Fentanyl is a synthetic opioid analgesic used to treat patients with severe pain. The drug is often used to mitigate discomfort after surgery or to treat cancer patients. Popular brand names for fentanyl include Sublimaze, Actiq and Duragesic.
It is the most potent opioid available for medical treatment and the most widely used for clinical practice. In 2013, more than 6.75 million prescriptions were dispensed in the United States, according to the Drug Enforcement Administration. In 2014, the number slightly dipped, though it remains a staple in hospital settings.
Fentanyl provides welcome relief to those suffering from chronic pain. It is most commonly administered via transdermal patch, lozenge, pill or intravenously. Cancer patients are often given Actiq, a lollipop version of fentanyl, to fight pain.
However, a rising number of people use the drug recreationally, giving way to addiction and death.
Like other opioids, Fentanyl affects the brain. The drug increases levels of dopamine, the neurotransmitter associated with pleasure and reward. This produces intense euphoric and relaxation effects, similar to heroin.
“Very small amounts of fentanyl can be fatal and could be readily absorbed through the skin.”
Fentanyl is fast-acting and habit-forming. A single dose of fentanyl yields extreme drowsiness, slowed heartbeat and irregular breathing. It is 25–50 times more toxic than heroin and 100 times more toxic than morphine.
Because of fentanyl’s chemical properties, law enforcement officials don hazmat suits when seizing the drug. Absorbing a pinch of fentanyl through the skin or eyes is enough to end lives.
In 1959, Dr. Paul Janssen first produced Fentanyl to relieve pain in patients. It was used in hospitals, where physicians administered the analgesic to individuals fighting chronic pain.
Fentanyl abuse began in the mid-1970s in an unlikely group. Hospital workers, anesthesiologists and nurses would draw out fentanyl from vials and replace it with saline. Consequentially, increasing numbers of healthcare professionals would overdose on the drug.
More recently, Chinese clandestine labs and Mexican cartels got ahold of the recipe and made synthetic versions of the drug to sell internationally. Over time, the popularity of the drug gradually increased, and it spread to individuals of all ages and socioeconomic backgrounds.
Fentanyl can be found anywhere from suburban homes to back alleys. It sometimes enters the United States through Mexico, but it can also be purchased on the internet and shipped directly to the buyer’s home. The Drug Enforcement Administration has said that illegal labs in China are the primary suppliers of fentanyl for dealers in the United States.
Law enforcement officials are unsure how much fentanyl is in the United States, but it appears to be the “it” drug on the black market. Mass amounts are found all over the country, and Americans are buying fentanyl in record numbers.
It is a valuable drug. Hydrocodone sells for about $30 per pill on the black market. A kilogram of fentanyl power goes for upwards of $3,300, which is then sold for millions, per the DEA.
Fentanyl is sold on the streets in powder form under the guise of hydrocodone or heroin, and individuals unknowingly consume the drug. Many users mix the drug with other prescription medicines to increase its effects, which has led to alarming overdose and death rates.
Since 2005, Fentanyl has killed hundreds of people in the United States. It has contributed to the growing opioid epidemic in North America.
“Most heroin addicts know how much their body can tolerate. Then someone cuts the heroin with fentanyl, and that person is probably going to die because they don’t know what they’re getting.”
According to the Centers for Disease and Control and Prevention, the drug claimed more than 1,000 lives from April 2005 to March 2007. Most of these deaths happened in Delaware, Illinois, Maryland, Michigan, Missouri, New Jersey and Pennsylvania.
Fentanyl abuse in recent years has been problematic:
Fentanyl has also had a profound effect on Canada. The number of Albertans succumbing to the drug has trended upward since 2011:
In 2015, Calgary saw drastic increases in theft, home invasions and bank robberies. Police say fentanyl abuse has contributed to this problem, according to the Calgary Herald.
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Fentanyl can be found in the body for about three days after last use. But research has indicated that norfentanyl, a metabolite of the drug, can remain for longer periods of time. Tests for fentanyl can use urine, blood or hair samples. Saliva tests are not reliable for detecting the drug.
A report published in the journal Anesthesia and Analgesia indicated that small doses of fentanyl were detectable in urine 24 hours after use. However, the opioid was not found in the system three days after ingestion. Norfentanyl was detectable in some patients four days after last use.
Fentanyl from a transdermal patch can be detected in blood plasma for more than 24 hours after use, according to test results from NMS Labs. The blood test targeted fentanyl and its metabolite norfentanyl.
Certain toxicology tests can detect fentanyl in hair follicles for up to 90 days after last use. A hair sample measuring 1.5 inches from the bottom of the root is required to confirm that fentanyl was used in this time frame. On average, it takes five to 10 days after fentanyl use for hair containing the drug to grow from the scalp.
Fentanyl can be helpful for patients battling severe pain. However, side effects are possible even when administered properly.
“Fentanyl and it’s analogues are the most powerful opioids available today. It produces similar effects to heroin and morphine but will cause a more intense quicker high, which leads to quicker respiratory failure,” Steve Collins, director of the Central Florida High Intensity Drug Trafficking Area, said at the 2018 Southeastern Drug Prevention Summit.
The most common symptoms include:
Less common and more moderate effects include:
Small amounts of fentanyl can lead to overdose. These symptoms include:
A single dose of fentanyl can be fatal. Within minutes, users may experience slowed breathing and lose consciousness. If untreated, this can lead to death.
“A minute amount will kill you. It is being mixed with heroin, Flakka and other drugs, and no one knows what they are taking. It’s scary.”
The onset of addiction is common among illicit users of fentanyl. These individuals exhibit volatile behavior, sometimes spending large amounts of money or committing crimes to feed their addiction. Those experiencing addiction must seek immediate treatment.
Fentanyl is physical and psychologically addictive. If used illicitly or for longer than prescribed, an addiction can form. Individuals may experience withdrawal symptoms that only a trained medical professional can alleviate.
Common withdrawal symptoms include:
Individuals with addictions often detox alone. This is dangerous and should not be considered, especially with a drug as powerful as fentanyl. Professional treatment is an effective option with proven results.
Fentanyl addiction detox is similar to other opioid treatment methods because all opioids affect the same parts of the brain that cause opioid use disorders.
Treatment requires 24/7 monitoring throughout the detoxification period to reduce withdrawal symptoms. Acute withdrawal generally lasts three to five days. Drugs such as naloxone, buprenorphine and methadone may be used to combat the effects of the drugs.
Fentanyl is a dangerous drug with fatal consequences. Luckily, treatment is available. Those with an opioid addiction should immediately contact an addiction rehabilitation facility for support.
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