image of Fentanyl transdermal patch. 50mcg/hr timed release skin patch and foil wrapper.

What Does Fentanyl Look Like?

Fentanyl is one of the most potent opioids that is up to 50 times stronger than heroin. Even a few grains of the drug can trigger a fatal overdose. It’s used in clinical settings to manage severe pain, but it’s also produced illegally and sold on the black market, often mixed with other drugs like heroin or cocaine. 

This synthetic opioid can appear in many different forms. This page explores what fentanyl looks like, how it’s most commonly found, and why it presents such a pressing danger. You can also discover how to get effective opioid addiction treatment.

Pharmaceutical Fentanyl vs Illicit Fentanyl

Fentanyl exists in two primary forms: pharmaceutical-grade fentanyl (prescribed by doctors) and illicit fentanyl (manufactured and sold illegally).

Pharmaceutical fentanyl

When doctors prescribe it, fentanyl comes in several forms, each of which is designed for controlled dosing with medical supervision. These include: 

  • Transdermal fentanyl patches: Thin, adhesive patches that release fentanyl gradually via the skin over 72 hours.
  • Fentanyl lollipops or lozenges: This solid form of fentanyl attached to a stick is intended for those who require fast-acting pain relief.
  • Sublingual fentanyl tablets: Small pills like Abstral dissolve under the tongue.
  • Fentanyl nasal sprays: Sprays such as Lazanda deliver fentanyl through the nasal passages for rapid absorption.
  • Injectable fentanyl: Liquid forms of fentanyl like Sublimaze are administered in hospitals for those who require relief from severe pain.

Illicit fentanyl

Illegally manufactured fentanyl is much more dangerous and unpredictable than its pharmaceutical counterpart. It is found in the following forms: 

  • Powder: A white, gray, or off-white powder that’s sometimes mistaken for heroin or cocaine.
  • Counterfeit pills: This form of fentanyl is pressed into tablets that resemble oxycodone, Xanax, or other prescription medications.
  • Liquid: Found in eye drops, nasal sprays, or absorbed into blotter paper, liquid fentanyl can be especially damaging.
  • Rainbow fentanyl: This variant of fentanyl comes in bright colors and is designed to look appealing and evade detection by law enforcement.

How to Identify Fentanyl in Different Forms

image of fentanyl lollipop
Lollipop - Ingested
image of Fentanyl Citrate anesthetic solution vial isolated on white.
Liquid - Injected
image showing What does brown heroin look like
Powder - Inhaled

Fentanyl is often mixed into other substances, so it can be almost impossible to identify without specialized testing—it’s odorless and tasteless. That said, here’s how to visually identify the drug in its various forms:

Powdered fentanyl

Illicit fentanyl in powder form is mainly: 

  • White, tan, or off-white
  • Fine and grainy, much like powdered sugar
  • Sometimes clumped together in chunks 

Drug traffickers often mix fentanyl with heroin, cocaine, or meth to increase potency. This practice of adulteration radically increases the risk of overdose due to the strength of fentanyl.

Counterfeit pills

Many fentanyl-laced pills are designed to look like common prescription drugs, making them especially dangerous. These laced pills: 

  • Resemble Percocet, OxyContin, Adderall, or Xanax
  • Often have imprinted numbers or letters to mimic authentic medications
  • May be slightly off in size, color, or texture compared to legitimate pills

Rainbow fentanyl

This is one of the most destructive forms of fentanyl. The pills may be pink, green, yellow, or blue. Different colors do not indicate the strength of the drug.

Liquid fentanyl

Fentanyl in liquid form may be: 

  • A clear or tinted liquid
  • Found in nasal sprays, eye drops, or small dropper bottles
  • Soaked into blotter paper like LSD

Why is Fentanyl so Dangerous?

Fentanyl is 100 times stronger than morphine and 50 times more potent than heroin. The drug can provoke life-threatening overdoses in minuscule quantities—the equivalent of a few grains of salt can kill an adult. The potency of the drug means there’s a narrow line between a therapeutic and fatal dose. 

Unlike pharmaceutical-grade fentanyl, there is no quality control when the drug is produced illegally. A single batch might contain uneven amounts of the synthetic opioid, prompting entirely unpredictable effects.

Overdose risk and symptoms

The extreme potency of fentanyl means that an overdose can happen within minutes. Signs include: 

  • Slow or stopped breathing
  • Blue lips or fingertips
  • Drowsiness
  • Unresponsiveness
  • Gurgling or choking sounds
  • Pinpoint pupils
  • Cold and clammy skin 

If someone shows these signs, call 911 immediately and give the person naloxone (Narcan) if it’s available. Naloxone can reverse the effects of opioid overdose and restore normal breathing, but it’s not a substitute for medical care. 

Here’s how to stay safe if you or someone you know is at risk of encountering fentanyl: 

  • Test for fentanyl: Fentanyl test strips can detect the presence of the drug. They can be found in pharmacies or obtained through harm-reduction programs. While they do not indicate how much fentanyl is in the sample, they can detect its presence.
  • Never use opioids alone: Using opioids like fentanyl alone raises the risk of a fatal overdose. Have someone nearby who can call for help in an emergency if you use pharmaceutical fentanyl. Carry naloxone and ensure that friends or family know how to use it.
  • Be cautious of fake pills: Avoid any pills from unknown sources, even if they resemble prescription medication. Only use medications prescribed by a healthcare provider and obtained from a pharmacy. Be aware that fentanyl may crop up in counterfeit oxycodone, Adderall, or Xanax pills.

Get Help Addressing Fentanyl Addiction at Tree House Recovery

Like all opioid use disorders, fentanyl addiction is aggravating but treatable. Whether you’ve become dependent on the drug after using it for pain relief or you have become addicted to illicit fentanyl, we can help you get back on track at Tree House Recovery. 

We offer a variety of outpatient and intensive outpatient programs for young men, all delivering personalized treatment plans that blend evidence-based therapies and holistic interventions. We’re happy to work with major health insurance providers to ensure no financial barriers prevent you from getting compassionate and effective care. 

Fentanyl addiction is a progressive condition, so the sooner you get help, the more seamless treatment will be—get immediate assistance by calling (855) 202-2138 today.

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