'If You Can See It, It Can Kill You'

When asked how small an amount of fentanyl can be lethal, Kelvin Walls’ response during a COMBAT Commission meeting was chilling: “If you can see it, it can kill you.” As the Commission’s Public Health Care Professional Member, Dr. Walls is a voice of authority on the subject.

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  • Is it really true that "if you can see it, it can kill you"? » Answer
  • What is fentanyl? » Answer
  • Why do drug dealers use fentanyl? Aren't they worried about killing their customers? » Answer
  • If a counterferfeit pill contains fentanyl, what are the odds that dosage could be lethal? » Answer
  • How will you know if you are taking a pill with fentanyl? » Answer
  • But isn't fentanyl used in medical treatments? » Answer
  • What are fentanyl's effects? » Answer
  • What makes fentanyl so deadly? » Answer
  • NEW! True or false, fentanyl overdoses have become a leading killer of young adults in the United States? » Answer

Is it really true that “if you can see it, it can kill you”?

Just consider this graphic we’ve posted multiple times on jacksoncountycombat.com and social media—a fatal dose of fentanyl compared to a penny.


You would scarcely be able see that lethal two milligram speck of fentanyl. And, yes, that would be, according to the federal Drug Enforcement Administration (DEA), enough to kill you! Just two milligrams—or 0.00007 ounces!

To put in perspective how tiny a speck just two milligrams is consider this: the typical housefly weighs about 12 milligrams.

Facts About Fentanyl
United States Drug Enforcement Administration
» DEA Fact Sheet

What is fentanyl?

A synthetic opioid. Fentanyl was first manufactured in the late 1950s and then used as an intravenous anesthetic in the 1960s.

Fentanyl can be 50 to 100 times more potent than morphine and heroin.

Heroin_Fentanyl_Fatal_DoseFATAL DOSE OF HEROIN VS. FENTANYL — Because of its potency fentanyl can be lethal in a much smaller amount.

While fentanyl continues to be used medically—in microgram doses administered with rigid safeguards—the DEA reports that more than a dozen fentanyl variants are now being produced illegally. Drug dealers routinely mix fentanyl with heroin, cocaine, meth and other drugs—and to produce counterfeit pills. They mix in fentanyl in unsanitary conditions without precisely measure the dose.

In 2020 an estimated 56,000 overdose deaths in the United States involved synthetics opioids. (That is 18 times higher than the number of synthetic opioid-related overdose deaths in 2013.)

The total number of overdose deaths involving any opioid surpassed 80,000 in 2021, the last year for which the National Institute on Drug Abuse (NIH) has complete data.

“People both knowingly consume fentanyl and other synthetic opioids and unknowingly consume them when they are mixed into or sold as other drugs,” reports the NIH. “Using a drug that has been contaminated with or replaced by fentanyl can greatly increase one's risk of overdose.”

Overdose Death Rates
National Institute On Drug Abuse
» NIH Trends & Statistics

Why do drug dealers use fentanyl? Aren’t they worried about killing their customers?

Dealers often add fentanyl to illegal drugs (like cocaine and heroin) and to counterfeit pills being passed off as authentic prescription medications like Xanax and OxyContin. Fentanyl is relatively cheap to manufacture, and a small amount goes a long way.

As Jackson County Drug Task Force Officer-In-Charge Dan Cummings points out, “there’s no quality control among drug dealers” who are motivated almost entirely by maximizing their profits. Using fentanyl allows them to add more potency to the drugs they’re selling, which also makes users even more dependent and likely to buy more.

“Dealers might not intend to put too much fentanyl in any tablet,” Cummings said after the Task Force confiscated 3,000 fentanyl-laced pills in a single search during 2021, “but they aren’t being too careful about it either. And they don’t really care.”

Fentanyl Means More MoneyALL ABOUT MONEY — Using fentanyl raises drug dealers' profits.

This wanton disregard for human life is reflected in the fact the DEA has often tested counterfeit OxyContin pills containing up to 5 milligrams of fentanyl—or 2½ times a lethal dose.

5 Thngs Everyone Should Know About Fentanyl
University of Colorado Boulder • Health & Wellness Services
» colorado.edu

If a counterferfeit pill contains fentanyl, what are the odds that dosage could be lethal?

Taking any counterfeit pill is a possible life-and-death proposition. What are your odds of not overdosing if that pill contains fentanyl? Probably worse than 50/50.

50-50_OddsWILLING TO BET YOUR LIFE? — That's what you're doing if you're taking pills not prescribed to you by your doctor.

Of the fentanyl-laced fake prescription pills the DEA tested in 2022, six out of 10 contained a potentially lethal dose of fentanyl. That is up from four out of 10 in 2021.

Stunning DEA Laboratory Test Results
‘Fentanyl remains the deadliest drug threat facing this country’
» DEA Public Safety Alert

How will you know if you are taking a pill with fentanyl?

You won’t.

Dealers use fentanyl “because its high potency allows [them] to traffic smaller quantities but maintain the drug effects buyers expect,” Dr. Kavita Babu wrote in article for the UMass Chan Medical School. And dealers certainly aren't about to tell their customers if or how much fentanyl they've mixed into their various illegal products.

“Unfortunately, fentanyl’s high potency also means that even just a small amount can prove deadly,” Dr. Babu noted. “If the end user isn’t aware that the drug they bought has been adulterated, this could easily lead to an overdose.”


You should never, ever take any pills not prescribed specifically for you by a physician. And you certainly can’t trust that a prescription medication a drug dealer is selling is the real deal. Again, most fentanyl-laced counterfeit pills the DEA tests have a potentially lethal dose of the synthetic opioid.

What is fentanyl and why is it behind the deadly surge in US drug overdoses?
By Kavita Babu, MD • UMass Chan Medical School • May 10, 2022
» Article

But isn’t fentanyl used in medical treatments?

Yes—with extreme caution.

Fentanyl is often administered to patients—many of whom have suffered a traumatic injury or are terminally ill—to relieve severe pain. According to the National Institute on Drug Abuse (NIDA), fentanyl can also be given as an injection, control-release skin patch or even cough drop-like lozenges. Each method strictly limits the fentanyl dosage given the patient.

That dosage is usually restricted to only a few mircograms (mcg) per hour. There are 1,000 micrograms in a single miligram (mg)—or 2,000 micorgams in a fatal dose of fentanyl

MicroGramsONLY 75 MICROGRAMS — This medicine strictly controls the release of fentanyl to only 75 micrograms (0.075 milligrams) per hour, yet it prominently warns about the dangers associated with the synethic opioid.

“Even in the controlled conditions of a hospital, there is still a risk that using fentanyl can reduce breathing rates to dangerously low levels, the main cause of opioid overdose deaths,” Dr. Babu, an emergency physician, warned in his UMass article. “For those taking fentanyl in nonmedical settings, there is no medical team available to monitor someone’s breathing rate in real time to ensure their safety.”

National Institute On Drug Abuse
Fentanyl DrugFacts
» NIDA DrugFacts

What are fentanyl’s effects?

From the National Institute on Drug Abuse:

Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. After taking opioids many times, the brain adapts to the drug, diminishing its sensitivity, making it hard to feel pleasure from anything besides the drug. When people become addicted, drug seeking and drug use take over their lives.

Fentanyl's effects include:

  • extreme happiness
  • drowsiness
  • nausea
  • confusion
  • constipation
  • sedation
  • problems breathing
  • unconsciousness


What makes fentanyl so deadly?

Two milligrams—the miniscule amount of fentanyl it takes to trigger a potentially fatal reaction—can drastically slow your breathing or even bring it to a complete stop. Lack of oxygen flow to the brain can lead to coma, permanent brain damage and death.

A scarcely visible speck of fentanyl is enough to kill; dealers are using increasingly larger amounts of the synthetic opioid to cut their drugs. That deadly combination has caused fentanyl overdoses to become the No. 1 killer of American adults 18 to 45, according to the Centers for Disease Control & Prevention (CDC).

An estimated 77% of the overdose deaths in the United States in 2021 involved fentanyl.

COMBAT Director Vince Ortega has put in perspective the 50/50 risk involved in swallowing a counterfeit pill: “Any tablet with a heavy enough concentration of fentanyl in it—and it doesn’t take much—could be every bit as deadly as biting down on a cyanide capsule.”


When you consider that dealers are mixing fentanyl with counterfeit pills, cocaine, heroin—and who knows what else?—the risk, potentially lethal, of taking any illegally-obtained drug right now may be higher than ever before.

True or false,  fentanyl overdoses have become a leading killer of young adults in the United States? 


Fentanyl-related overdoses have become the No. 1 cause of death among America's young adults (18-45), according to the Centers for Disease Control & Prevention (CDC). The CDC estimates that between October 2020 and October 2021, overdoses killed 105,000 Americans. And two-thirds of those overdose deaths involved a synthetic opioid like fentanyl.

That averages out to nearly eight fentanyl-related overdose deaths per hour in the United States.

Overdose_Deaths copy

Fentanyl killed more Amreicans in 2021 than car accidents and guns combined, according to the Drug Enforcement Administration.


  1. September 2, 2022 (Updated May 9, 2023)
    'Rainbow Fentanyl'
    Targeting_Children_250Brightly colored fentanyl is being produced in multiple forms, including pills, powder, blocks that resemble sidewalk and other variations "made to look like candy." Are drug cartels deliberately targeting young people to increase their sales of highly addictive—and potentially deadly—fentanyl? 

  2. Fentanyl-OD_Arrest_250January 30, 2023
    Jackon County Task Force Spearheads OD-Related Investigation
    An investigation the Jackson County Drug Task Force spearheaded has led to multiple federal charges against a Kansas City man linked to at least three fatal fentanyl overdoses in 2022. Firearms, numerous pills containing fentanyl and hundreds of thousands of dollars seized.

  3. June 22, 2022
    Investigation Breaks Up Major Cartel Trafficking Operation
    Enough Fentanyl Seized For Potentially Millions Of Lethal Doses
    Fentanyl_Seized_250An investigation that the Jackson County Drug Task Force and federal Homeland Security officials initiated more two years ago has culminated in 39 defendants being indicted for their roles in a conspiracy to distribute more than 335 kilograms (738½ pounds) of methamphetamine and 22 kilograms (48½ pounds) of heroin. Especially alarming was the amount of fentanyl also seized: 10.4 kilograms (22.9 pounds), enough for millions—literally millions—of potentially lethal doses.”

  4. March 8, 2022
    149% Increase In Overdose Deaths Linked To Fentanyl
    250_OverdosesJust a speck of fentanyl—seven hundred thousandths of an ounce (0.00007)—can kill a person, but drug dealers are using the synthetic opioid more and more to manufacture counterfeit pills or to mix it with other drugs (like a fentanyl-meth combo being distributed in baggies with a "red lips" logo). They’re recklessly doing this to increase their profits, with a wanton disregard for the fact fentanyl-related overdose deaths in the Kansas City metro have increased 149%.

  5. October 13, 2021
    Counterfeit Pills—‘Widely Available’ & ‘More Lethal’
    One_Pill_Can_Kill_Slide_250Prescription pills not obtained from a licensed pharmacy are not only illegal to possess, but when taken can also be dangerous. There’s a good chance those pills might be fakes with potentially fatal side effects. According to the DEA, counterfeit pills are “widely available” and “more lethal than ever before.” Seizures of phony pills containing fentanyl have increased 420% since 2019. Just two milligrams of fentanyl can be a deadly dose.
    » MORE

  6. October 1, 2021
    The 'Gateway Drugs' To The Opioid Crisis
    Prescription_Medicines_250During National Medicine Abuse Awareness Month, COMBAT Director Vince Ortega is urging people to remember doctor-prescribed painkillers were the “gateway drugs” that triggered America’s ongoing epidemic of opioid overdose deaths. Across the nation, another 49,860 lives were lost due to opioid overdoses in 2019—a 50.7% increase compared to the 33,091 lives lost in 2015. Despite efforts to curtail the use of—and addictiveness of—prescribed opioid medications, the FDA notes, “The scope of the opioid crisis continues to grow.”
    » MORE

  7. September 24, 2020
    Drug Task Force Seizes 3,000 Pills Laced With FentanylJust A Speck Of Fentanyl Can Kill You
    A two milligram dose of fentanyl can be lethal. That’s why the Jackson County Drug Task Force’s seizure of 3,000 pills stamped as OxyContin but laced with fentanyl almost certainly saved lives—and sounded alarms. As COMBAT Director Vince Ortega points out, swallowing a tablet with fentanyl in it “could be every bit as deadly as biting down on a cyanide capsule.” While morphine is 1½ times stronger than oxycodone, the semi-synthetic opioid in OxyContin, fentanyl is 50 to 100 times stronger than morphine.
    » MORE