Fentanyl is an extraordinarily potent narcotic. “Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States”. https://www.cdc.gov/drugoverdose/opioids/fentanyl.html. Fentanyl is prescribed legally under brand names such as Duragesic. However, “non-pharmaceutical fentanyl is frequently referred to as illicitly manufactured fentanyl (IMF). IMF is often mixed with heroin and/or cocaine—with or without the user’s knowledge. Id. It comes as little surprise to anyone that follows the news that we are in the midst of what is being called an ‘opioid epidemic”, and, significant components in that epidemic are synthetic opioids. Indeed, the Drug Enforcement Administration advises: “Fentanyl is the most prevalent and the most significant synthetic opioida threat to the United States and will very likely remain the most prevalent synthetic opioid threat in the near term. The fentanyl threat remains most severe in the white powder heroin user market in the Midwest and Northeast United States, and fentanyl availability continues to be primarily by itself or with heroin. Fentanyl mixtures with non-opioid substances are a cause for public health concern due to the high potential for large numbers of fatal overdoses in short periods of time." https://www.dea.gov/documents/2018/05/01/2018-fentanyl-remains-most-significant-synthetic-opioid-threat-us.
The Department of Health provides some sobering statistics related to fentanyl. Between 2016 and 2017 the number of Maryland fentanyl related deaths increased from 1119 to 1594, and “[s]eventy-eight percent of heroin-related deaths in 2017 occurred in combination with fentanyl”
In 2017 the legislature reacted to the swift rise in fentanyl use, and related deaths, enacting section 5-608.1 of the Criminal Law Article. Under this provision, any person who distributes, or possesses with the intent to distribute “a mixture that contains heroin and a detectable amount of fentanyl or any analogue of fentanyl, or fentanyl or any analogue of fentanyl” is subject to an enhanced penalty of up to 10 years, which must run concurrently with any penalty imposed for the on the distribution charge.