“Fentanyl is the single deadliest drug threat our nation has ever encountered,” according to DEA Administrator Anne Milgram. But what can employers do about fentanyl use among workers? Before we try to tackle that pressing question, let’s take a quick overview of what fentanyl is…and why business owners and supervisors need to take it seriously.
What is Fentanyl?
Developed in 1959 as a synthetic opioid, pharmaceutical fentanyl actually took several years to become a “street drug.” It was created as an anesthetic and has been used to help cancer patients with pain management for decades. But illicitly-manufactured fentanyl (IMF) hit the radar of law enforcement agencies around 1979, sold by dealers as “China White.”
From that point on, awareness of the risk posed by illegal fentanyl use began to surface, finally boiling over when the national death toll from overdoses spiked dramatically. The rise in overdoses was partly attributed to the fact that many buyers didn’t realize they were using adulterated products laced with the highly addictive synthetic drug. By 2013, the problem was so widespread that fentanyl was cited as the new face of America’s opioid epidemic, which was entering a deadly third wave.
Illicit fentanyl use may come from abuse of medically-prescribed pills, stolen pharmaceutical pills, and illegally-made forms of the drug, such as powdered IMF often sold in tiny plastic “trash bag” containers. Today, as experts warn of an even more complex and lethal fourth wave of this ongoing fentanyl abuse crisis, employers are increasingly seeing the effects of this toxic drug in the workplace…and feeling the pressure to do more about it.
What Does Employee Fentanyl Use Look Like?
As is frequently noted, fentanyl is 50 times stronger than heroin and up to 100 times more powerful than morphine. As a synthetic opioid, fentanyl – a Schedule II narcotic under the Controlled Substances Act – can produce a wide range of physical effects in the users, including “relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, and vomiting.”
Clearly, any employee who is impaired by fentanyl while at work is a severe liability to themselves and others. And with so many possible external signs, fentanyl use among workers is sometimes easy to spot. However, one common characteristic among modern users is poly-substance use, i.e., the combination of different types of drugs (such as “depressant” opioids – like fentanyl – and stimulants such as cocaine or methamphetamine).
Nicknamed “speedballs,” these deadly poly-substance mixtures are designed (in theory) to “reduce the negative effects of both drugs” by initiating a so-called “push-pull” reaction. In other words, someone using fentanyl with a stimulant may be able to mask or mitigate the outward signs of their drug use. But this hardly means they’re able to safely perform their duties.
Specific Signs to Watch For
Since users may be on more than one drug at a time, it is important to not only screen for specific signs of fentanyl use, but also for more generalized signs of any illicit drug-related impairment.
Tennessee’s Department of Mental Health & Substance Abuse Services posted a list of common warning signs of drug use. Depending on your employee’s duties, the signs that relate to the workplace may include:
- Bloodshot eyes
- Dilated or constricted pupils
- Odd body or breath odors
- Unkempt physical appearance
- Loss of appetite
- Visibly impaired coordination
- Coming in late to work
- Neglecting responsibilities
- Disorderly conduct
- Suspicious behavior
- Risky driving habits
- Changes in personality and attitude
- Mood swings, irritability, angry outbursts, anxiety, or paranoia
Statistics on the Impact of Drug Use in the Workplace
The National Institute for Occupational Safety and Health (NIOSH) notes that 51% of drug users (ages 18+) report having full- or part-time jobs.
The Bureau of Labor Statistics writes that “Unintentional overdoses from nonmedical use of drugs [including fentanyl] accounted for 388 workplace deaths in 2020.” Such overdoses have increased every year for the past eight years.
Per NIOSH, there were 106,699 drug overdose deaths in 2021* – a number cited as “more than any other year on record.” Of those, 22% involved synthetic opioids such as fentanyl – twice as many as had occurred two years prior.
*Note, this figure is for all drug overdose deaths, not just workplace-related ones.
Fentanyl and Workers Compensation Claims
Impairment from fentanyl and other drug use can lead workers to have mishaps where they injure themselves or someone else. But, ironically, injured workers are often prescribed opioids as part of a worker’s compensation claim. And many times, it is these powerful narcotics that workers end up getting hooked on. There have even been cases where workers faked injuries and filed fraudulent claims in order to obtain these highly-addictive pain medications.
It is a problem that many States have been aware of for some time. Per NIOSH, in 2012, over half of all worker’s compensation claims included habit-forming opioid prescriptions. States have sought to curb that number by: “Limiting opioid availability, educating health care providers on responsible opioid prescribing, and increasing awareness among injured workers.” Yet despite these efforts, last year 32% of claims still had “at least one prescription for opioids.”
Nicknames for Fentanyl That Employers Should Be Aware Of
There are so many legal and illegal drugs on the market that employers can’t be expected to be familiar with all their medical names, brand names, and nicknames (or “street names”). However, because fentanyl abuse in particular has become such an epidemic, it is useful to be aware of the various names employees may use when talking about it. Below are a few of the most common.
Common Street Names For Illegally-Manufactured Fentanyl (IMF)
- Apache
- Blonde
- China Girl
- China Town
- China White
- Chinese Buffet
- Crazy One
- Dance Fever
- Dragon
- Dragon’s Breath
- F
- Fent
- Fenty
- Fire
- Freddy
- Friend
- Fuf
- Girl/White Girl
- Goodfella/Goodfellas
- Great Bear
- Heineken
- He-Man
- Jackpot
- Lollipop (lozenge form)
- Murder 8
- Nal
- Nil
- Opes
- Pharmacy
- Shoes
- Snowflake
- Tango & Cash
- TNT
Color-Based Names
- Blue Diamond
- Blue Dolphin
- Blues
- China White
- Gray Stuff
- King Ivory
- Snowflake
- White Girl/White Ladies
Names For Fentanyl + Other Drugs
- Birria (fentanyl + heroin)
- Chiva Loca (fentanyl + heroin)
- Facebook (fentanyl + heroin in pill form)
- Dirty Fentanyl (fentanyl + cocaine)
- Takeover (fentanyl + cocaine)
Employers who have good cause to suspect an employee is actively impaired due to drug or alcohol use may have the right – and the obligation – to require a worker to submit to a drug and alcohol test. Reasonable suspicion drug and alcohol testing is a powerful tool employers have to keep employees, customers and the general public safe from harm. No one wants to end up a statistic.
