[stordoff]

It's more dangerous in street drugs because it is potent at extremely low doses, so poorly mixed drugs can contain fatal doses very easily.

In a controlled setting, where the dose is precisely known, that is not an issue. I did some reading of fentanyl vs. morphine a while ago, and found that fentanyl is often preferred for acute pain due to faster onset, shorter duration (which may make controlling adverse reactions/overdoses easier), fewer side-effects and less histamine release. Specifically:

> When adverse event rates were counted across both the out-of-hospital and ED phases, morphine's and fentanyl's safety levels were extremely close, erasing even the suggestion of a trend toward safety in one drug or the other. Our data do not suggest that further work should be done to try to determine which drug is safer: The low absolute rates and small difference between the two drugs make it unlikely that this difference would become either clinically or statistically significant, even with a larger sample size.

I don't believe the notion that fentanyl is per se more dangerous, rather than being dangerous when misused/poorly handled, is supported.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924527/

[selectodude]

Fentanyl is also far more addictive due to its rapid onset and short duration of effect. Not that they give that stuff to anybody other than cancer patients and those undergoing anesthesia. But in theory it’s more dangerous.