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Fentanyl Overdose and Adulterated MDMA: 3 Facts You Need to Know

By Ashley Hinson
Fentanyl is saturating the illicit drug market. Did you know it can even appear in MDMA?

The opioid crisis isn’t limited to prescription drugs and heroin use. In fact, some users don’t know that the drugs they're taking contain fentanyl, a highly potent synthetic opioid. People who misuse this synthetic opioid may encounter it mixed in with other drugs, including MDMA. And exposure to tiny amounts of fentanyl can lead to an accidental overdose, especially when someone doesn’t know it’s in their drug supply. But what, exactly, is fentanyl? And how does taking MDMA laced with fentanyl affect the body? Read on to learn three key facts about this dangerous drug combination.

1. MDMA is sometimes "cut" with fentanyl. 

Fentanyl is an FDA-approved narcotic painkiller that binds to opioid receptors in the brain. It works faster and in smaller doses than morphine or heroin.  

According to the National Institute on Drug Abuse, fentanyl side effects include:

  • Extreme happiness
  • Drowsiness
  • Problems breathing
  • Confusion
  • Unconsciousness 

And what is MDMA? MDMA, also known as Ecstasy, is a party drug common at clubs, colleges, and live music festivals. It’s supposed to create euphoric feelings, so why is it getting mixed with fentanyl?

“When you're dealing with a street medication, you never know about the purity of the medication,” Jonathan Sprecher, RN, director of nursing at Nevada Desert Hope Treatment Center, tells WebMD Connect to Care. “Often, the initial ingredient you believe you're buying is on the expensive side or difficult to obtain. To make the medication or pill feel like it’s giving an effect to the user, you will cut it with a cheaper drug. You'll mix it.” 

2. You can’t detect fentanyl by sight. 

Fentanyl is odorless and tasteless. So how can you tell if MDMA is adulterated?

“When looking at the pill, some people think some forms have a little bit of color to them. I have not found that to be the case. We really can't tell by looking at it. There's no real smell with fentanyl,” Sprecher says. 

According to a 2020 article published by Current Opinion in Psychiatry, testing drugs like MDMA for fentanyl can help users detect adulterants like fentanyl before taking them. However, it can be difficult to test drugs in pill form, and the practice is not widespread among illicit drug users. 

2. Using MDMA laced with fentanyl can lead to dangerous cardiac symptoms. 

MDMA is a stimulant. This means that it will typically increase your heart rate. While this side effect can be dangerous on its own, the additional presence of fentanyl, a depressant, can increase the risk of harmful or even fatal cardiac complications. 

“Any time you're dealing with a concoction of meds, you affect your cardiac status. [With fentanyl and MDMA], you have a stimulant and depressant going on in your body at the same time. You get respiratory depression, and that causes a reduction in the ability to breathe which reduces the oxygen content in the blood. That will cause heart attacks,” Sprecher says. 

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