What is fentanyl? The potent drug behind US-Canada trade war

What is fentanyl? (Image: Freepik)

US President Donald Trump has implemented a 25 percent tariff on imports from Canada and a 10 percent tariff on goods from China. However, he has temporarily postponed tariffs on Mexican imports until April 2. His main concern is that these nations have failed to prevent the smuggling and illegal trade of Fentanyl, a powerful painkiller.

Despite a decline in fentanyl overdose deaths, the tariffs have still been enforced. According to the Centers for Disease Control and Prevention (CDC), the US recorded 87,000 drug overdose deaths between October 2023 and September 2024, down from 114,000 the previous year.

But what is fentanyl?

Fentanyl has become a major topic of discussion in the medical community, primarily due to its extreme potency and high potential for misuse. While it serves as a life-saving medication for some, it has also contributed to a global opioid crisis due to its illicit use.

According to Dr Palleti Siva Karthik Reddy, consultant physician at Koshys Hospitals, Bengaluru, fentanyl is a synthetic opioid analgesic, meaning it is a lab-made painkiller that mimics natural opioids like morphine, but is far more potent. "It belongs to the class of mu-opioid receptor agonists, meaning it binds to opioid receptors in the brain, altering pain perception and inducing euphoria and sedation," he explains.

Initially synthesised in the 1960s by Dr Paul Janssen, fentanyl was designed for severe pain management in medical settings. However, in recent decades, its illicit production has fueled a public health crisis, particularly in North America.

Why is fentanyl so potent?

Fentanyl is lipophilic, meaning it dissolves easily in fats, allowing rapid absorption through skin, mucous membranes, and blood-brain barrier. "This makes it fast-acting, but also highly dangerous in uncontrolled doses," says Dr Reddy.

Even a tiny amount of fentanyl can cause a strong effect, making it very easy to overdose. "It is about 50 times stronger than heroin and 100 times stronger than morphine. This means even a small dose, sometimes as little as a few grains of salt — can be deadly," Dr Tushar Tayal, consultant, internal medicine, CK Birla Hospital, Gurugram warns.

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Is fentanyl used medicinally?

Fentanyl is widely used in medicine, but only in strictly controlled environments. "Doctors prescribe it to patients with severe pain, especially those with cancer or those who have had major surgeries. It comes in different forms, such as patches, lozenges or injections," Dr Tayal explains, adding, "When used properly, it is a very effective pain reliever." However, because of its strength, doctors must carefully control the dosage to avoid dangerous side effects.

There are several side-effects of fentanyl, just like other opioids. (Image: Freepik)

Side effects of fentanyl

Like all opioids, fentanyl has serious side effects, but due to its potency, these effects occur at much lower doses compared to other painkillers.

"Common side effects include drowsiness and sedation, dizziness and confusion, constipation, nausea and vomiting and slowed breathing," Dr Reddy notes.

It has severe and life-threatening risks as well if not taken under medical supervision. "Even small amounts of fentanyl can cause overdose by suppressing breathing, leading to death within minutes," Dr Tayal cautions.

But even under medical care, fentanyl is highly addictive and overtime, users needs higher doses to achieve the same pain relief, increasing overdose risk. "Stopping fentanyl suddenly can cause severe withdrawal symptoms, including muscle pain, nausea, anxiety and insomnia," Dr Tayal adds.

Also Read | China vows to hit back against US tariffs linked to fentanyl

As the opioid crisis continues worldwide, public awareness, medical regulation, and addiction treatment efforts are critical in managing fentanyl's risks while preserving its benefits for those who truly need it.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.