We analyze 25 accidental childhood fentanyl exposures reported to FDA, 2004–2013. These exposures had a case-fatality rate = 48%; male:female ratio = 7.3; 76% were within the 2–4 age range. The ability of fentanyl to kill children so quickly is explained by fentanyl’s ability to suppress respiration—as quantified by the antinociceptive potency per milligram, fentanyl far and away leads all narcotics. FDA recommends for fentanyl disposal: flush all forms of fentanyl down the toilet.
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