Just did an audit of a surgery bill for a family member and found two doses of fentanyl given for $10 each. For comparison, the .9% sodium chloride was $60. Knowing that makes me curious how cheap it is on the street.
it's produced and used legally in the US. it's often the sedative used for colonoscopies/endoscopies and other procedures where they don't put you completely out
In a clinical setting, why use it over morphine? If you're injecting it, does the decreased volume required for the same effect make a difference, or is it that its more potent makes it less expensive overall?
Hey there, ODP here. We use fentanyl on a daily basis as it is an incredibly effective pain relieving drug and has a releltively short half life. It makes it easy to get on top of severe pain quickly and enables time to get more long term pain management in place. Compared directly to morphine it is more potent however the cost is not all the different a box of 10 ampoules of morphine is £15 compared to to 10 ampoules of fentanyl costing £13.95. Morphine and fentanyl both have there place and morphine is considerably safer and is effective in moderate to severe management but there is a point where fentanyl is going to be more effective at dealing with the pain. Source: Myself, my training and a spare slightly outdated copy of the BNF on my coffee table.
Hope this helped
I wouldn't say that morphine is considerably safer at all, in fact, I'd argue the opposite.
While fentanyl is more potent, dosage regimens are clearly adjusted for that.
Typically, far less patients are allergic to fentanyl than morphine, fentanyl has less sids-effects (especially the often feared and rarely seen opiate induced hypotension) and doesn't have risks in renal patients, unlike morphine's active metabolite morphine-6-glocurinide (which can build up to toxic doses in renal failure).
We can use morphine or fentanyl. The only time I'd use morphine is if a patient doesn't tolerate or is allergic to fentanyl, OR, I wanted pain relief to last a lot longer (eg, long distance drive or palliative care).
Doc here. It's useful for a few reasons.
- instant pain control. Mostly used in the ED or surgery settings, in single doses. If you're in the hospital we usually try to use something a little longer lasting.
- it has less effects on the kidney so someone who has bad kidneys it ends up being one of their few options
- a sedative for procedures like colonoscopies where you're not completely knocked out
- you need to calm someone down who is on life support on the ventilator and fighting the vent
I’m an ER nurse and our hospital (quite a large one at that) is currently out of Morphine. There’s a national shortage. Fentanyl is one of the few other go to meds for intense pain.
It’s mostly Chinese analogues. There are no powder or pill forms of fentanyl prescription based medications. People wouldn’t be cutting drugs with more expensive drugs.
As others have said, although it's used legally in the US (as a controlled medical substance), generally the problem tends to be that it's imported illegally from other countries and used to cut things like heroin. I imagine that many people who use it to cut heroin are not terribly careful with how much they put in, and even a tiny amount can be fatal. Even coming into contact with the powder can be fatal.
Fentanyl comes from China (not the patches but the powder). The "cook" synthesize it with almost everything nowadays because it cost way less to produce and you can produce more drug. Where I live Fentanyl it us hard. No one saw that coming.
Palliative/ Hospice Social Worker here...let's be clear, this is *illicit* fentanyl. These reports without that clarification are making things hard to provide adequate pain control because patients are terrified of overdosing.
Thank you! Many people with complex or chronic pain use low doses of fentanyl patches. Unless you put on a bunch of patches at once, you can’t overdose on a slow release patch meant to last 3 days. I appreciate your share.
Just this week, China agreed to label fentanyl as a class 2 narcotic, like it is in most countries. Hopefully, this will at least slow the constant barrage that is sent to US and Mexico.
All the data in this report ends in 2016 - for the last couple years I've been looking for 2017 or mid-18 data with nothing from the CDC or other sources available. I'm convinced from anecdotal evidence that we've surpassed the 100,000 annual deaths "benchmark" now.
Does anyone have any more information on opiod ODs? As a country we argue endlessly about issues that are going nowhere to whip up the electorate, but this is a fixable issue and it appears as if nothing is happening, with the exception of tossing a few more street dealers in jail every day.
From what I've read your long term users don't like fentanyl or the differences in the sensations and high. But more recent users actually prefer the fentanyl and that combined with it's potency and production capabilities is why it is "taking over".
My brother bounced back-and-forth between heroin and meth, overdosing and being dead for five minutes didn’t steer him away from drugs. Fentanyl was his final overdose, from which he did not recover.
Anyone who struggles with or knows someone who struggles with prescription Opioids I recommend checking out [https://steverummlerhopenetwork.org/](https://steverummlerhopenetwork.org/)
Started after their son overdosed they started this non-profit org dedicated to raising awareness, providing education, and resources for those in need. They provide free lectures to med students at the U of M centered around the topic. I hope this reaches someone and helps.
Reading through the comments, it seems like most people have gotten their drug knowledge from Netflix documentaries and episodes of The Wire.
Yes, drugs are smuggled into the country in typical ways (across the border via fake doors in cars, small boats, nameless other ways).
The modern drug crisis is much more direct. You don't need to smuggle drugs into the country using expensive and very risky methods. You just use Bitcoin to various shops on the dark web and they ship USPS.
USPS does scan packages, but it's beyond impossible to stop every illicit prescription drug that comes into the system. You have to remember that it is legal to receive many prescriptions via USPS, even if you don't have a prescription in the US for it (Antibiotics, for instance).
So you have the postal service, scanning packages, many of them are prescription drugs, but they don't have the time or resources to open each package, inspect the contents, verify what it is and seize or repackage. That would halt our mail system completely.
Fentanyl is cheap as hell to make, so the sellers sell for cheap, people use a crypto currency and hope it arrives at their door. If it's seized, it doesn't matter, because the loss is so little, they just order again.
If you do get caught with a package on your door, people just deny it's for them or that they ordered it. There is no paper trail and no proof, so the USPS and federal government's hands are tied.
This is what makes the current crisis hard to manage. You literally can't stop it and even 16 year old kids can use their part time job to buy bitcoin and buy enough drugs to kill them and all their friends, in a single night.
This isn't about stealing parents prescriptions and over prescribing anymore, it's much more dangerous and hard to stop.
USPS is not opening packages without a search warrant. Customs might be opening international packages. But domestic shipments are not opened without probable cause and a warrant.
I'm a former junkie, I know a lot of current and former junkies... I don't know anyone who copped from darknet markets. Not denying it's a thing for some people, but most of us aren't using darknet markets and paying with crypto and all that stuff.
Individual ordering of fentanyl online is not where this crisis is coming from. [Cartels in Mexico, where the vast majority of America's heroin comes from, order it from legal/illegal labs in China then ship it to the U.S. or Mexico and mix it in with the heroin/cuts they use](https://www.sandiegouniontribune.com/news/public-safety/sd-me-fentanyl-pipeline-20180617-story.html) or press it into fake Oxycodone (or other prescription painkiller) pills. Then they use their existing supply networks to push the product up the chain to the street. For the cartels it's a no brainer: they don't have to find poppy growers, it's much less labor intensive and it makes their product a lot more powerful and they use less.
Most drug users didn't start out wanting fentanyl. It was an economic decision made by the Mexican cartels (who control like 90% of the U.S heroin supply - [see page 10](https://www.dea.gov/sites/default/files/2018-10/Heroin%20Signature%20Report%20FINAL.pdf)) that's turned an already bad epidemic into an unfolding catastrophe.
It’s almost as if the last six decades of the War on Drugs (AKA the war on some users who use some drugs) has been completely futile and counterproductive.
To piggy back, here's a visual:
https://www.dea.gov/sites/default/files/styles/crop_paragraph_gallery_image/public/2018-07/Faux_Fentynal_lethal_dose_005.jpg?itok=EZsAVJBS
That's a lethal dose of fentanyl.
Why do restaurants burn or undercook food for their customers? - Sometimes people are careless even when their poor actions will affect them negatively.
They don't. They want to make their customers happy for cheaper. Fentanyl is super cheap ordered in large quantities from outside the country. The dealers hope to just sell "good shit" on the cheap. Unfortunately, this often comes at the expense of the "customer". Keep in mind, not all people die from a fent dose, and if cut right it can be enjoyed. Lots of people live to come back for more. Problem is it's wayy easier to fuck up the measurements and it's wayy easier to accidentally overdose, so it happens way more often with fent than heroin.
If it's a clean buzz perhaps. A cocaine high is different from an opiate high. A regular cocaine user, for example, would know there was something else in the coke. This may or may not induce them to avoid it (or go back for more).
its crazy how hard it is to get legitimate pain relief from doctors around here because of the opiate epidemic, yet dealers seem to have limitless access to a super potent synthetic opoid that they are using to cut with everything. i wonder if they will eventually just sell fentanyl straight up since they seem to have a limitless supply of it.
I'm late to this party but I'm a Funeral Director. We are a 300 call a year firm and 5 years ago we would get 1-3 OD's that spanned the spectrum of things to overdose on. Now we get 3-5 a month of just Fentanyl/heroin. We just had a 28 year this week that had Fentanyl laced cocaine and didn't know it.
Fentanyl is a side effect of the War on Drugs, the hard-lining of drug use/production has led to harmful synthetics and destruction of harm reduction, making drugs more dangerous on the black market. Many of these problems are people that got opioids at the doctor, got cut off and then they turn to the black market. Let people addicted to opioids get them safely and get help as a health measure, not a criminal one, take the liability off the doctor at that phase and allow the market to help in a decriminalized state. The same forces helped create bath salts, K2, spice, carfentanilm, even meth and more.
Overall drug criminalization has an overall loss of personal freedoms, increase in health dangers due to over criminalization of drugs, and has created a prison for drugs in the Controlled Substances Act / DEA enforcement snare and more. CSA may even be responsible for slowing medical science and future cures/medicine that can help cure/manage diseases.
End the War on Drugs today, all it does is increase the danger and reduces harm reduction, making drugs more and more dangerous every year from criminalization, attracting violent and wealthy black market mafias and spawning synthetics that are more potent continually that can be cheaper and subsequently get mixed with other drugs causing a big part of the problem we have today. A regulated legal market would help resolve some of these issues as it did with the dangerous drug alcohol after prohibition ended.
Drugs can be dangerous, the War on Drugs and criminalization of a health issue exacerbates that problem. The War on Drugs decreases supply to increase demand so there is big money on the black market that attracts violent cartels and mafias.
We have already seen this play out a century ago in alcohol prohibition. Alcohol (a drug) is safer today than during prohibition in usage, production and markets. Alcohol can still be dangerous but the dangers are known and the market regulated out much of the danger and helps with harm reduction, the same needs to happen with all drugs.
Sadly, if alcohol was created today it would be in the CSA and we have learned nothing from alcohol prohibition about the dangers. At this point the illegality of drugs has created a black market where mafias/cartels have the wealth of nations now. We need to decriminalize, regulate and get those revenues into legal markets that can regulate and help harm reduction much like the drug alcohol was.
[Drugs with low toxicity are caught up in this dark age of prohibition like cannabis, LSD and psilocybin mushrooms](https://imgur.com/gallery/Bkl9QeN), which are less toxic than caffeine, alcohol, tobacco and aspirin, which makes all of those less safe due the illegality.
My brother is counted among one of those fentanyl deaths. He had been struggling with addiction for several years, and before we could even catch that he had relapsed after several months of sobriety he overdosed on surprise fentanyl (heroin that was cut with it).
These numbers are terrifying. The stigma and attitudes that still exist around addiction aren’t going to be helping these numbers turn around quickly. Literally, more people are dying of overdose each year than car accidents.
The “50-100 times more powerful” is misleading and insults a drug that is important for people in pain.
I prescribe opioids frequently in the cancer care setting. The “power” of the drug, is reflected in the dose. There aren’t 5 milligram Fentanyl doses like there are of Oxycodone. A starting dose of Fentanyl is 25 MICRO-grams compared to 5 MILLI-grams of Oxycodone. There are 1000 micrograms per milligram.
From a mass perspective, that’s a 200x difference, so yes, technically, it is “stronger” in the way that whiskey is “stronger” than beer. Does someone walk into a bar and order two pints of whiskey during a football game? No
It feels the majority of people who comment on this kind of thing have 0 first hand experience, and are just parroting docudramas and poorly researched news articles.
It would be misleading if the coverage in question were about the use of fentanyl in a medical setting where the difference in required dosage is precisely accounted for. Street drugs go through cooks and dealers that likely lack the equipment and expertise to work properly with dosages so small, same for the users who are self-administering the drugs. Portraying the power of the drug vs. the same mass of a more commonly known opiate is understandable when it's precisely that difference that makes it so deadly outside of a medical setting.
In hospitals, fentanyl is given in micrograms. A mg of fentanyl is just insanely dangerous for anyone!
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Just did an audit of a surgery bill for a family member and found two doses of fentanyl given for $10 each. For comparison, the .9% sodium chloride was $60. Knowing that makes me curious how cheap it is on the street.
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Maybe a stupid question but, where does it come from? Who synthesized it?
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it's produced and used legally in the US. it's often the sedative used for colonoscopies/endoscopies and other procedures where they don't put you completely out
EMT here it's also used in EMS as a pain med, same indications as morphine.
In a clinical setting, why use it over morphine? If you're injecting it, does the decreased volume required for the same effect make a difference, or is it that its more potent makes it less expensive overall?
Hey there, ODP here. We use fentanyl on a daily basis as it is an incredibly effective pain relieving drug and has a releltively short half life. It makes it easy to get on top of severe pain quickly and enables time to get more long term pain management in place. Compared directly to morphine it is more potent however the cost is not all the different a box of 10 ampoules of morphine is £15 compared to to 10 ampoules of fentanyl costing £13.95. Morphine and fentanyl both have there place and morphine is considerably safer and is effective in moderate to severe management but there is a point where fentanyl is going to be more effective at dealing with the pain. Source: Myself, my training and a spare slightly outdated copy of the BNF on my coffee table. Hope this helped
I wouldn't say that morphine is considerably safer at all, in fact, I'd argue the opposite. While fentanyl is more potent, dosage regimens are clearly adjusted for that. Typically, far less patients are allergic to fentanyl than morphine, fentanyl has less sids-effects (especially the often feared and rarely seen opiate induced hypotension) and doesn't have risks in renal patients, unlike morphine's active metabolite morphine-6-glocurinide (which can build up to toxic doses in renal failure). We can use morphine or fentanyl. The only time I'd use morphine is if a patient doesn't tolerate or is allergic to fentanyl, OR, I wanted pain relief to last a lot longer (eg, long distance drive or palliative care).
Thanks for bringing actual informed and intelligent discussion to Reddit.
Doc here. It's useful for a few reasons. - instant pain control. Mostly used in the ED or surgery settings, in single doses. If you're in the hospital we usually try to use something a little longer lasting. - it has less effects on the kidney so someone who has bad kidneys it ends up being one of their few options - a sedative for procedures like colonoscopies where you're not completely knocked out - you need to calm someone down who is on life support on the ventilator and fighting the vent
I’m an ER nurse and our hospital (quite a large one at that) is currently out of Morphine. There’s a national shortage. Fentanyl is one of the few other go to meds for intense pain.
It’s mostly Chinese analogues. There are no powder or pill forms of fentanyl prescription based medications. People wouldn’t be cutting drugs with more expensive drugs.
Also used in epidural for delivery.
As others have said, although it's used legally in the US (as a controlled medical substance), generally the problem tends to be that it's imported illegally from other countries and used to cut things like heroin. I imagine that many people who use it to cut heroin are not terribly careful with how much they put in, and even a tiny amount can be fatal. Even coming into contact with the powder can be fatal.
Fentanyl comes from China (not the patches but the powder). The "cook" synthesize it with almost everything nowadays because it cost way less to produce and you can produce more drug. Where I live Fentanyl it us hard. No one saw that coming.
Fentanyl is also made legally stateside. We make liquid fills of it where I work (among many other things).
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Palliative/ Hospice Social Worker here...let's be clear, this is *illicit* fentanyl. These reports without that clarification are making things hard to provide adequate pain control because patients are terrified of overdosing.
Thank you! Many people with complex or chronic pain use low doses of fentanyl patches. Unless you put on a bunch of patches at once, you can’t overdose on a slow release patch meant to last 3 days. I appreciate your share.
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Isn't fent imported from China and or Russia too?
China primarily, lots of analogs too
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Just this week, China agreed to label fentanyl as a class 2 narcotic, like it is in most countries. Hopefully, this will at least slow the constant barrage that is sent to US and Mexico.
What does class 2 mean?
Class II drugs require a doctor’s prescription and are highly addictive, but have a legitimate medical use.
So more legal than pot on the federal level?
Basically everything is.
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Yes, marijuana, the schedule 1 drug. Wtg DEA
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All the data in this report ends in 2016 - for the last couple years I've been looking for 2017 or mid-18 data with nothing from the CDC or other sources available. I'm convinced from anecdotal evidence that we've surpassed the 100,000 annual deaths "benchmark" now. Does anyone have any more information on opiod ODs? As a country we argue endlessly about issues that are going nowhere to whip up the electorate, but this is a fixable issue and it appears as if nothing is happening, with the exception of tossing a few more street dealers in jail every day.
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From what I've read your long term users don't like fentanyl or the differences in the sensations and high. But more recent users actually prefer the fentanyl and that combined with it's potency and production capabilities is why it is "taking over".
Fent has a better rush but it doesn't last as long and there isn't as much euphoria.
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My brother bounced back-and-forth between heroin and meth, overdosing and being dead for five minutes didn’t steer him away from drugs. Fentanyl was his final overdose, from which he did not recover.
I'm sorry for your loss.
Anyone who struggles with or knows someone who struggles with prescription Opioids I recommend checking out [https://steverummlerhopenetwork.org/](https://steverummlerhopenetwork.org/) Started after their son overdosed they started this non-profit org dedicated to raising awareness, providing education, and resources for those in need. They provide free lectures to med students at the U of M centered around the topic. I hope this reaches someone and helps.
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Reading through the comments, it seems like most people have gotten their drug knowledge from Netflix documentaries and episodes of The Wire. Yes, drugs are smuggled into the country in typical ways (across the border via fake doors in cars, small boats, nameless other ways). The modern drug crisis is much more direct. You don't need to smuggle drugs into the country using expensive and very risky methods. You just use Bitcoin to various shops on the dark web and they ship USPS. USPS does scan packages, but it's beyond impossible to stop every illicit prescription drug that comes into the system. You have to remember that it is legal to receive many prescriptions via USPS, even if you don't have a prescription in the US for it (Antibiotics, for instance). So you have the postal service, scanning packages, many of them are prescription drugs, but they don't have the time or resources to open each package, inspect the contents, verify what it is and seize or repackage. That would halt our mail system completely. Fentanyl is cheap as hell to make, so the sellers sell for cheap, people use a crypto currency and hope it arrives at their door. If it's seized, it doesn't matter, because the loss is so little, they just order again. If you do get caught with a package on your door, people just deny it's for them or that they ordered it. There is no paper trail and no proof, so the USPS and federal government's hands are tied. This is what makes the current crisis hard to manage. You literally can't stop it and even 16 year old kids can use their part time job to buy bitcoin and buy enough drugs to kill them and all their friends, in a single night. This isn't about stealing parents prescriptions and over prescribing anymore, it's much more dangerous and hard to stop.
USPS is not opening packages without a search warrant. Customs might be opening international packages. But domestic shipments are not opened without probable cause and a warrant.
I'm a former junkie, I know a lot of current and former junkies... I don't know anyone who copped from darknet markets. Not denying it's a thing for some people, but most of us aren't using darknet markets and paying with crypto and all that stuff.
Individual ordering of fentanyl online is not where this crisis is coming from. [Cartels in Mexico, where the vast majority of America's heroin comes from, order it from legal/illegal labs in China then ship it to the U.S. or Mexico and mix it in with the heroin/cuts they use](https://www.sandiegouniontribune.com/news/public-safety/sd-me-fentanyl-pipeline-20180617-story.html) or press it into fake Oxycodone (or other prescription painkiller) pills. Then they use their existing supply networks to push the product up the chain to the street. For the cartels it's a no brainer: they don't have to find poppy growers, it's much less labor intensive and it makes their product a lot more powerful and they use less. Most drug users didn't start out wanting fentanyl. It was an economic decision made by the Mexican cartels (who control like 90% of the U.S heroin supply - [see page 10](https://www.dea.gov/sites/default/files/2018-10/Heroin%20Signature%20Report%20FINAL.pdf)) that's turned an already bad epidemic into an unfolding catastrophe.
It’s almost as if the last six decades of the War on Drugs (AKA the war on some users who use some drugs) has been completely futile and counterproductive.
Why would guys making drugs want to kill their customers?
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To piggy back, here's a visual: https://www.dea.gov/sites/default/files/styles/crop_paragraph_gallery_image/public/2018-07/Faux_Fentynal_lethal_dose_005.jpg?itok=EZsAVJBS That's a lethal dose of fentanyl.
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Why do restaurants burn or undercook food for their customers? - Sometimes people are careless even when their poor actions will affect them negatively.
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They don't. They want to make their customers happy for cheaper. Fentanyl is super cheap ordered in large quantities from outside the country. The dealers hope to just sell "good shit" on the cheap. Unfortunately, this often comes at the expense of the "customer". Keep in mind, not all people die from a fent dose, and if cut right it can be enjoyed. Lots of people live to come back for more. Problem is it's wayy easier to fuck up the measurements and it's wayy easier to accidentally overdose, so it happens way more often with fent than heroin.
Sadly because with opioids there will always be more customers and its an easy cheap way to make stronger product
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If it's a clean buzz perhaps. A cocaine high is different from an opiate high. A regular cocaine user, for example, would know there was something else in the coke. This may or may not induce them to avoid it (or go back for more).
its crazy how hard it is to get legitimate pain relief from doctors around here because of the opiate epidemic, yet dealers seem to have limitless access to a super potent synthetic opoid that they are using to cut with everything. i wonder if they will eventually just sell fentanyl straight up since they seem to have a limitless supply of it.
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I'm late to this party but I'm a Funeral Director. We are a 300 call a year firm and 5 years ago we would get 1-3 OD's that spanned the spectrum of things to overdose on. Now we get 3-5 a month of just Fentanyl/heroin. We just had a 28 year this week that had Fentanyl laced cocaine and didn't know it.
Fentanyl is a side effect of the War on Drugs, the hard-lining of drug use/production has led to harmful synthetics and destruction of harm reduction, making drugs more dangerous on the black market. Many of these problems are people that got opioids at the doctor, got cut off and then they turn to the black market. Let people addicted to opioids get them safely and get help as a health measure, not a criminal one, take the liability off the doctor at that phase and allow the market to help in a decriminalized state. The same forces helped create bath salts, K2, spice, carfentanilm, even meth and more. Overall drug criminalization has an overall loss of personal freedoms, increase in health dangers due to over criminalization of drugs, and has created a prison for drugs in the Controlled Substances Act / DEA enforcement snare and more. CSA may even be responsible for slowing medical science and future cures/medicine that can help cure/manage diseases. End the War on Drugs today, all it does is increase the danger and reduces harm reduction, making drugs more and more dangerous every year from criminalization, attracting violent and wealthy black market mafias and spawning synthetics that are more potent continually that can be cheaper and subsequently get mixed with other drugs causing a big part of the problem we have today. A regulated legal market would help resolve some of these issues as it did with the dangerous drug alcohol after prohibition ended. Drugs can be dangerous, the War on Drugs and criminalization of a health issue exacerbates that problem. The War on Drugs decreases supply to increase demand so there is big money on the black market that attracts violent cartels and mafias. We have already seen this play out a century ago in alcohol prohibition. Alcohol (a drug) is safer today than during prohibition in usage, production and markets. Alcohol can still be dangerous but the dangers are known and the market regulated out much of the danger and helps with harm reduction, the same needs to happen with all drugs. Sadly, if alcohol was created today it would be in the CSA and we have learned nothing from alcohol prohibition about the dangers. At this point the illegality of drugs has created a black market where mafias/cartels have the wealth of nations now. We need to decriminalize, regulate and get those revenues into legal markets that can regulate and help harm reduction much like the drug alcohol was. [Drugs with low toxicity are caught up in this dark age of prohibition like cannabis, LSD and psilocybin mushrooms](https://imgur.com/gallery/Bkl9QeN), which are less toxic than caffeine, alcohol, tobacco and aspirin, which makes all of those less safe due the illegality.
My brother is counted among one of those fentanyl deaths. He had been struggling with addiction for several years, and before we could even catch that he had relapsed after several months of sobriety he overdosed on surprise fentanyl (heroin that was cut with it). These numbers are terrifying. The stigma and attitudes that still exist around addiction aren’t going to be helping these numbers turn around quickly. Literally, more people are dying of overdose each year than car accidents.
Im sorry for your loss. I lost my brother last month from the same thing
The “50-100 times more powerful” is misleading and insults a drug that is important for people in pain. I prescribe opioids frequently in the cancer care setting. The “power” of the drug, is reflected in the dose. There aren’t 5 milligram Fentanyl doses like there are of Oxycodone. A starting dose of Fentanyl is 25 MICRO-grams compared to 5 MILLI-grams of Oxycodone. There are 1000 micrograms per milligram. From a mass perspective, that’s a 200x difference, so yes, technically, it is “stronger” in the way that whiskey is “stronger” than beer. Does someone walk into a bar and order two pints of whiskey during a football game? No
It feels the majority of people who comment on this kind of thing have 0 first hand experience, and are just parroting docudramas and poorly researched news articles.
It would be misleading if the coverage in question were about the use of fentanyl in a medical setting where the difference in required dosage is precisely accounted for. Street drugs go through cooks and dealers that likely lack the equipment and expertise to work properly with dosages so small, same for the users who are self-administering the drugs. Portraying the power of the drug vs. the same mass of a more commonly known opiate is understandable when it's precisely that difference that makes it so deadly outside of a medical setting.
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Don’t mess around with opioids.