Fentanyl, a powerful synthetic-opioid painkiller, is at the center of the deadliest drug epidemic in American history. More people around the country have died of synthetic-opioid overdoses than the number of U.S. military personnel killed during the Vietnam, Iraq and Afghanistan wars combined. Fentanyl is now the leading cause of death for Americans ages 18 to 49, according to a Washington Post analysis of death data for 2021 from the Centers for Disease Control and Prevention. Fatal overdoses involving fentanyl among children ages 10 to 19 increased by 182% from 2019 to 2021.

To combat the growing number of fentanyl overdose deaths in Texas, Gov. Greg Abbott has announced a $10 million fentanyl awareness campaign and plan to distribute doses of Narcan to every county in the state. Narcan is a life-saving medication that can reverse the effects of opioid overdose and save lives. It is available in all 50 states and can be purchased from a local pharmacy without a prescription in most states.

Abbott said the state’s “One Pill Kills” multimedia campaign is designed to warn Texans about the use of fentanyl.

Fentanyl is 100 times more powerful than morphine and 50 times more powerful than heroin. The drug has become readily available on the illicit market. As little as 2 milligrams, about the size of five grains of salt, can be deadly depending on a person’s body size and tolerance. Overdose deaths involving fentanyl in Texas rose nearly 400%, from 333 people dying in fiscal year 2019 to 1,662 dying in fiscal year 2021.

Because the synthetic opioid is often mixed with other drugs, there’s been a rise in deaths known as polysubstance overdoses. The most recent state data shows those deaths reaching a rate of four per 100,000 people in 2019.

Recognizing the signs of opioid overdose can save a life. Here are some things to look for:

• Small, constricted “pinpoint pupils”
• Falling asleep or losing consciousness
• Slow, weak or no breathing
• Choking or gurgling sounds
• Limp body
• Cold and/or clammy skin
• Discolored skin (especially in lips and nails)