What Are the Different Derivatives of Fentanyl?

Fentanyl is a synthetic opioid that, according to the U.S. Centers for Disease Control and Prevention (CDC), has been experiencing a fentanyl overdose death epidemic over the last 25 years. In addition to fentanyl, there are also modified versions of the original drug called fentanyl derivatives that generally have more potency than the original. While original fentanyl and some of its derivatives—such as sufentanil, alfentanil, remifentanil, and carfentanil—are approved for medical use, many are made and used illegally. And with so many unknowns regarding how the analogues are made, their side effects, and how they affect the brain, their use can be fatal.

 

---

Table of contents

» What Are Fentanyl Derivatives or Analogues?

» Why Are Fentanyl Analogues Abused?

» What Are the Most Common Medical Derivatives of Fentanyl?

» How Do Fentanyl Analogues Differ in Potency?

» How Do Fentanyl Derivatives Contribute to the Overdose Crisis?

» Key Takeaways on Fentanyl Derivatives

» Resources

---

What Are Fentanyl Derivatives or Analogues?

Fentanyl derivatives—also known as fentanyl analogs—are modified versions of the synthetic opioid fentanyl. Both fentanyl and its derivatives are made in a lab and contain no natural ingredients. In many cases, fentanyl analogues are created to increase the original drug’s potency.

According to an article in the journal Drug and Alcohol Dependence, fentanyl was approved by the U.S. Food and Drug Administration (FDA) in 1968 for use as an anesthetic during surgical procedures. It is also sometimes prescribed by doctors for treating severe and chronic pain.

The U.S. Drug Enforcement Administration (DEA) reports that fentanyl is about 100 times more potent than morphine. However, the United States Sentencing Commission stated in its 2021 report “Fentanyl and Fentanyl Analogues: Federal Trends and Trafficking Patterns” that some fentanyl analogues can be up to 10,000 times more potent than morphine.

Fentanyl and its derivatives are considered Schedule II drugs under the Controlled Substances Act (CSA), which CSA defines as substances that “have a high potential for abuse which may lead to severe psychological or physical dependence.”

Drugs grouped into Schedule II include opiates and stimulants such as:

• Fentanyl and its derivatives
• Oxycodone
• Morphine
• Opium
• Codeiene
• Methamphetamine
• Methadone

While legitimate pharmaceutical companies create the few medically used fentanyl analogues, most of what is available illegally is made by unregulated laboratories in the U.S., China, and Mexico. Additionally, some black market drug makers also create derivatives of fentanyl to be sold illegally.

---

Why Are Fentanyl Analogues Abused?

Because of its potency and the sense of euphoria it provides, fentanyl and its derivatives are very addictive and have a high rate of abuse, which contributes to the growing crisis of fentanyl in Florida and the U.S.

According to the U.S. Department of Health & Human Services, overdose deaths by synthetic opioids increased 103-fold between 1999 and 2023. The National Institute on Drug Abuse reports that as little as 2 mg of fentanyl can be deadly.

Fentanyl and its analogues work by binding to the mu opioid receptor (mOR) in the brain. The mOR receptors are what allow fentanyl users to experience pleasurable effects and pain relief. These enjoyable results can be very addictive, leading to overuse.

Fentanyl derivatives can create intense feelings that can be addictive, such as:

• Euphoria
• Happiness
• Relaxation
• Pain relief

However, fentanyl and its analogues can also cause health problems, including:

• Nausea and vomiting
• Fatigue
• Confusion
• Dizziness
• Vision issues
• Respiratory problems
• Stiff muscles

---

What Are the Most Common Medical Derivatives of Fentanyl?

A study published in the journal Heliyon reports that there are more than 1,400 known derivatives of fentanyl. Of that large number, only a few are approved to be used medically. They include:

• Alfentanil: Used as an anesthetic and pain reliever in surgical situations. Because it is five to 10 times less potent than fentanyl, it is mainly used during shorter procedures and when a quick recovery time is needed.
• Carfentanil: Considered to be up to 100 times more potent than fentanyl, this derivative is medically used only in veterinary medicine as a tranquilizer for very large animals.
• Remifentanil: This analogue has a potency very similar to fentanyl. Because it metabolizes very quickly through the body, it is mainly used for rapid pain relief after surgery or during labor and delivery.
• Sufentanil: About five to 10 times more potent than fentanyl, this derivative is used medically as part of anesthesia and pain management.

---

---

What our customers are saying

---

How Do Fentanyl Analogues Differ in Potency?

Derivatives of fentanyl vary significantly in terms of potency, with some being less potent than the original drug and others being massively more powerful. This is why there is such a high overdose potential for fentanyl analogues.

Some of the derivatives that are more potent than fentanyl are:

• 3-methylfentanyl: reported to be about 20 times more powerful
• Carfentanil: up to 100 times more potent
• Furanylfentanyl: about seven times more powerful
• Ocfentanil: about 2.5 times more potent

In addition to greater potency, derivatives of fentanyl generally have other features that can make them even more dangerous than fentanyl, such as:

• Differing Duration of Action: Some analogues are effective for a much shorter time than fentanyl, while others last longer.
• Unspecified Brain Interactions: Analogues can sometimes affect the brain’s opioid receptors differently than fentanyl, increasing their associated risks.
• Unknown Side Effects: Modifying fentanyl can create new side effects that may be similar to those of the original drug or completely different.
• Treatment Challenges: Because some derivatives are so potent, medications normally used for a fentanyl overdose may not work.

---

---

How Do Fentanyl Derivatives Contribute to the Overdose Crisis?

With so many unknown factors, including potency, duration of action, and potential side effects, derivatives of fentanyl are part of the reason why fentanyl-related overdoses have been on the rise.

According to the CDC, about 70% of all overdose deaths in the U.S. in 2023 are attributable to illegally manufactured fentanyl analogues. Overdoses of just carfentanil alone increased sevenfold from 2023 to 2024.

Here are some of the main reasons why fentanyl analogues are contributing to our current drug overdose issues in the U.S., including fentanyl addiction in teens:

• Undisclosed potencies, with some so high that just a small amount can be fatal.
• Mysterious side effects, some of which could be deadly.
• Unknown interactions with other medications or medical conditions.
• Inconsistent mixtures of analogues on the illegal drug market.
• Accidental ingestion of derivatives can sometimes be hidden in other drugs or created to look like other drugs.
• Overdose reversal medication challenges.

---

---

Key Takeaways on Fentanyl Derivatives

• Fentanyl derivatives are modified versions of the synthetic opioid fentanyl.
• Fentanyl analogues have a high rate of abuse due to their addictive nature.
• Of the more than 1,400 types of derivatives, currently only four are used medically.
• Fentanyl analogues range greatly in potency, with some being as much as 100 times as powerful as fentanyl.
• Derivatives of fentanyl contribute to the U.S. overdose crisis due to many unknown factors, including potency, side effects, and duration of action, as well as overdose reversal medication challenges.

If you or a loved one is struggling with an addiction to fentanyl or one of its many derivatives, WhiteSands Treatment in Florida is here to help. Our medical detox program offers personalized care and focuses on helping you toward a healthy recovery. And our substance use disorder treatments are designed to treat not only your addiction, but also any underlying mental health conditions that might be behind your substance abuse or making it more difficult to stop.

Call WhiteSands Treatment Center today at 877-855-3470 to learn more about our inpatient and outpatient treatment options for abuse of fentanyl and its analogues.

---

Resources

• U.S. Centers for Disease Control and Prevention (CDC) — Understanding the Opioid Overdose Epidemic
• Drug and Alcohol Dependence — Understand the FDA-cleared fentanyl testing: A clinical evaluation of the SEFRIA fentanyl immunoassay
• U.S. Drug Enforcement Administration (DEA) — Facts About Fentanyl
• United States Sentencing Commission — Fentanyl and Fentanyl Analogues: Federal Trends and Trafficking Patterns
• U.S. Department of Justice Drug Enforcement Administration — Controlled Substance Schedules
• U.S. Department of Health & Human Services — Overdose Prevention Strategy
• National Institute of Drug Abuse — Fentanyl
• Heliyon — Fentanyl and its derivatives: Pain-killers or man-killers?
• U.S. Centers for Disease Control & Prevention (CDC) — Detection of Illegally Manufactured Fentanyls and Carfentanil in Drug Overdose Deaths — United States, 2021–2024

If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.