Fentanyl: Powerful, Addictive, Deadly

Source: WebMD.com

All you need to know about the dangers of fentanyl.

In recent years, news reports on drug overdoses have centered on fentanyl. Whether it’s used alone or combined with other drugs, the results can be deadly.  We know that fentanyl is dangerous, but what is it exactly?

Belgian physician Dr. Paul Janssen (founder of Janssen Pharmaceutica) led a team of doctors who developed fentanyl in 1959, along with a number of other anesthesia drugs. Throughout the 1960s, the drug was widely used as a general anesthetic.  It wasn’t until the 1990s when Janssen Pharmaceutica developed and tested fentanyl for severe pain management.  Originally formulated as a transdermal patch, further variations included flavoured lollipops or lozenges, dissolvable film that is applied to the inner lining of the cheek and also a nasal spray.  The transdermal method of delivery goes directly to the bloodstream through the skin or mucous membranes.  Even used patches contain enough residual fentanyl to cause harm to an unintended user.

When used as a painkiller, fentanyl is much like morphine, except 50 to 100 times stronger. Fentanyl is prescribed to treat people experiencing severe chronic pain, or to manage pain following surgery; it is also used in cases where patients need pain management and are physically tolerant to other opioids.  Fentanyl is described as an “opioid analgesic”; however, by definition analgesic is a medication that relieves pain without the loss of consciousness.  This is a pretty tame description considering that even small amounts of fentanyl can cause respiratory distress, slowed breathing and/or heartbeat, and unconsciousness.

Actiq, Duragesic and Sublimaze are among the various prescription names for fentanyl. On the street, fentanyl or heroin mixed with fentanyl carries one of these monikers: Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash.

Like other opioids, the high experiences from taking fentanyl are euphoria and relaxation. The reason why opioids, and especially fentanyl, are so dangerous is because the brain’s opioid receptors – areas of the brain that control pain and emotions – are very close to the parts of the brain that control breathing rate.  Therefore, high doses of this already potent drug can cause breathing to stop altogether, inevitably leading to death.  The quick and deadly effect of fentanyl is amplified when drug users are unaware that their product contains fentanyl, prompting campaigns in major cities advising drug users not to get high alone.

A fact sheet on the RCMP’s website mentions a recent United Nations report indicating that Canada consumes the most prescription opioids per capita than any other country in the world. Many drug addicts were introduced to opioids following a legitimate prescription course.  Prior to the rise of fentanyl, oxycodone was the opioid of choice; however, its formula was changed in 2012 making it less addictive.  Any oxycodone being sold on the street today is actually fentanyl made to look like the old form tablets.

Due to the high rate of fentanyl deaths, Health Canada has deregulated injectable drug Naloxone, which can reverse the effects of an overdose. Naloxone kits have already become part of the protocol for ambulances in Western Canada and hopefully this will become the status quo for the rest of the country.

Despite increased public awareness about protecting legitimate opioid prescriptions from being misused and educating the public on the dangers of street drugs of unknown origin, the fentanyl crisis is not under control. Fentanyl in its original form is already extremely potent and now police are discovering substitutes called carfentanil and W-18 – both of which are 100 times stronger than the original.

Sources: National Institute on Drug Abuse; mayoclinic.org

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