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The Scary Truth About Fentanyl

Fake pills are being laced with the highly addictive and often deadly drug. Here’s how to keep yourself and your friends—safe. 

November 2025
By Joey Bartolomeo

As you read, ask yourself: What makes fentanyl such a dangerous drug?

Courtesy of Sarah Nowels; Shutterstock.com (illustrations)

Sarah Nowels was addicted to fentanyl for three years before recovering.

One day during Sarah Nowels’s senior year of high school, her boyfriend offered her what looked like a prescription painkiller. Sarah had taken drugs recreationally before, so she thought she knew what to expect. In fact, that one pill was about to throw her life into chaos. “I had no idea how serious things were about to get,” Sarah says.

As soon as she took the pill, Sarah, who experiences anxiety and depression, immediately felt different. Her thoughts quieted down and her brain became numb. She loved the feeling and began regularly taking the pills with her boyfriend. At first, Sarah didn’t know they were laced with fentanyl, a highly addictive—and often deadly—opioid. By the time she found out, she was addicted. “People think, ‘Oh, it takes a while before things get really bad,’ but that is not the case,” she says. “Addiction can happen really, really quickly.”

Sarah began by taking 10 pills a day, but she soon needed more to get the same effect. If she didn’t take fentanyl, she experienced withdrawal symptoms, including vomiting, diarrhea, anxiety, and tremors in her arms and legs. Sarah wasn’t able to eat or sleep if she didn’t use the drug every few hours. Within a year, she was taking more than 100 pills a day.

Her boyfriend became addicted too. One night, he overdosed at Sarah’s house. “He got quiet and pale and then suddenly collapsed,” she remembers. Sarah woke up her father, who called an ambulance. Her younger brother performed cardiopulmonary resuscitation (CPR) on her boyfriend until the ambulance arrived. “I was sure he was going to die,” she says. Medics were able to revive him, and he recovered.

Today, after more than three years of fentanyl addiction, Sarah is drug free. Her former boyfriend is in prison for fentanyl possession. Sarah says the drug robbed her of time with her family and friends. “I missed out on a lot of experiences,” she says. Sarah barely graduated from high school and lost several jobs because of fentanyl. At one point she and her boyfriend were living in his car. Still, she’s just happy to have made it through alive. If she hadn’t gotten help, she says, “I don’t think I would have lived much longer.”

Raising Awareness

www.FentanylHigh.com

Kyle Santoro’s sophomore year at his San Francisco-area high school began in a shocking way: with a fellow student overdosing on fentanyl in a bathroom down the hall from his classroom. Fortunately, the paramedics arrived in time to save the teen. Kyle wanted to raise awareness about why kids were using drugs in the first place and start a conversation in his community. So Kyle—who had experience in filmmaking—decided to make the documentary Fentanyl High. It features teens and adults, including parents of kids who have overdosed, talking about the drug. Kyle hopes the film encourages discussions about self-medicating but also “lets teens know they're not alone.” Since May 2023, there have been more than 150 screenings of Fentanyl High across the U.S.

Jim Block

Kyle at a screening of his film in his hometown of Los Gatos, California

A DEADLY DOSE

Courtesy of Sarah Nowels

Sarah started taking fentanyl during her senior year of high school.

Although Sarah is alive to tell her story, many other young people who have used fentanyl are not. According to the Centers for Disease Control and Prevention, in 2023, 76 percent of drug-induced deaths among people ages 10 to 24 involved fentanyl. One reason fentanyl is so incredibly dangerous is its potency, or strength. It can be up to 50 times stronger than heroin. Just 2 milligrams of the drug, or the amount that can fit on the tip of a pencil, can kill someone.

Another reason fentanyl is often deadly is that many people take it without meaning to. That’s because fentanyl is commonly added to counterfeit prescription drugs. It’s often found in pills being sold illegally as the painkiller Percocet, the anxiety drug Xanax, and the attention deficit/hyperactivity disorder (ADHD) drug Adderall. But any counterfeit pill can contain fentanyl. The fake drugs look the same as real medications, so there’s no way to know if pills bought illegally are safe. According to the U.S. Drug Enforcement Administration, more than half of the counterfeit pills officials have recovered have been laced with potentially deadly amounts of fentanyl.

The dealers who make these drugs use fentanyl because it’s cheaper than other drugs, and it gets their customers hooked quickly. According to Sivabalaji Kaliamurthy, a child and adolescent psychiatrist and addiction expert at Children’s National Hospital in Washington, D.C., a person can develop an addiction to opioids after using them for just a few days.

Sarah was introduced to fentanyl by her boyfriend. But many other teens wind up taking the drug after buying fake pills on social media. In 2022, the families of more than 60 teens and young adults filed lawsuits against Snap, the parent company of Snapchat. These young people used the app to buy pills that turned out to contain fentanyl. All but two of them died after taking the pills. As of press time, the cases were still proceeding through the courts.

There are risks around fentanyl, even if you don’t take any pills yourself. Just giving someone a counterfeit pill that contains the drug, whether you know it or not, can land you in a lot of trouble. It may not matter if you’re not legally an adult. In Florida, a recently passed law allows kids under the age of 18 to face murder charges if they distribute drugs to someone and that person dies of an overdose. Last year, a Wisconsin teen overdosed and died after taking a pill given to her by a 17-year-old girl. The girl who supplied the pill was sentenced to 10 years in prison. And in Alabama, a 15-year-old was sentenced to more than eight years in prison after his girlfriend died while taking fentanyl with him.

Deadly Disguise

Counterfeit pills laced with fentanyl are made to look like medication prescribed by a doctor. That’s why it’s important to never take pills that aren’t prescribed to you.  

DEA

Xanax pill (left); Counterfeit pill (right)

SHARING HER STORY

Courtesy of Sarah Nowels

After recovering, Sarah, with her father (right), shared her story with a reporter (left).

By December 2022, Sarah’s addiction had gotten so bad that her family feared her life was in danger. Her parents had her placed in a drug rehabilitation facility for eight days. When she was released, she enrolled in an intensive outpatient addiction treatment program. Eventually, Sarah was able to get her life back on track. Today she works for an organization that provides support for people after they get out of prison. She recently went back to school to study social work and criminal justice.

Sarah also speaks at schools and shares her experience with fentanyl addiction. “When I was a kid, people would talk about strangers on the street handing you drugs,” she says. “Never once in my life have I been offered drugs by a stranger. It was always someone I knew. I want teens to know that if that happens to you, you don’t have to take what they’re offering.”

REFLECTION PROMPT

What can teens do to help prevent fentanyl deaths?

Signs of an Opioid Overdose

If a person takes an opioid and begins to overdose, they may not realize what is going on. That’s why it’s important to know how to recognize the signs of an overdose. If you think someone near you is overdosing, call 911 immediately.  

Slow or stopped respiration: Breathing slows down or stops completely.

Slow cognition: Without oxygen, the brain struggles to think quickly.

Limp limbs: Muscles become weak as the nervous system shuts down.

Blue-tinged fingertips: A lack of oxygen in the blood turns tissues blue.

SOURCES: nih,gov, cdc.gov, songforcharlie.org

What to Know About Narcan

The best way to keep yourself safe is to never take a drug that wasn’t prescribed to you by a doctor. However, people will use illegal drugs or take pills that weren’t prescribed to them. Learning how to administer Narcan—a brand name of the medicine naloxone—can save their lives. Narcan is available at drug stores without a prescription, often as a nasal spray. It quickly reverses the effects of fentanyl and other opioids.

You can also talk to your parents about keeping Narcan in your house. Almost
50 percent of fentanyl deaths occur in homes. “Just like every house should have a fire extinguisher, every house should have naloxone,” Sivabalaji Kaliamurthy says. “It’s one of those things where you hope you don’t have to use it, but in the event that it’s needed, you’re happy it’s there.”

Shutterstock.com

Narcan nasal spray can reverse the effects of an overdose.

If you or someone you know is experiencing an opioid or other substance use disorder, consider calling the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1 (800) 662-HELP.

Substance Abuse

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