What Is Fentanyl? Former NHLer Jimmy Hayes Died With Opioid and Cocaine in System

The family of deceased former NHL player Jimmy Hayes has revealed that the 31-year-old right-winger had fentanyl and cocaine in his system when he died.

Hayes was found dead at his home in Milton, Massachusetts, on August 23. A toxicology report later determined that the cause of death was "acute intoxication" due to the combined effects of the two substances, his wife and father told The Boston Globe in an article published Sunday.

"I was completely shocked,'' his wife, Kristen Hayes, told the Globe. I was so certain that it had nothing to do with drugs. I really thought it was a heart attack or anything that wasn't that [drugs.]"

"It didn't make any sense, so it was hard. I was hoping to get a different phone call when they called. I was hoping to get some clarity and I was shocked to hear that it was that. He never showed any signs of a struggle at home.''

But what is fentanyl, the substance that contributed to the death of the 31-year-old?

Fentanyl is a powerful, synthetic opioid that is around 50 to 100 times more potent than morphine, according to the National Institute on Drug Abuse (NIDA).

Natural opioids are a class of drugs derived from the opium poppy plant. Synthetic opioids, such as fentanyl, are based on the same chemical structure as these substances but are made in the lab by scientists.

Fentanyl is primarily used to treat patients with severe pain, or to manage the pain of individuals who have just undergone surgery. In addition, the drug is sometimes given to patients with chronic pain who are physically tolerant to other opioids.

Prescription fentanyl is sold under names including Actiq, Duragesic, and Sublimaze and can be given as a shot, a patch that is placed on someone's arm or a lozenge that is sucked.

But the substance is also sold illegally in several forms, including powder, blotter paper, eye drops, nasal sprays and pills.

Natural and synthetic opioids work by binding to opioid receptors in an area of the brain that deals with pain and emotions.

Fentanyl produces several effects on the body that are similar to other opioids, including relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupil constriction and respiratory depression, according to a Drug Enforcement Administration fact sheet.

When people take opioids frequently, the brain adapts to the substance, reducing its effects and making it difficult for the individual to feel pleasure from anything else aside from the drug.

Fentanyl is highly addictive because of its potency, according to the NIDA. People can experience dependence that can sometimes lead to addiction.

Synthetic opioids, such as fentanyl, are now the most common substances involved in drug overdose deaths in the U.S., according to the NIDA. Around 60 percent of opioid-related deaths in the U.S. in 2017 involved fentanyl—a significant rise from the figure of about 14 percent that was reported for 2010.

The high potency of fentanyl means an individual can easily overdose by taking only slightly more than they thought they were administering.

Sometimes, drug dealers even mix fentanyl with other drugs—such as cocaine, cocaine, methamphetamine and MDMA—which the NIDA describes as an "especially risky" practice that increases the chance of overdose.

Overdosing on fentanyl can be life-threatening, with individuals potentially experiencing respiratory failure that can lead to coma, permanent brain damage, and death.

Dr. Lawrence Weinstein, chief medical officer of American Addiction Centers (AAC), told Newsweek: "On its own... a very minimal amount [of fentanyl] can be fatal; but when this depressant is combined with a stimulant like cocaine, the effects of both substances are amplified. Last year, approximately 70 percent of cocaine overdose deaths involved fentanyl showing that this combination is quickly becoming a very troubling trend."

UPDATE 10/20/21, 8:49 a.m. ET: This article was updated to include a comment from Dr. Lawrence Weinstein.