Fentanyl, one of the strongest opiods and narcotic analgesics in the market today, is indicated for the management of chronic pain mostly prescribed for cancer patients or in treating patients after a major surgery. It is commonly known under the brand names Durogesic, Duragesic, Sublimaze, Abstral, Haldid and Lazanda, among others.
This substance is said to be 50 times more potent than heroin and 100 times more potent than morphine. It is usually used in combination with Demerol or morphine. Any misuse or abuse of this drug can lead to addiction that may eventually lead to death.
It was in the 1970’s when Fentanyl has begun circulating for non-therapeutic purposes. Its biological effect was said to be similar as that of heroin, which is why sometimes street heroin is mixed with fentanyl or sold as fentanyl itself because of its euphoric effect.
There are several known fentanyl analogue, such as the following:
The prescription or administration of fentanyl should only be done by a health care professional who has full knowledge in using such potent opiod to manage chronic pain.
Different Forms of Fentanyl
Fentanyl Transdermal Patches
Known through the brand name Duragesic, this form of fentanyl is absorbed through the skin into the bloodstream. Its effect can last up to 72 hours, which is very favorable in managing chronic pain. This is only prescribed to patients who are opiod-tolerant or those patients who are have been taking at least 60 mg of morphine in a day.
Under the brand name Sublimaze, this is most commonly used as anesthesia accompanied with another substance like propolol for epidural or spinal administration. In combination with sedatives like benzodiazepine, it is used for medical procedures like surgery and endoscopy.
Used patches should be discarded properly because the gel of these patches can be swallowed or injected, which may cause some serious side effects on the person.
This form, popular as Actiq, may pose danger when children accidentally ingest them. This should not be prescribed along with other narcotic medicines because it may lead to difficulty in breathing, which could be fatal. Although fentanyl is an analgesic, it is not recommended for short- term pain such as migraine or dental pain. Fentanyl lozenges should be taken with a 4-hour interval.
This form should be used with utmost care. It is not advised to convert or substitute it with other products that may contain fentanyl. The prescribed dosage may be different on each patient.
Like most prescribed drugs, there are certain side effects that the patient may feel after administration or ingestion of fentanyl. These are:
- Dry mouth
- Abdominal pain
- Muscle spasms
- Slow heart rate
- Cold, clammy skin
Dangers of fentanyl abuse
Drinking alcohol is prohibited while taking Fentanyl because it increases the risk of feeling sleepy or dizzy. The drug is not advisable over a long period of time because of it being highly addictive. However, there are individuals who have illicitly used this medicine.
Its efficacy in treating pain has been proven to be very high. However, there had been reports of abuse in the usage of the said drug. Fentanyl is highly addictive. Meanwhile, the slight difference between the prescribed medical dosage and dead dose can be very slim.
Fentanyl is sometimes sold combined with low-quality heroin to increase the heroin value. The combination of these substances can be more than a hundred times more potent than street heroin. Drug users take Fentanyl orally, injected, snorted or smoked. This causes severe respiratory depression, wherein there is inadequate ventilation to perform gas exchange. This is a very common side effect among those who use recreational drugs.
Since Fentanyl can only be purchased through prescription, the black market has found its way to sell and distribute fentanyl transdermal patches from which the gel inside the patches can be injected or ingested. This poses danger to children when these patches are not properly disposed. According to some reports, children who have been exposed to these transdermal patches have died due to ingestion.
Actiq Fentanyl lollipop, sold as Oral Transmucosal Fentanyl Citrate (OTFC) and listed as a Schedule II Controlled Substance under the Federal Controlled Substances Act, is a sugar-coated fentanyl on a stick. This is absorbed through the buccal mucosa (inner cheek), where it is slowly dissolved in the mouth. Actiq lollipop contains 2 grams of sugar in raspberry flavor and is available in 6 different strengths. The strongest is 1600 mcg, which could be the equivalent of absorbing 160 mg of morphine.
Other than the common psychological effects of taking fentanyl is the increase of dental caries on long-time users of this drug. This may be due to the sugar that goes with the fentanyl lozenges since it does not dissolve quickly and sugar sticks into their teeth for a long time.
Individuals using Fentanyl can also quickly create tolerance to this substance. The usage of an individual may increase week after week until it comes to a point of endangering his own life.
There is an increase in the number of overdose cases with fentanyl-laced heroin. According to the Drug Enforcement Administration (DEA), “drug incidents and overdoses related to fentanyl are occurring at an alarming rate throughout the United States and represent a significant threat to public health and safety”. Chicago, Philadelphia and Detroit have been reported to have multiple cases of deaths due to fentanyl overdose. They have traced the source of the lab to be in Mexico.
Fentanyl users have common reasons why they resort to substance abuse when they are asked. They want to either get away from their problems, or have the sense of belongingness and have fun. What comes with this addiction is losing integrity and credibility. With that, drug addiction in general has been linked to so many crimes that even family members are not spared.
Unless we take a step in helping these individuals, more people will succumb to drug abuse, which can lead to the total destruction of the community.