Acetyl fentanyl can be 15 times stronger than heroin, but users can often buy it through legitimate retail outlets and online stores, researchers warn in a new report.

Acetyl fentanyl is an opioid analgesic with no recognized medical uses, the researchers write. On the street, it’s often sold as heroin, so users don’t realize the potency of what they’re taking. Like heroin, it can produce euphoria, altered mood, drowsiness, miosis, cough suppression, constipation, and respiratory depression.

But the standard dose of the heroin andidote (naloxone) isn’t enough to counteract it.

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Acetyl fentanyl “exists in a legal grey area in that it is considered illicit for human consumption but if a package is labeled ‘not for human consumption,’ the product is technically legal,” says a press release. “A large quantity of acetyl fentanyl would potentially be immune to regulation as long as it was titled, labeled and stored as a product with industrial or non-human research purposes.”

In 2013, the Centers for Disease Control and Prevention issued an alert for overdoses connected with acetyl fentanyl after the Rhode Island State Health Laboratories noticed a cluster of 10 overdose deaths of suspected illicit drug users that tested positive for acetyl fentanyl.

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“Heroin users may obtain and administer packages that they believe is heroin and experience severe consequences if the package contains only the more potent acetyl fentanyl or a mixture of acetyl fentanyl and heroin. Clinicians should realize that these individuals may present in emergency departments in much the same manner as heroin overdose victims (lethargic and disoriented, with shallow breathing, bradycardia, and hypotension) and, if conscious, may claim that they used heroin or oxycodone rather than acetyl fentanyl,” the researchers write.

Reclassifying acetyl fentanyl as an illegal narcotic could help prevent overdose deaths, although broader policy reform should also be considered to prevent similar scenarios with other compounds in the future, the researchers suggest.

Photo: Acetyl fentanyl can be passed off as heroin by drug dealers. Credit: ThinkStock