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Substance education guide

Parafluorofentanyl (Fluorofentanyl)

Synthetic fentanyl analogue · Designer opioid · Rapid respiratory depressant

· How it works

Classification and primary mechanism

Parafluorofentanyl is a fluorinated fentanyl analogue and full mu-opioid receptor agonist. Its high lipophilicity allows rapid blood-brain-barrier penetration, producing an intense onset followed by sudden sedation and respiratory depression.

· Immediate effects

Recognize the effects

Signs of Use

  • Pinpoint pupils, nodding, itching, and facial flushing
  • Mental incoherence, slurred speech, or inability to stay awake
  • Slow heart rate, hypothermia, limpness, or shallow breathing
  • Gurgling, cyanosis, and profound unresponsiveness
  • Respiratory arrest or coma in toxic exposure

Short Term

  • Rapid pain relief, euphoria, drowsiness, and mental detachment
  • Moderate exposure: stupor, blunted airway reflexes, hypothermia, and shallow breathing
  • Severe exposure: coma, cyanosis, respiratory arrest, and cardiac complications
  • Frequent redosing can rapidly escalate overdose risk
  • Naloxone and rescue breathing are time-critical

Long Term

  • Rapid physical dependence and severe withdrawal
  • Hypoxic brain injury after nonfatal overdose
  • Injection-related endocarditis, abscesses, and hepatitis C risk
  • Opioid use disorder and unpredictable counterfeit-pill exposure

· Long-term consequences

Classic opioid overdose

Call 911, administer naloxone, repeat it after two to three minutes if breathing does not normalize, provide rescue breathing, and place the person in the recovery position once breathing returns.

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