Dose of Reality: Get the Facts on Opioids

What are opioids?

Opioids are a class of drugs that alleviate pain and may produce a pleasurable effect on the brain and body. Opioids are used in many ways. A health care professional may prescribe them as part of a treatment plan following an injury or surgery. Opioids also may be used in nonmedical ways. Some people may use opioids to cope with painful emotions, trauma, or other life experiences.

• Prescription pain relievers: Prescription opioids include oxycodone, hydrocodone, morphine, and methadone that relieve pain by changing the way the brain and body feel pain. They don't cure the pain, but they may help a person manage it.
• Fentanyl: Fentanyl is a very strong opioid.
  • Pharmaceutical fentanyl is prescribed by doctors to treat severe pain. It is available as a lozenge, pill, nasal/sublingual spray, transdermal patch, or as an injection.
  • Illegally manufactured fentanyl/non-pharmaceutical fentanyl is sold for its ability to produce good feelings. It is often mixed into illegal drugs and pills made to look like prescription medications.
• Heroin: Heroin is an illegal opioid. Most people who use heroin say it causes a short-term rush of good feelings. There are no medical uses for heroin. Heroin can be found in both pure form and mixed with other drugs.

Why are opioids risky?

All types of opioids are addictive. The brain and body develop a tolerance to opioids very quickly, meaning more amounts are needed to feel the same effect. This may rapidly become dependence, meaning that not taking opioids may cause severe pain and discomfort because opioids are no longer in the brain and body. This leads some people to use opioids more and more, a cycle that can lead to opioid use disorder. Opioid use disorder occurs when opioid use interferes with daily life. This may include challenges at home, at work, at school, or in relationships. Anyone who uses opioids can develop opioid use disorder. It is a chronic disease that can be managed. Taking too many opioids at one time can cause a person to stop breathing and die.

Fentanyl: You can't see it, smell it, or taste it.

People all over Wisconsin are unknowingly taking drugs containing fentanyl and overdosing because the drugs look identical to what they are used to taking. Get the facts on fentanyl to know how to protect yourself and your loved ones.

Illegally manufactured fentanyl is strong and unevenly mixed into drugs.

• Fentanyl is up to 50 times stronger than heroin and up to 100 times stronger than morphine.
• Because fentanyl is strong and cheap to produce, people who manufacture illegal drugs use fentanyl to make their drugs more powerful and less expensive to manufacture.
• The amount of fentanyl in illegal drugs as well as counterfeit pills is completely random—even from the same supply. One portion or pill may not contain fentanyl, while other portions and pills from the same supply may contain fentanyl.

Illegally manufactured fentanyl is being found in many drugs.

• Illegally manufactured fentanyl is often found in counterfeit pills that are made to resemble prescription drugs. This includes prescription pain relievers, like oxycodone, and stimulants like ADDERALL®. You are at risk for a fentanyl overdose if you buy pills from any source that is not a licensed pharmacy.
• Illegally manufactured fentanyl is also found in other drugs like cocaine, methamphetamine, and heroin. You are at risk of a fentanyl overdose if you use any of these drugs.

Fentanyl overdoses are often fatal.

• Because fentanyl is very strong, it does not take a lot of fentanyl to cause an overdose, especially for someone who does not usually take opioids.
• In 2020, the latest year in which data is available, 86% of opioid deaths in Wisconsin were connected to a synthetic or manufactured opioid like fentanyl.

You can't overdose from fentanyl by simply touching it or breathing it in. Fentanyl must be consumed directly to cause an overdose.

Learn more about fentanyl and how to respond to a fentanyl overdose: Fentanyl: What is it? P-03608 (PDF)

Take action: Test for fentanyl

Fentanyl test strips can reduce the risk of a fentanyl overdose. They are easy to use. Follow the steps below.

1. Place a small amount of the drug supply in crushed, crystal, or powdered form in a container. A container with the residue of the drug supply can also be used.
2. Add about 1/4 inch of water to the container. If testing MDMA or methamphetamine, add about a shot glass of water to the container.
3. Insert the fentanyl test strip in the water for 15 seconds.
4. Take the fentanyl test strip out of the water and lay it flat for three minutes.
5. Read the fentanyl test strip.
   • One line (positive result): Fentanyl or a similar opioid has been detected in the drug supply. Avoid using this drug supply.
   • Two lines (negative result): Fentanyl or a similar opioid has not been detected in the drug supply. Remember, no test is 100% accurate and the drug supply may still contain fentanyl or another deadly drug.
   • Invalid test: Retest the drugs using a new fentanyl test strip.

Fentanyl test strips should only be used once and thrown away.

NOTE: Fentanyl test strips are not guaranteed to detect all forms of fentanyl. People can overdose even if the test says there is no fentanyl in the drug supply. There are other dangers associated with using drugs, including infection, disease, and psychological harm. The safest practice is to avoid using drugs altogether.

Print these instructions (PDF)

Get free fentanyl test strips

Use the map below to find an organization or vending machine offering free fentanyl test strips near you or view a spreadsheet of all the locations (Excel).

Have a pickup location to add to this map? Email dhsdcts@dhs.wisconsin.gov.

Wisconsin residents can request free fentanyl test strips by mail through NEXT Distro. Submit a request for fentanyl test strips to be shipped to you at no cost.

Promote the use of fentanyl test strips: Visit the Dose of Reality: Partner Resources section for social media posts and more.

Carry naloxone

Naloxone is the opioid overdose reversal drug. It is available as a nasal spray or an injection. It can be used to save the life of someone experiencing a fentanyl-related overdose. Act fast in the case of a fentanyl-related overdose. Call 911, then give naloxone. More than one dose of naloxone may be needed. Learn more about naloxone and where to get it near you.

What are the common signs of opioid use disorder?

• Unexplained changes in behavior, such as attitude, appetite, mood swings, sleep patterns, and irritability.
• Sudden changes in activities, such as friends or social activities or sudden shifts in jobs or hobbies.

Opioid use disorder is a medical condition that can affect anyone who uses opioids. Wherever you or someone you care about may be in a struggle with opioids, there are people ready to help. In Wisconsin, no one is alone in their journey to overcome opioid use disorder. Explore treatment options for opioid use disorder.

What should you ask your health care professional before taking opioids?

Prescription pain relievers should be used with caution. Ask your health care professional these questions when getting a prescription for an opioid.

• Why do I need this drug?
• What are the most common side effects of this drug? Are there ways to minimize these effects?
• Are there ways to lower the dosage or length of time that I need this drug?
• How long should I take this opioid and how do I wean myself off this drug?
• How should I store this drug to prevent others from taking it?
• Does this opioid interact with any other drug I’m currently taking?
• Can I drink alcohol while taking this drug?
• Do any of my medical conditions increase my risk of a bad reaction to this drug?
• What should I do with leftover doses of this drug?
• Can I share this drug with someone else?
• What if I have a history of misusing drugs?
• What if there’s a history of substance use disorder in my family?

Prescription opioids are not the only option for pain management. An over-the-counter pain reliever may be enough. Other options, like acupuncture, cognitive behavioral therapy, chiropractic care, yoga, massage therapy, meditation and relaxation, and physical therapy can also help you feel better with fewer risks and side effects. Discuss these options with your health care professional to determine if they will work for you.

Drugged driving: A growing problem

Too many people in Wisconsin are using opioids, then getting behind the wheel and endangering themselves, their passengers, and other motorists. Drugged driving deaths in Wisconsin have increased nearly 200% in the last 10 years. Together, we can work to achieve zero preventable deaths due to drugged driving. Visit Zero In Wisconsin to learn more. Zero In Wisconsin is a campaign of the Wisconsin Department of Transportation.

Get the conversation started

You can do this. You have the facts and are ready to start having real talks with the people in your life about opioids. It’s easier than you think. We can show you how to get started.

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