Rutgers Experts on Fentanyl: Clinical, Research and Policy Perspectives
We launched a new educational content aimed at helping the lay public better understand key topics in brain health and neuroscience. Our first topic is on fentanyl, as it is one of the most searched words in the field of substance use disorders. We are inviting faculty at the Rutgers Brain Health Institute to share insights from clinical, research, and policy perspectives.
A Clinical Perspective with Dr. Ethan Cowan
Dr. Ethan Cowan, Professor in the Department of Emergency Medicine at NJMS, Associate Director of Treatment & Recovery at the RARC, and Core Member of BHI, explains what fentanyl is, how dependence differs from addiction, and why medication-assisted treatment is a critical tool in saving lives.
What is Fentanyl?
Fentanyl is a strong opioid pain medication that doctors use for things like surgery or cancer treatment. When it’s prescribed and used the right way, it can be safe and effective.
What makes fentanyl especially dangerous is how powerful it is. It’s up to 100 times stronger than morphine. Just a few grains can be enough to cause an overdose and stop someone’s breathing.
Dependence vs. Addiction
If you take opioids regularly, even if they’re prescribed, your body can get used to them. That’s called dependence. It means you might feel sick or anxious if you stop suddenly. That’s a normal physical response.
Addiction is a chronic medical condition. It affects the brain and makes it very hard to stop using, even when someone wants to. Addiction is driven by changes in the brain’s reward system, and it often takes over someone’s life.
The Importance of Medication-Assisted Treatment
There are three medications approved by the FDA—methadone, buprenorphine, and naltrexone—that help people stop using opioids like fentanyl. They reduce cravings, ease withdrawal, and lower the risk of overdose.
And when those medications are combined with counseling, support groups, or therapy, people have a much better chance at long-term recovery and getting their lives back on track.
A Research Perspective with Dr. David Barker
Dr. David Barker, Assistant Professor of Psychology at the Rutgers School of Arts and Sciences, and Core Member of the BHI and RARC, explores the neurological mechanisms of addiction and shares evidence-based approaches for treatment and overdose prevention. From the many fentanyl analogues and derivatives to the life-saving action of Narcan, Dr. Barker breaks down the science of addiction and how research is opening new pathways to save lives and confront the fentanyl crisis.
What are fentanyl derivatives?
Fentanyl is a synthetic opioid, meaning it’s made entirely in a lab. While originally developed as a powerful medication for pain management, illicit versions are fueling a public health crisis. Chemists have created many derivatives, also called analogues, which are similar chemically but slightly altered. These derivatives can be even more potent and deadly.
Common fentanyl analogues include acetylfentanyl, furanylfentanyl, and especially carfentanil. Carfentanil is notably dangerous—it’s thousands of times stronger than morphine and approximately 100 times more potent than fentanyl itself, making it extremely lethal, even in microscopic amounts.
How does fentanyl and its derivatives affect the brain and body?
Opioids like fentanyl and its analogues primarily work by attaching to specific sites in the brain called mu-opioid receptors. These receptors control pain and pleasure pathways, but critically, also impact areas that regulate breathing. High potency opioids can rapidly slow or stop breathing altogether, causing overdose and death.
Fentanyl’s potency and inconsistent strength in street drugs dramatically increase overdose risks. Long-term use severely damages health, impacting the heart, lungs, and weakening your immune system. Chronic users frequently experience anxiety, depression, memory loss, and trouble experiencing pleasure without drugs.
Treatment of Addiction and Overdose
In the event of overdose, rapid treatment with Narcan—also known as naloxone—is critical. Narcan works by quickly blocking opioid receptors, reversing fentanyl’s lethal effects, and restoring normal breathing within minutes. It’s highly effective, especially if administered promptly.
For treating opioid addiction over the long term, we have proven tools. FDA-approved medications like methadone, buprenorphine, and naltrexone help people manage withdrawal, reduce cravings, and stay in recovery. When combined with counseling or behavioral therapy, these treatments offer the best chance for lasting success.
A Policy Perspective with Dr. Elizabeth Stone
Dr. Elizabeth Stone, health services and policy researcher at Rutgers University, shares policy-level solutions and community engagement tactics. Dr. Stone highlights practical steps, such as access to Naloxone or Narcan, fentanyl test strips, and prevention initiatives, and available resources for individuals and communities. Through education, prevention, and scientific research, we can work together to end the fentanyl crisis and save lives.
How can we prevent fentanyl addiction or overdoses?
Staying informed is key. Fentanyl test strips, available online or at pharmacies, can detect fentanyl in other drugs, potentially preventing fatal overdoses. Carrying naloxone, or Narcan, is another lifesaving tool—it can reverse an overdose by restoring breathing within minutes.
Is fentanyl a problem in my area, and what can I do about it?
Many cities have programs to distribute naloxone and fund treatment services. You can contact your local health department to find out what’s available. Schools, workplaces, and community groups can all help raise awareness by sharing facts and hosting events.
Where can I learn more or get help with fentanyl addiction?
If you or someone you love is struggling, resources are available. Call the SAMHSA Helpline at 1-800-662-4357, visit CDC.gov, or GetSmartAboutDrugs.gov for reliable information. Support groups like Al-Anon also help families navigate these challenges.
Fentanyl is dangerous, but we are not powerless. Through education, prevention, and compassion, we can save lives and make our communities safer.
