National Fentanyl Awareness Day on May 7th provides an opportunity to have an open, honest conversation with your kids about the dangers of fentanyl. Watch the four-minute video above, then have a relaxed conversation with your kids. Here are a few tips on how to keep it low-key:

  • Talk while completing a task. You can chat while making dinner or walking the dog.
  • Dress for the occasion. Many of us get dressed up for presentations at work. This is on the other end of the spectrum. Wear comfortable clothing so you can relax. This conversation might be quick, or it could take a while. Show you’re ready either way.
  • Talk over food. Dinner, a cup of hot cocoa, a glass of iced tea, a bowl of ice cream…all help set a casual tone.
  • Reassure your child that this is about learning together, not judging. Remind them you will love and support them no matter what.

Here are a few conversation starter questions from the National Fentanyl Awareness Day toolkit that might help you:

  • “What fact from the video did you find most surprising?”
  • “Why do you think teens rate fentanyl as less dangerous than cocaine or heroin, even though it’s much more deadly?”
  • “Why do you think some young people take pills they didn’t get from a pharmacist?”
  • “Do you see drugs at school?”
  • “Do you feel like you can talk to friends and family about fentanyl? If not, what would have to change?”
  • “What steps can we take as a family to stay informed about drug safety?”

For more information, visit the National Fentanyl Awareness Day website.

Your teen heads off to a party with your blessing. You’ve done your homework. Parents will be there, and some of the kids attending are ones you’ve known forever. It will be good for your child to blow off some steam with friends, you think. Life has been so stressful lately. You’re thankful your teen has surrounded themselves with “good” kids. Like many parents, you don’t know about fentanyl.

Which is why the phone call that comes a few hours later is so completely unexpected.

Your child is being taken to the hospital after overdosing on some sort of drug. Confused and frantic, you beg their friends to help you understand as you all sit in the waiting room anxiously awaiting news. The story comes out in bits and pieces.

In the end, you learn that one of the kids shared a counterfeit pill with your teen. It was laced with fentanyl, a synthetic opioid that is 50 times stronger than heroin, 100 times more powerful than morphine.

Two grams, what can fit on the tip of a pencil, is enough to kill someone.

Urgent update: Lethal doses of fentanyl found in 7 out of 10 pills

We have written articles on our website before about fentanyl. Unfortunately, the news has gotten worse instead of better. In 2021, 4 out of 10 counterfeit pills contained a potentially lethal dose of fentanyl. In 2022, it was 6 out of 10. Now, it’s 7 out of 10. Put another way, 70% of the pills contain a potentially lethal dose.

A person is about to take a pill that could contain fentanyl

What does “potentially lethal” mean?

People often ask why there aren’t even more overdose deaths if so many pills contain a potentially lethal dose. The answer is that a lot of factors go into determining if it is a deadly dose. The guide is 2 mg, which is enough to kill an average-weight person who has not built up a tolerance. If a person has built up a tolerance for opioids, or is above-average in weight, those are two factors that could cause them to not overdose. But many other factors come into play. It can never be assumed that you have built up enough of a tolerance to be safe. There is no such thing as safe when it comes to street drugs containing fentanyl.

Getting back to those odds…

If you accept a counterfeit pill, you have a 70% chance of that pill containing enough fentanyl to kill you. Even cutting it in half won’t keep you safe. Just like chocolate chips in a cookie, fentanyl doesn’t distribute evenly. Therefore, just as you can have a group of chocolate chips in half of a cookie and one or even none in the other half, you can have all 2 mg (or more) of fentanyl in one half of a pill and practically nothing in the other half.

So how does that 70% compare to other odds? Let’s take a look at a few common dreams parents and their teens have for themselves, and the chances they have of making it happen:

  • Becoming an NFL player: 1.6%
  • Becoming an NBA player: 0.03%
  • Becoming an astronaut: 0.001%
  • Becoming a published author: 1% to 2%

Obviously, those stats reflect careers, which is something kids can work towards. To make it more relevant to the chances of taking in a lethal dose of fentanyl, let’s look at a few things that are more chance-based:

  • Odds of pulling an ace from a deck of 52 cards: 4 in 52, or 7.69%
  • Odds of being dealt a royal flush out of a 52-card deck: 4 out of 2,598,960, or 0.000154%
  • Odds of being bitten by a dog: 1 in 50, or 2%

To make the danger more relatable to your children, you can look up stats about something they enjoy.

Give your kids a visual

Of course, for many of us, trying to compare a 70% chance to a .000154% chance seems hard to comprehend. Numbers work well for some teens, but a visual may help others. Instead of looking up statistics, take ten pieces of a favorite candy or potato chips and lay them out. Talk with your kids about whether they would pick any one of those if they knew that seven of them could kill them.  

If you knew that seven out of ten potato chips were poisonous and would kill you, would you eat one? Seven of ten counterfeit pills contain a potentially lethal dose of fentanyl.

Remember, fentanyl is odorless and tasteless. It is impossible to tell if a counterfeit pill contains the deadly drug. Many of our teens have died because they trusted the person giving it to them and/or thought it couldn’t happen to them. It is important to talk with your kids often and be firm in your expectations. Studies have shown that kids are less likely to try drugs or drink underage if they know their parents would not approve.

One more suggestion: Register for a free Revive training and keep naloxone in your home. While the hope would be that you never need it, it’s better to be prepared to save a life.

If you want to know more about fentanyl, visit the DEA website One Pill Can Kill.

Because of the more than 107,000 overdose deaths during the 12-month period ending October 2022, most people are aware of fentanyl, a synthetic opioid that is 100 times more powerful than morphine. Tranq, however, is relatively new to the illicit drug scene (it began making headlines in 2019). Although tranq is less familiar, its notoriety–and that of xylazine–is growing quickly.

On April 12, 2023, the White House declared fentanyl mixed with xylazine to be an “emerging threat” to the United States. This combination is commonly known as “tranq” or “tranq dope.” But what is xylazine, and what makes it so dangerous?

What is Xyalzine?

Xylazine is a tranquilizer (hence the street nickname of “tranq”) approved for use in veterinary medicine, including horses and cattle. It is used for sedation, anesthesia, muscle relaxation and analgesia. More than 3,000 people in the U.S. died from fentanyl-tranquilizer mixes in 2021, which was triple the fatalities from 2020.1 In addition to its deadly nature, it also causes necrosis—rotting flesh wounds—which has led some to call it a zombie drug. This necrosis can be so bad that amputations become necessary.

Although it was unknown only a few years ago, tranq has now been related to overdose deaths in 48 of 50 states. In 2022, the Drug Enforcement Agency found tranq in 23% of fentanyl powder and 7% of fentanyl pills that were tested.3

Effects of Xylazine

Xylazine is not approved for human use. Even in the animals for which it is used, it can cause a severe form of anemia. This symptom has been displayed in humans as a near-fatal form of blood iron deficiency, particularly when tranq is mixed with heroin.2

In humans, xylazine slows breathing and heart rate, and lowers blood pressure. The effects are similar to those of an opioid, which makes an overdose from either drug look very similar—a person could be mistaken for sleeping, when in reality they have stopped breathing completely. Unfortunately, naloxone (sold as the brand name Narcan), which is used to reverse and opioid overdose, has no effect on tranq.

This means that the mere presence of xylazine in any drug or pressed pill greatly increases the risk of death. Just as with fentanyl, people who use drugs are often unaware that xylazine is in what they are using, until it is too late.

Why Tranq?

The most frequent question posed are: “Why would drug dealers put deadly chemicals into their drugs? Why would they want to kill their customers?”

The answer is that they don’t want to kill their customers, but they are driven solely by profit. They use the cheapest products available to produce the best high for their customers at the highest profit margin. Drugs are now sold more on social media such as SnapChat and Instagram than on the street corner. If someone dies from an overdose, drug dealers have no trouble replacing the customer with one of the billions of people on social media.

Fortunately, reported cases of tranq are low in the Northern Shenandoah Valley. However, the drug has been found in Virginia and every surrounding state. Awareness and education are key to helping prevent deaths.

What To Do for an Overdose

It is important to still administer Narcan (naloxone) if you suspect someone is experiencing an overdose, because xylazine is typically used in combination with other drugs. While Narcan may not reverse the effects of xylazine, it will help reduce or reverse the effects of any opioids it is mixed with, including fentanyl.

If someone is experiencing an overdose, follow these steps:

  • Call 911.
  • Administer Narcan/naloxone.
  • Stay with the person until help arrives. Try to keep them awake and breathing.
  • Turn them onto their side to avoid choking.

Sign up for our free Revive! Training to learn more about recognizing the signs of an overdose and how to administer Narcan. Attendees are mailed two free doses of Narcan after completing the training.


(1) https://www.msn.com/en-us/news/crime/artist-s-death-spotlights-peril-posed-by-xylazine-fentanyl-mix/ar-AA1axZCp

(2) https://www.cnn.com/2023/04/12/health/fentanyl-xylazine-emerging-threat-us/index.html

(3) https://www.dea.gov/alert/dea-reports-widespread-threat-fentanyl-mixed-xylazine

The preliminary overdose deaths for 2021 are now available on the Virginia Department of Health website, and they reveal a sobering fact: fentanyl is becoming an increasing problem in the northern Shenandoah Valley. 

In 2021, in Frederick, Clarke, Warren, Page, and Shenandoah Counties, as well as the city of Winchester, there were a total of 60 overdose fatalities reported. Nearly 87% of those (a total of 52) were a result of fentanyl.  

This is not unique to the local area. According to the CDC, “over 150 people die every day from overdoses related to synthetic opioids like fentanyl.” It has become a leading cause of death in people under 50, surpassing heart disease and cancer. Just last week the University of Ohio issued a warning about fake Adderall pills laced with fentanyl, which were believed to be responsible for the deaths of two students.

The Onslaught of the Pressed Pill  

This surge in overdose deaths is due at least in part to the rapid emergence of these “pressed pills,” or “fentapills,” which are illegally manufactured tablets containing fentanyl. They are created to look like other medications, such as Xanax or Percocet or Adderall. Mixed with fillers and dyes and pressed into a shape resembling their legal counterparts, these fentanyl-based fake pills are often sold online. There is no quality control, no testing that occurs, no oversight to ensure that the amount of fentanyl in each pill is a non-lethal amount.  

In fact, according to the DEA, of the pressed pills containing fentanyl, four out of every ten pills contain a potentially lethal dose of fentanyl. 

Think about that for a moment. In a room of ten people, if each one took a fake Vicodin purchased from a dealer on Snapchat or Instagram, at least four of those people will overdose and potentially die. The danger is so high because fentanyl is so potent. It is 50x more powerful than heroin, and 100x more powerful than morphine. So just a few grains can mean the difference between life and death. In fact, according to fentanylawarenessday.org, “there are documented cases of people dying after ingesting just one half of a fentapill.” 

It’s All About the Money 

For the drug manufacturers and dealers, using fentanyl to imitate real pills is a no-brainer. It is relatively inexpensive to create fentapills and they are highly addictive. That means high profits and a lot of repeat customers. They aren’t trying to kill their customers. They just don’t care if they do.  

Remember the goal of people dealing in these fentapills is not to help you. Their goal is to make money off of you. Fentanyl, like all opioids, is highly addictive. So that “free” sample isn’t provided to help you out of a tough spot. It’s given to you with the hope that you will become addicted and become a regular customer.  

The best way to stay safe is to make sure your prescription pills are coming from a legitimate pharmacy. Don’t believe anyone online who tells you pills are “real,” and don’t try to tell if the pills are real by looking at them, because that is exceptionally difficult and often impossible.  (Take a look at photos of real vs. counterfeit pills on the DEA’s “One Pill Can Kill” website.)

Be smart. Stay safe. Get prescription drugs from your doctor or pharmacy. If cost is a concern, talk with your doctor, local churches, and/or social services office to see what help might be available in your area.  

Tuesday, May 10th is National Fentanyl Awareness Day.  Learn more about the dangers of illegally manufactured fentanyl at https://www.fentanylawarenessday.org/ 

Marijuana has officially became legal in Virginia this year; joining a host of other states that have already taken the plunge into placing this new law into effect. But, does legalizing it make it safe? If marijuana is used in moderation, is it more safe? What can we learn from the history of other states so far?

Fentanyl has made its way into the Shenandoah Valley, and is believed to be responsible for numerous overdose deaths in recent months. In the drug prevention community and among law enforcement, it is a recognized problem. But for many family members whose loved ones are dealing with a substance use disorder, fentanyl is still unfamiliar. 

What exactly is fentanyl?

Fentanyl is a powerful synthetic prescription opioid that was developed to treat patients with severe pain; usually after surgeries or for people suffering from cancer.