Buying drugs on the street is a game of Russian roulette. From Xanax to cocaine, drugs, or counterfeit pills purchased in nonmedical settings may contain life-threatening amounts of fentanyl.
Physicians like me have seen a rise in unintentional fentanyl use from people buying prescription opioids and other drugs laced, or adulterated, with fentanyl. Heroin users in my community in Massachusetts came to realize that fentanyl had entered the drug supply when overdose numbers exploded. In 2016, my colleagues and I found that patients who came to the emergency department reporting a heroin overdose often only had fentanyl present in their drug test results.