In the time of the Covid-19 pandemic, it’s very easy to forget about so many other epidemics that are needlessly taking so many lives, one being the persistent opioid epidemic in the United States.

A “how-to” guide has begun to circle across San Francisco, targeting users of the potent opioid fentanyl, a drug that has killed more people in the city in 2020 than Covid-19, with 700 people dying from a Fentanyl overdose compared to 235 Covid-19 deaths.

Firstly, what is Fentanyl?

Fentanyl is a very powerful and potent synthetic opioid that can be used as a prescription drug for pain treatment, or as which is more common, illegally to get high.

The drug, which can be up 100 times more potent than morphine, is typically administered in hospitals to reduce pain after surgery and then prescribed thereon after if the pain continues.

Fentanyl is also used to treat patients who suffer from chronic pain issues; however, these patients already need to have built a strong tolerance to other opioids.

Fentanyl is commonly prescribed and taken as either a shot injected into the patient or as a patch that releases the drug slowly.

However, the usage of Fentanyl on the streets is far greater.

Synthetic Fentanyl which has caused so many deaths in the last decade is usually made in a lab and is commonly sold as a powder or a pill.

Illegal users will take this drug combined with others, causing a massive overdose death toll.

In 2017, 59% of the opioid-related deaths in the United States involved the usage of Fentanyl, compared to just 14% in 2010.

In 2019, 441 people died from a Fentanyl overdose in San Francisco, an increase of just over 70% from the year before.

What about this guide?

The guide, titled “Smoking Fentanyl”, has been spreading across the city like wildfire, having been reached by many active users of the killer drug.

The guide shows how to smoke the drug “safely”, in a step-by-step worksheet akin to constructing a piece of furniture.


The first page details quickly what you will need to smoke the drug, which includes a picture guide on how to set everything up.

The page also compares “common practices” when using the aluminum foil advised before going onto page two, where it describes in detail how to effectively smoke the drug.

The official author of the guide is unknown and isn’t listed on the guides that have been distributed throughout the city.

However, rumors circling online are claiming that guide was drafted and published by The San Francisco Drug Users’ Union.

The Union describes itself as a “non-profit organization that offers harm-reduction based services to people who take drugs”, which would make for a very big scandal if it were proved they were teaching Fentanyl users how to take the drug “correctly”.