Fentanyl Awareness

 
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Visual representation of the fentanyl crisis in Fresno County, showcasing the urgent need for awareness and intervention.
Fentanyl Crisis in Fresno County
Fresno County District Attorney's Office
ALERT
Fentanyl is up to 100 times more potent than morphineEven a tiny dose can be deadly — know the warning signsCall 911 immediately if you suspect an overdoseIf you sell, you may face murder liability chargesOne loss is too many — protect your community Fentanyl is up to 100 times more potent than morphineEven a tiny dose can be deadly — know the warning signsCall 911 immediately if you suspect an overdoseIf you sell, you may face murder liability chargesOne loss is too many — protect your community

How Fresno County is Combating this Issue

Our office remains committed to the fight against fentanyl. Since 2021, we have visited numerous schools, attended community events, and spoken to countless organizations to educate the public about its dangers. In addition, we have taken an aggressive approach to prosecuting fentanyl dealers for murder — securing the county's historic first conviction in April 2025, only the third in the state.

If you'd like us to bring this important awareness to your 
School or organization, scan the QR code to request a visit!

Scannable QR Code

Potential Murder Liability

You are hereby advised that it is extremely dangerous to human life to provide, distribute, or furnish fentanyl or analogs of fentanyl in any form. Deadly substances such as fentanyl and analogs of fentanyl kill human beings even in small doses. If you provide, distribute, or furnish fentanyl or analogs of fentanyl in any form and as a result someone dies, you can be charged with murder.

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What is Fentanyl?

It is a deadly synthetic opioid that is being pressed into fake pills or added to heroin, meth, cocaine, and other street drugs to drive addiction in our communities.

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Why is Fentanyl so Dangerous?

Because it's so potent, even a small dosing error can slow or stop breathing; law-enforcement testing shows as little as about 2 milligrams can be lethal depending on a person's tolerance. On top of that, people often encounter fentanyl unknowingly in counterfeit pills or mixed into street drugs, so they can't "dose" it reliably. Importantly, medical toxicologists emphasize that incidental skin contact is extremely unlikely to cause overdose — so it's safe to help someone if you use basic precautions.

Source: US DEA Facts about Fentanyl
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How Does Fentanyl Get Into Other Drugs?

Illicitly manufactured fentanyl is frequently blended into heroin, cocaine, and methamphetamine and is also pressed into fake prescription pills that look like oxycodone, Xanax, and others—often without the user's knowledge. This contamination and counterfeiting create unpredictable strength from dose to dose, which sharply raises overdose risk.

Source: National Institute on Drug Abuse
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How Can I Protect Myself and Others?

Only take medications dispensed by a pharmacy; avoid pills from friends, dealers, or online sources. Carry naloxone (now available over the counter) and learn overdose response - give naloxone, call 911, and provide rescue breathing.

Source: National Institute on Drug Abuse
 

Even a very tiny dose is deadly

Warning Signs of Fentanyl Use

  1. Sleep & Eating Changes

    Ongoing irregular sleep or eating patterns.

  2. Low Energy

    Persistent fatigue and lack of motivation for daily activities.

  3. Mental Health Changes

    Sudden signs of depression or anxiety.

  4. Irritability

    Unusual irritability or mood swings without clear cause.

  5. Academic Decline

    Slipping grades or performance at work or school.

  6. Lost Interest

    Lack of interest in activities that they once loved.

Signs of a Fentanyl Overdose

Open white pill bottle on dark surface, with scattered light blue tablets and a silver cap nearby, conveying a clinical and organized tone.

Fentanyl overdoses can happen suddenly, and every second counts. Recognizing the earliest warning signs could mean the difference between life and death. Fentanyl is far more potent than most opioids — even a tiny amount can overwhelm breathing in minutes.

If someone may have taken fentanyl, stay calm, act quickly, and watch closely for changes in their breathing, alertness, or body color. The following signs can help you tell when it’s time to get emergency help right away.

Review some Early-Warning signs and Life-Threatening signs of Fentanyl Use below.

Early-Warning

Pinpoint Pupils

Pinpoint pupils (very tiny, constricted pupils) are one of the earliest and most recognizable signs of opioid overdose. When fentanyl affects the central nervous system, it forces the pupils to tighten dramatically, even in low light.

Extreme drowsiness / “nodding off”

People may appear unusually sleepy, drift in and out of consciousness, or be unable to stay awake. Their responses may be slow or confused. This is caused by fentanyl suppressing brain activity and reducing oxygen levels.

Cold, clammy skin

As breathing slows, blood flow and oxygen drop. The skin may feel cool, sweaty, or moist to the touch. This change often appears early and can worsen quickly if the person does not receive help.

Limp or very weak body

Muscles lose strength when fentanyl depresses the nervous system. A person may be unable to sit up, control their movements, or keep their head from falling forward.

Nausea or vomiting

Opioids can disrupt normal digestive function. Nausea or vomiting may occur suddenly, and if a person is very weakened or unconscious, vomiting increases the risk of choking.

Life-Threatening

Breathing slow, irregular, or stopped

Fentanyl can severely suppress the part of the brain that controls breathing. Someone may take shallow breaths, breathe irregularly, or stop breathing entirely. This is the most dangerous sign and requires immediate emergency action.

Blue/gray lips or fingertips

When oxygen levels drop, blood cannot circulate normally. Lips, nails, or fingertips may turn blue or gray — a sign of critical oxygen loss that indicates the person is not getting enough air.

Unresponsive or unconscious

A person may not wake up even when shaken or called by name. Loud noises or pain may not get a response. This happens when fentanyl overwhelms the brain’s ability to stay awake.

Choking, gurgling, or loud snoring

These sounds can indicate that the airway is partially blocked or that breathing is dangerously shallow. Gurgling or “death rattle” sounds mean the person’s airway needs to be cleared and emergency help is needed right away.

Slow or no heartbeat

A weakening or absent pulse is a sign that the body is shutting down due to lack of oxygen. This is a life-threatening emergency and requires immediate CPR and naloxone if available.

Even small changes — a slowed breath, pale skin, or sudden silence — can mean the difference between life and death. Fentanyl can overwhelm the body in moments, leaving little time to react.

These aren’t just signs. They’re the last chance to notice.
Even when help is close, fentanyl can move faster.
It doesn’t wait.
It kills.

Here's What to Do in an Overdose

If you suspect a fentanyl overdose, act immediately — every second counts.

Follow each step below carefully. Click or tap a number to reveal the instructions for that step. Continue until you've completed all six actions.

Call 911 Immediately

Contact emergency services right away. Time is critical in an overdose situation. Provide your location and describe the situation clearly to the dispatcher.

Administer Narcan

Use naloxone (Narcan) nasal spray.

How to Access Narcan (Instructions)

Narcan

How to Access Narcan

Narcan is now on all Fresno County junior high and high school campuses due to a partnership between the Fresno County Department of Public Health and the Fresno County Superintendent of Schools.

The public can access free Narcan from the following locations:

In addition, pharmacies sell it over the counter and the City of Fresno also requires businesses serving alcohol to have Narcan readily available.

Check for Responsiveness

Try to wake the person by calling their name loudly and rubbing your knuckles firmly on their chest. If they don't respond, they may be experiencing an overdose.

Position the Person

If the person is unconscious but breathing, place them in the recovery position on their side. This helps prevent choking if they vomit.

Stay with the Person

Remain with the person until emergency services arrive. Continue monitoring their breathing and be prepared to administer additional doses of Narcan if needed.

Second Dose

Give another Narcan if no response in 2-3 minutes.

Contact emergency services right away. Time is critical in an overdose situation. Provide your location and describe the situation clearly to the dispatcher.

Use naloxone (Narcan) nasal spray.

How to Access Narcan (Instructions)

Narcan

How to Access Narcan

Narcan is now on all Fresno County junior high and high school campuses due to a partnership between the Fresno County Department of Public Health and the Fresno County Superintendent of Schools.

The public can access free Narcan from the following locations:

In addition, pharmacies sell it over the counter and the City of Fresno also requires businesses serving alcohol to have Narcan readily available.

Try to wake the person by calling their name loudly and rubbing your knuckles firmly on their chest. If they don't respond, they may be experiencing an overdose.

If the person is unconscious but breathing, place them in the recovery position on their side. This helps prevent choking if they vomit.

Remain with the person until emergency services arrive. Continue monitoring their breathing and be prepared to administer additional doses of Narcan if needed.

Give another Narcan if no response in 2-3 minutes.

One Loss is Too Many

The stories shared here belong to mothers who have lost a child to fentanyl.

Their words remind us that behind every overdose statistic is a life cut short, a family grieving, and a community forever changed. By listening, we honor their children and help others see the urgent need for awareness, compassion, and prevention.

Ways Fentanyl is Distributed

Solid blue and colorful, counterfeit pills resembling candy are appearing in the Central Valley, making fentanyl even more dangerous to youth. Many may use drugs to cope with stress or experiment socially, drawn to fentanyl’s bright powders and laced pills. These forms are often smuggled for recreational use.

Fentanyl also appears as a powder and is commonly mixed with other lethal drugs like heroin, meth and cocaine. Its high potency and unpredictable doses greatly increase the risk of overdose and death.

Pill Images

  • Blue fentanyl pills stacked together on a dark black background.
    Blue Fentanyl Pills
  • A large quantity of blue pills in plastic bags, alongside three wrapped blocks of unknown substances, laid out on a surface.
    Bagged Drugs
  • A colorful collection of pills stacked together on a table, showcasing a variety of shapes and hues.
    Multi-Colored Pills

Social Media Apps

Most of the fentanyl pills and powder are being sold via social media platforms. Drug dealers are contacting users through various social media and cash transfer apps. Be knowledgeable about the apps that youth are using.

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For more information regarding the dangers of fentanyl, visit:  

fresnoda.org/fentanyl
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