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Fentanyl is one of the most lethal drugs, contributing to over 70,000 deaths in the US in 2023, including around 700 teens. It also comes with a range of side effects that can become deadly, including the “fentanyl fold”, a term referring to a dangerous posture seen in fentanyl addicts [1].
If you’ve ever been around an opioid addict, particularly fentanyl or heroin, it is common for them to be dramatically bent at the waist, slumped forward, face in their food or shoulders slouched completely over, and almost mimicking what many Americans mockingly refer to as “zombies”. This is the fentanyl fold. It’s scary to observe and represents the danger of fentanyl.
Understanding the Fentanyl Fold
The fentanyl fold is more than just a medical or behavioral term; it’s a symbol of the opioid crisis in cities across the US, such as the Kensington neighbourhood in Philadelphia, often referred to as “Zombie Land,” highlighting the devastating reality of communities affected by fentanyl. It’s common to see fentanyl users in the streets of the open-air drug market, bent over in a rigid fold and unaware of their surroundings.
This increases the risk of vulnerability to crime, assault, and muggings. Chronic fentanyl users might wake up in random apartments, trap houses, on sidewalks, or in city parks, unaware of how they got there, with most of their things missing. One former fentanyl user shared, “It’s like your body freezes, and you’re stuck, barely breathing, barely there” [2].
Why Does Fentanyl Make Users Bend Over?
Fentanyl’s high potency and quick absorption in the brain trigger muscle rigidity (especially in the back and neck), sedation, and a lack of consciousness. This prevents normal, upright posture. The activity of the central nervous system is also reduced, slowing breathing and further weakening awareness [3].
How the Fentanyl Epidemic Has Emerged Among Teens
One of the most concerning parts of the fentanyl crisis in teens is the lack of knowledge or awareness around the drug. Most teens do not seek out or abuse fentanyl intentionally, but mistakenly take it laced in other drugs such as vapes, counterfeit pills, ecstasy, or cocaine.
However, growing concerns around fentanyl-laced pills and vapes have sparked a new danger. Law enforcement across the US has recently documented several incidents of fentanyl showing up in counterfeit THC and nicotine vapes. These are often sold online or on the street [4].
Many teens also do not realize how potent fentanyl actually is. How much fentanyl is lethal? As little as 2 milligrams. And many illegal pills laced with fentanyl have tested for up to 5 milligrams [5].
Dangers and Consequences of Consuming Fentanyl
Fentanyl is a synthetic opioid nearly 50 times more potent than heroin. It is a depressant and as such slows down regions of the brain, including the spinal cord, brain stem, and central nervous system, which control essential functions to survive, such as breathing and heart rate [6].
This is why opioids have such a high overdose rate. Activity in the brain stem slows down, which can be deadly. Other consequences of consuming fentanyl include:
- Worsened Mental Health: Teens using fentanyl often struggle with increased mental health issues such as anxiety, depression, and mood swings.
- Worsened Physical Health: Fentanyl abuse increases the risk of infections such as HIV (through shared needles). It can also cause poor nutrition and extreme weight loss, and impact the hormones and menstrual cycle in women.
- Homelessness and Social Instability: Fentanyl addiction can lead to loss of family support, financial challenges, and increased risk of homelessness or unstable living conditions.
Warning Signs of Fentanyl Consumption Parents Should Know
Besides the fentanyl fold, there are several signs to be mindful of that can indicate your teen is using fentanyl. It’s important to teach your teen the warning signs. Many times, fentanyl-related overdoses result from teens unintentionally and unknowingly consuming fentanyl when it’s laced in more common drugs among youth, such as cannabis, designer pills, MDMA, and vapes.
The top 5 fentanyl specific warning signs include:
- Small, contracted pinpoint pupils
- Loss of consciousness or falling asleep
- Slow, weak, shallow breathing
- Choking, gurgling, or snoring
- Limp or overly rigid body
Other signs include common behavioral and psychological symptoms of substance use disorders, such as academic decline, mood swings, increased anxiety or depression, aggression, secrecy, and changes in everyday habits/decline in functioning.
If you notice any of the signs of fentanyl abuse, it’s important to connect your teen with professional addiction treatment. In the case of an overdose (lack of responsiveness, stopped breathing, blue/purple fingertips or lips), call 911 immediately.
Prevention, Education & Support at Clearfork Academy
Clearfork Academy is a network of behavioral health facilities in Texas committed to helping teens recover with evidence-based fentanyl addiction treatment.
Our full continuum of care helps teens stabilize and supports their long-term recovery. We offer several levels of care, including residential treatment, partial hospitalization (PHP), and intensive outpatient (IOP). If your teen is experiencing a crisis, call our fentanyl rehab today. Our admission team is available 24/7.
Sources
[1] National Institute on Drug Abuse. 2024. Drug Overdose Deaths: Facts and Figures.
[2] Toledo, A. 2024. Here’s why fentanyl users on S.F.’s streets are bent over. San Francisco Chronicle.
[3] Buiter, N. et al. 2023. Effects of sub-lethal doses of fentanyl on vital physiologic functions and withdrawal-like behaviors. Frontiers in Physiology.
[4] DEA. 2022. Laboratory Testing Reveals that 6 out of 10 Fentanyl-Laced Fake Prescription Pills Now Contain a Potentially Lethal Dose of Fentanyl.
[5] Texas Human and Health Services. Fentanyl: One Pill Kills.
[6] George, T. P. (2002). The neurobiology of opioid dependence: implications for treatment. Science & practice perspectives, 1(1), 13–20.
Mike Carter, LCDC
Alumni Relations Manager
Mike grew up on a dairy farm in Parker County, Texas. At the age of 59, he went back to college and graduated 41 years after his first graduation from Weatherford College. God placed on his heart at that time the passion to begin to help others as they walked from addictions, alcoholism, and abuse of substances. He is a Licensed Chemical Dependency Counselor and in the past few years he has worn many hats, from intake and assessment, group counseling, individual and family counseling, intensive outpatient and now he is working with clients, therapist, and families on discharge planning and aftercare. He also coordinates our Alumni Outreach Program.
