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On August 31, International Overdose Awareness Day, we all have a chance to learn about opioid overdose and how to prevent it. It’s also an opportune moment to educate ourselves about the role of fentanyl as the main driver of the current stage of the opioid crisis in the United States, why the drug is so dangerous and what we can do to mitigate its dangers.��

This summer, the New York City Council passed a law that requires the Department of Correction (DOC) to provide annual training to all uniformed staff in city jails on the proper use of Narcan—the over-the-counter remedy containing an anti-overdose drug called naloxone—and make the training available to incarcerated individuals as well. The DOC will also be required to provide kits to every individual when released from DOC custody.����

“The new law is a step in the right direction,” says Dr. Jonathan Avery, Vice Chair of Addiction Psychiatry, Stephen P. Tobin and Dr. Arnold M. Cooper Professor in Consultation-Liaison Psychiatry and Program Director of the Opioid Overdose Prevention Program at �鶹����.��

Keep reading for Dr. Avery’s responses to your FAQs, along with his best, most timely advice around an issue that can affect anyone, anywhere, anytime.��

What is fentanyl?��

Fentanyl is a powerful synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is used medically to treat severe pain, often after surgery or for advanced cancer pain.��

Why is it so dangerous?��

Even a tiny amount of fentanyl can cause a fatal overdose, says Dr. Avery. �ճ󲹳�’s because it suppresses breathing. “Illegally made fentanyl is often mixed into other drugs without the user knowing, increasing the risk of accidental death,” he explains.��

Are doctors prescribing it less often nowadays in light of the potential for addiction?��

Pharmaceutical fentanyl is safer when used exactly as prescribed, but it still carries a high risk of addiction and overdose. Doctors are prescribing it less frequently these days due to heightened awareness of the fentanyl-driven opioid crisis and the risks of misuse.��

Is it possible for a person to recognize illegally made fentanyl by its appearance alone?��

No, fentanyl is usually indistinguishable by sight alone from other powders, pills or counterfeit medications. This makes unintentional exposure a clear and present danger.��

Can a person test for the presence of fentanyl in pills or other forms?��

“Yes,” Dr. Avery says, “test strips can detect the presence of fentanyl in pills, powders or injectable drugs. These strips are inexpensive, easy to use and increasingly available through harm reduction programs. We provide them to people at �鶹����-affiliated hospitals.”��

What is the extent of opioid addiction in the U.S.? Has the crisis eased or worsened in the past few years?��

Opioid addiction remains a major public health crisis, with millions affected and close to 100,000 opioid overdose deaths reported annually, although there have been small improvements in overall deaths.��

Earlier waves of the opioid epidemic were characterized by heroin and prescription pain medications. Now, says Dr. Avery, “we’re in the third wave, driven overwhelmingly by fentanyl—a drug so potent that ����’s equivalent to a huge increase in opioid supply.”��

What does an overdose look like?��

If a person takes too much of an opioid or mixes an opioid with other substances, they may end up in a state where their breathing slows down. They may start turning blue, and their pupils may look abnormally small. “Left untreated, an opioid overdose slows everything down to a point of no return, he says.”��

People with substance use disorder are dealing with a double burden: the disorder itself and being blamed for it. “If people are deemed unworthy, why should they receive the help, care and compassion that other patients expect to receive?” asks Dr. Avery. “But they do deserve that care, just as surely as patients with diabetes, heart disease and cancer do.”��

Stigma isolates people with substance use disorder by making them feel ashamed, judged or blamed for their use. This often prevents them from seeking medical care, accessing treatment or reaching out for support, increasing the risk of ongoing use and overdose. ����

“Here at Weill Cornell, we have one of the only centers in the country dedicated to understanding and alleviating the stigma leveled against those who suffer from substance use disorder,” he says. See what the center offers .��

How can we spread the word about the dangers of fentanyl?��

“We recommend that doctors and families start talking about these topics with children as young as 9 years old,” Dr. Avery says. “�ճ󲹳�’s what needs to happen to erase stigma and improve the way people with substance use disorder are viewed and treated in our society,” he says—and even to prevent the disorder from taking hold in younger generations.��

It's heartening to know that �ٳ�����’s a psychiatrist in a position of leadership at �鶹����, Dr. Avery, who advocates for the health, dignity and recovery of people with substance use disorder and for those who love them, as well as for accidental overdose victims across our communities.��

If you have substance use disorder and are ready to seek treatment, learn about the clinical services available through �鶹����’s Department of Psychiatry .��