Is Fentanyl a Weapon of Mass Destruction?

This article, in a slightly edited form, first appeared on Pain News Network on April 27, 2019.

Usually, we think of bombs, missiles, rockets, and dangerous chemicals as weapons of mass destruction (WMD). However, Task & Purpose reported on April 15, 2019 that James F. McDonnell, who heads the Department of Homeland Security’s (DHS’s) WMD division, wants to classify fentanyl as a potential WMD. He proposed this in a February memo to then-DHS Secretary Kirstjen Nielsen.

The drug’s “high toxicity and increasing availability” make it “attractive to threat actors seeking nonconventional materials for a chemical weapons attack,” according to McDonnell. It is not clear that he is correct. In any case, he neglected to mention that fentanyl has a legitimate medical use, too.

What Is a Weapon of Mass Destruction?

According to Title 18 U.S.C. §2332a, weapons that can kill or severely injure “through the release, dissemination, or impact of toxic or poisonous chemicals, or their precursors” fall into the category of weapons of mass destruction.

WMDs are meant to kill the maximum number of people in the shortest amount of time. On the other hand, fentanyl — even when it is laced with heroin — is not intended to kill people. Drug cartels want to make money. Their goal isn’t to murder their customers.

McDonnell thinks fentanyl fits the definition. However there isn’t much evidence for classifying fentanyl as a WMD, but McDonnell’s suggestions could still find support for reasons that have more to do with politics than science.

History of Fentanyl

Fentanyl is a powerful synthetic opioid typically prescribed to patients in acute pain or during surgeries. According to data from the National Center for Health Statistics, 48 million surgical inpatient procedures were performed in the United States in 2009. Most of those procedures involved administering fentanyl intravenously as an analgesic.

Fentanyl was first developed in 1960 by Belgian chemist Dr. Paul Janssen. The patent for fentanyl was obtained under his company name, Janssen Pharmaceutica.

It was first approved by the Food and Drug Administration (FDA) in 1968 and introduced to the marketplace as an analog for Demerol with plans that it would be used only for palliative care.

In 1978, I coauthored with my professor mentor, Dr. T.H. Stanley, a manuscript titled Anesthetic Requirements and Cardiovascular Effects of Fentanyl – Oxygen and Fentanyl – Diazepam – Oxygen in Man: Anesthesia Analog that described the use of high dose fentanyl for cardiac anesthesia.

The anesthetic technique we described allowed patients to undergo coronary artery bypass and valve replacement more safely and with greater success because of fentanyl’s unique pharmacologic properties. The technique was considered a seminal event in anesthesia for cardiac surgery.

Since the publication of that paper, millions of people have successfully undergone heart operations. The advance of using fentanyl in anesthesia may have helped some of those patients survive their heart operations.

It wasn’t until the late 1980s that testing was done for delivering fentanyl through a transdermal patch for the treatment of cancer-related pain and noncancer chronic pain. Later, transmucosal delivery of fentanyl was made available for cancer breakthrough pain. Each of these new uses of fentanyl exposed millions of Americans to the drug without evidence of an inordinate degree of harm if it was used as directed.

In contrast, nonpharmaceutical fentanyl has caused enormous harm. But as use of the drug proliferates so, too, do myths about its real dangers. McDonnell’s memo fits into an overarching narrative that bestows almost magical properties on fentanyl.

What’s Behind the Fentanyl Panic?

In New York Magazine, Sarah Jones writes about a Bloomberg News story describing the possibility that fentanyl could be used as a WMD. The article claims the opioid “is so potent that even a small amount — the equivalent of a few grains of salt — can be lethal.” However, the title of Jones’s article is “No, Fentanyl Isn’t a Weapon of Mass Destruction.”

The opioid crisis is real, and the use of illicit fentanyl is often lethal. But mischaracterizing the effects of fentanyl may be only a political maneuver.

As Jones points out, the DHS’s WMD division has experienced a decline in funding because of the Trump administration’s focus on immigration and building a wall at the border. One way to reclaim some of that money for the WMD division is to build a case against fentanyl.

Other drugs, such as ricin, pose greater risks because they’re more easily attainable and are probably more lethal than fentanyl. However, the word “fentanyl” packs a far larger emotional punch than “ricin” does because of the public’s familiarity with it.

The Pentagon realized the harm that an opioid attack could cause when the Russian military used aerosolized carfentanil against terrorists who had taken over a theatre in Moscow in 2002. The drug killed dozens of hostages and their captors, and it put the U.S. on notice that opioids could be weaponized. But carfentanil wasn’t fentanyl.

Protecting Access to Legitimate Fentanyl

The opioid crisis is largely driven by the illicit use of nonpharmaceutical fentanyl and fentanyl analogs, not prescription fentanyl. Solving the opioid problem will require making greater efforts to reduce the illegal production and distribution of the counterfeit fentanyl.

Could fentanyl be weaponized and used to attack citizens? Maybe, but not easily.

However, before we classify the chemical fentanyl as a WMD, we need to know what that would mean for its legitimate use during surgery, or for cancer and chronic pain patients. Access to the medication for the treatment of pain must be part of the calculus in assessing if a relatively safe and effective drug should be classified as a WMD.




  1. Suffering in the USA on April 28, 2019 at 11:59 pm

    2019 – Pain patient advocate groups need to align and unite. On May 22, 2019 Don’t Punish Pain Rallies will be held in cities across the United States. I encourage all people to attend a rally nearest to them or host one in your community to be seen and heard as one voice united for your right to humane treatment. Spread the word. Check at the for city list. This is a grassroots volunteer effort. Remember, there’s strength in numbers. Together, let’s tell the government what we need!

    • Sherene on May 10, 2019 at 12:12 am

      Do you have a list of cities where the rallies are?

    • Larry W on May 12, 2019 at 8:14 pm

      I am going to be in OKC at the capitol building hope to see any of you Oklahoma Americans there. I have fears we may never be heard. The country is just too corrupt speaking first of the national media and the leftists. I have tried many times to get attention from the city newspapers on the pain epidemic to no avail. If you try and send a letter to the editor it is never published whether you are mentioning the pain epidemic or politics. If your opinion of politics differs from the norm of mainstream media it just never is heard. This rally needs media attention the whole country and the academic-public schools, media and fluoride addled minds general public just cannot reason logic or understanding. Instead they sit in front of their boob tubes being spoon fed lies by corrupt talking heads. It is a very sad day in America, prayers that the rally may get deserved attention.

  2. Larry Wilson on April 29, 2019 at 2:16 am

    Very good information doctor. I had never heard of “carfetanil” I didnt read that article yet but somehow it must be somehow chemically akin to fetanyl. Our country as beloved as it is to myself I am daily disgusted by politics and the media. Moreso with the media definitely. I cannot place any blame on President Trump for the way things have been blown so out of proportion about the opioid crisis because I believe he is doing what he honestly believes is best for the country. The media however they don’t really care. They just run with whatever fits their agenda. I wrote Trump a letter a year ago and you know he referred me to Dr. Vanilla Singh and she wrote me and it seemed personal .All it consisted of was news about new programs and new task force etc. None of them which helps me in my locale and I do need the help of SAMHSA asap since my supposed to have been chronic pain doctor gave me the boot on the 18th. I have A 30 day supply of pain pills left If I take as directed but of course trying to stretch the supply as much as possible. No help from SAMHSA and really no affordable pain doctor. I did not mean to get off subject there.
    IF opioids can be weaponized you can bet they will. Heck they weaponized fluoride in my opinion that may sound as I am talking conspiracy but why take something that is a by product of aluminum and put it in our water? WHY in God’s name spray heavy metals in the atmosphere? Think about it, it certainly is not for climate change… I better sign off with that before I turn what was meant to be a short thanks to you Dr. Webster for sharing the information with us. Your post is certainly something that brings a lot to mind about just where our world is headed. Does anyone know what happened at the drug summit last week? I started to look into it. I grow weary with trying to keep up with today’s world and had to put it aside. Thanks Dr.,best regards. Larry

Leave a Comment