Fentanyl continues to be at the center of America’s opioid & OD crisis, especially here in MD. As a Medication-Assisted Treatment (MAT) provider, Grasonville Health Services is committed to offering clarity, education, & life-saving resources. Whether you’re someone seeking help or a loved one trying to understand, here’s what you need to know as of 2025.
What Is Fentanyl?
Fentanyl is a synthetic opioid—meaning it’s lab-made & designed to relieve pain. It’s up to 50 times more potent than heroin & 100 times stronger than morphine.
There are two main types of fentanyl:
1. Pharmaceutical (Prescribed) Fentanyl
This is FDA-approved, produced under strict medical supervision, & typically used to treat severe pain, such as cancer-related pain or post-surgical pain. It’s administered through:
• Patches
• Lozenges
• IV
• Nasal sprays
When used as prescribed, it’s safe & effective. It’s a great medication for its intended purpose & has helped many with chronic pain or during/after surgery. But due to its strength, even a small dosing error can be dangerous.
2. Illegally Manufactured Fentanyl (IMF)
This is what’s driving the current overdose epidemic. IMF is made in clandestine labs, often outside the U.S., and is sold:
• As powder
• Pressed into pills made to look like Oxycodone, Xanax, Percocet, etc.
• Mixed into other drugs like heroin, cocaine, meth, or fake Adderall
Most people overdosing from fentanyl never knew they were taking it.
2025: What’s New & Concerning in Maryland’s Drug Supply?
Overdose Deaths Are Down—but the Risk Is Still High
Maryland saw a 38% drop in fatal overdoses in 2024, the lowest since 2015. However, Baltimore City still accounts for nearly half of all fatal OD’s in the state. Rural areas, including parts over here on the Eastern Shore, continue to see fentanyl mixed into other substances.
Pressed Pills Are Everywhere
Fake pills (pressies/presses/pressed pills) are being mass-produced to mimic real medications. & trust me, to the untrained eye, or those not in the know- they’re VERY deceiving. There are some that literally can’t be told apart unless with a drug test. They’ve become THAT good at replicating these medications. These are commonly laced with fentanyl or fentanyl analogues, which can be stronger & harder to detect.
Fentanyl Analogues on the Rise
Analogues like carfentanil, which is 100x more potent than fentanyl, are showing up in autopsy reports. These analogues may not be detectable with standard fentanyl test strips, & they vary on potency, making them even more chaotic & challenging.
Xylazine (“Tranq”) & Other Sedatives
Xylazine, a non-opioid veterinary tranquilizer, is now extremely common in the supply. In fact- it’s almost impossible to find samples without it these days. It causes:
• Deep sedation
• Severe skin ulcers & infections, that can lead to necrosis & amputation
• Overdoses that may not respond to Narcan alone
• Not much is known about it, as it’s not approved for human use for a reason, but many users have reported it has its own withdrawal- mainly extremely high blood pressure & extreme anxiety.
I think now is a good time to mention- majority of users do not like tranq, from my experiences speaking with users. In fact, it’s pushed many into treatment. Of course, it varies by user, but based off my work dealing with the Baltimore population when doing harm reduction, as well as at the clinic- I hear nothing good about it from the users. But they felt stuck, as they couldn’t find anything else. Basically tranq had “appeared one day & just took over,” as one man put it. He even bought test strips & tested many corners himself personally, as he wanted to avoid it. His arms showed the reason why. He had almost lost them, due to the necrotic wounds that tranq causes. He said, at that time around 2018-2019 when he did the tests, he could only find one corner in one of the large open air markets in the city that didn’t have it. Other users spoke of the it having its own withdrawal, extremely high BP & anxiety seem to be the most common symptoms.
Maryland recently issued guidance on xylazine, urging health professionals & the public to be cautious. Although xylazine is just now getting the media coverage it deserves, we know it’s been in Maryland, since at least 2018- this has been confirmed by the wounds being caused, & test strips. It’s also concerning as new animal sedatives- like Medetomidine – is on the rise. Its presence was first detected in Maryland this year, in Cecil County.
Why Is Fentanyl So Dangerous?
• Minuscule amounts can be fatal: just 2 milligrams can cause fatal outcomes.
• Users often don’t know it’s there: it’s odorless, tasteless, & often invisible.
• Polydrug use (mixing with alcohol, benzos, meth, etc.) increases overdose risk dramatically.
How Grasonville Health Services Can Help
We are here for you—no judgment, just care.
• Medication-Assisted Treatment (MAT)
• Harm Reduction Support & Education
• Naloxone (Narcan) Access & Training
• Community-Based Referrals
• Ongoing Recovery Support
The opioid drug supply is changing fast, BUT so are the tools we have to fight it. Knowledge, harm reduction, & treatment save lives.
If you or someone you love needs help, contact Grasonville Health Services today. You are not alone & recovery is possible.
We’re open Monday – Friday 5:30am-12:30pm. You do NOT need an appointment, & same day intake/dosing is available!
📲- 1 (410) 413-7880
📍101 Drummer Drive Grasonville MD 21638
