What Is The “Fentanyl Fold”?
by Jessica Sherer B.A., Ashford University –
The “fenty fold” (also “fenty lean” or “fentanyl fold”) is a startling but common occurrence among regular users of fentanyl, and other illicit drugs like xylazine, where they are bent at the waist, slumped forward, in a rigid position. Their heads are bowed, their knees are bent, and they are often unable to respond or move.
While jarring to witness, the fenty fold has become a sad yet common phenomenon in cities like San Francisco and Baltimore, where fentanyl use has grown rampant alongside the growing nationwide trend. Chronic users of fentanyl can be stuck in this position for minutes to hours, with possible complications including decreased breath rate, poor circulation, and increased risk of falls and injuries.
Research has not yet pinpointed what exactly causes the fenty fold, as fentanyl use is not known to directly affect the spine. Instead, it’s becoming clear that it is a neuromuscular side effect of synthetic opioids like fentanyl. Studies from the Journal of Applied Physiology and the Harm Reduction Journal highlighted similar findings that fentanyl use can lead to severe and widespread muscle rigidity, particularly in the trunk muscles, which restricts respiration and affects posture and mobility.
Additionally, doctors and addiction professionals think the fold is also connected to the central nervous depression caused by opioids. After using fentanyl (usually in large amounts), people enter a state of slowed consciousness (nodding out), where their bodies and brains are functioning at a depressed level. This system depression leads to muscle weakness, which causes bending, and slowed thought processing, which inhibits the brain from instructing the body to stand upright, resulting in prolonged time spent in an unnatural position.
While more research is needed on the causes of fentanyl fold, it is clear that it is an uncomfortable and potentially dangerous side-effect of fentanyl use.
Pain: A Common Path To Fentanyl Addiction
In the 2024 exposé on the fentanyl fold, the San Francisco Chronicle highlighted that many of the fentanyl users they interviewed were first introduced to the pain-numbing effects of opioids through prescription opioids. These people were prescribed opioids like oxycodone and hydrocodone for legitimate pain and turned to fentanyl when they could no longer obtain their prescriptions.
This is the story of many fentanyl users who become dependent on and develop a tolerance to opioids without realizing it until they are unable to get them. As they continue to seek a solution for their pain, fentanyl often fills the gap as a cheaper, easier-to-obtain alternative, leading to a cycle of addiction that supersedes most everything else in their life.
Social Media’s Take On The “Fenty Fold”
In 2024, videos started circulating on social media sites like X and TikTok of people experiencing the fold, often on urban streets, with tags of #fentyfold and #fentylean used. This exposure garnered both disdain and empathy as the real-life effects of fentanyl abuse were put on display.
Some videos of the fenty fold, often stripped of context, were met with ridicule and disdain for the people featured in the videos. However, public health officials and substance abuse professionals warn of the dehumanizing effects of social media and urge the general public to acknowledge it for what it is: a sobering reminder of the dangerous and debilitating effects of opioid addiction.
They further emphasize the need for harm reduction strategies and addiction treatment to help the growing problem of fentanyl abuse.
Seek Help For Fentanyl Addiction
While more nationwide prevention efforts and reduction strategies are needed to combat the opioid epidemic, prevention can also start in the home. If you or a loved one is struggling with a fentanyl addiction, help is available. Inpatient treatment can provide you with a safe environment where you can detox and learn the tools necessary for a healthy recovery. Contact a treatment provider today to learn more and begin your healing journey.