentanyl most often in pill form.

The study noted that nearly 10 million pills were seized in 2021.

Banta-Green says some users may think the pill form of the drug is safer than injected opioids or heroin, especially if the pills are crushed and smoked. But he said pills are not necessarily safer, because their potency can vary. And because the fentanyl "high" is more fleeting than other drugs, people end up consuming it more often — even 20 or 30 times a day.

"Every time you're using, you also have a risk of overdose," says Banta-Green. "It's one of the reasons we're seeing these death rates that are so high, because there are so many more opportunities for a person to overdose, because they're using so much more frequently."

The NIDA-funded study recommends more close monitoring of the illicit fentanyl market in order to provide early warning to the public about what forms the drug is taking.

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