Rainbow Fentanyl: What It Looks Like and What Happens if You Overdose

Multi-colored fentanyl pills, nicknamed "rainbow fentanyl," have been increasing in popularity across the U.S.

According to a press release from the Drug Enforcement Administration (DEA) in August, rainbow fentanyl had been seized in 18 states. The DEA said it was concerned that the brightly colored, candy-like appearance of the drugs may be deliberate, in an effort to sell the highly addictive drug to young people or even children.

"Rainbow fentanyl—fentanyl pills and powder that come in a variety of bright colors, shapes, and sizes—is a deliberate effort by drug traffickers to drive addiction amongst kids and young adults," said DEA Administrator Anne Milgram in a statement. "The men and women of the DEA are relentlessly working to stop the trafficking of rainbow fentanyl and defeat the Mexican drug cartels that are responsible for the vast majority of the fentanyl that is being trafficked in the United States."

Fentanyl is a synthetic opioid drug, often prescribed as a pain relief treatment. According to a DEA fact sheet, fentanyl is extremely addictive and is around 100 times more potent than morphine and 50 times more potent than heroin. While providing pain relief, fentanyl binds to the body's opioid receptors, which also leads to symptoms of extreme happiness, drowsiness, nausea, sedation or unconsciousness.

This rainbow fentanyl is not the first time that drugs have appeared in different colors than normal, however.

"Colored fentanyl pills have been going around for some time," Joseph J. Palamar, an associate professor at New York University Langone Medical Center's Department of Population Health, told Newsweek.

"This is regular fentanyl. Effects of any drug depend on the mode of administration. If a drug is injected or smoked it acts much faster than if swallowed," Palamar said. "Effects also depend on how much of the drug is used and whether the user has a tolerance. If a pill containing fentanyl is accidentally ingested, I'd think there's more time to seek help as opposed to someone who sniffs, smokes, or injects a drug not known to contain fentanyl. It's possible that different colors represent different doses, so the color of the pill might also be a factor."

Due to its addictive quality, fentanyl may lead to overdose and potentially even death. According to the National Institute on Drug Abuse (NIDA), synthetic opioids like fentanyl are the most common drugs involved in drug overdose deaths in the U.S., with 59 percent of opioid-related deaths involving fentanyl in 2017. This was a significant increase from the 14.3 percent seen in 2010.

"We found that not only has fentanyl seizures been increasing, but the proportion of pills seized to overall fentanyl seizures has been increasing," Palamar said. "The proportion of pill seizures increased from 14 percent in early 2018 to 29 percent in late 2021.

According to Palamar, the most common fentanyl pills have been blue counterfeit oxycodone pills labeled "M30", which were particularly dangerous not because of their color, but rather because they look like real oxycodone, which is a much weaker opioid.

"These new pills also often have M30 logos, but they come in a wider array of colors somewhat reminiscent of Sweetart candy," he said.

Rainbow fentanyl may be a risk to kids, but not for the reasons that the DEA fears, however.

"I don't think these manufacturers or dealers are targeting kids, but this doesn't mean that such pills aren't attractive to kids," Palamar said. "These pills cost money, so I think the concern about people giving kids these pills for Halloween has been overblown. What I'd worry about is parents or others who use fentanyl and leave the pills around when they have kids."

Sometimes other drugs like cocaine or MDMA are mixed with the cheaper fentanyl, which may mean that a fentanyl overdose may occur without the person knowing it is actually fentanyl. Naloxone can be used to treat a fentanyl overdose if administered quickly.

Withdrawal from fentanyl is extremely unpleasant, which makes it very difficult for people to give it up after becoming addicted. Withdrawal symptoms include muscle and bone pain, sleep problems, diarrhea and vomiting, cold flashes with goosebumps, uncontrollable leg movements, and severe cravings, according to NIDA.