The effect is immediate. If the dosage is to strong or mixed with fentynl there is “No opportunity to cry for help, you just die,” forensic pathologist Dr. Cyril Wecht stated. “The two of them acting together have a tremendous effect in depressing the brain. The brain gets depressed and that leads to respiratory depression, a slowing of the heart, then cardio-respiratory arrhythmia and depression. The next thing you know, you’re dead.”