The synthetic opioid drug fentanyl is used primarily for patients with terminal cancer or those suffering from severe chronic pain. The drug Fentanyl tops the list of the most powerful painkillers on the market. It is a 100 times more powerful than morphine and cheaper to manufacture than heroin. As a result, the illicit use of fentanyl fuels the stark increase in accidental and fatal overdoses across the country.
It was introduced into medical practice as an intravenous anesthetic under the trade name of Sublimaze in the 1960s. In 2014 there were 6.5 million fentanyl prescriptions dispensed in the U.S.
“A sprinkle of 2 milligrams – the weight of about six grains of salt,” writes the Wall Street Journal, “can be lethal and kill so quickly that first responders frequently find victims with needles still stuck in their arms.”
Fentanyl Drug Abuse – Addiction & Death
The opioid crisis in the United States has the government and healthcare professionals scrambling to find a solution. The Centers for Disease Control and Prevention (CDC) reports that nearly 19,000 people died in 2014 compared to less than 3,000 in 2013 as a result of prescription painkillers and heroin. Among this demographic, fentanyl related deaths rose by 79 percent.
Much of the illegal fentanyl on the streets comes from underground laboratories in China. It’s then sold to cartels in Mexico who move the drugs into the states. Because it’s so potent, dealers on the end of chain often cut other narcotics, such as heroin and cocaine, with fentanyl and sell it to unwitting customers. “That’s really the madness of it,” Dr. Gary Thrasher, a medical director at an Ohio detox facility, tells the WSJ. “[Some users] don’t know what they’re taking.”
Fentanyl is abused for its intense euphoric effects. Fentanyl can serve as a direct substitute for heroin in opioid dependent individuals. Fentanyl is a very dangerous substitute for heroin because it is much more potent than heroin and results in frequent overdoses that can lead to respiratory depression and death. Fentanyl patches are abused by removing the gel contents from the patches and then injecting or ingesting these contents. Patches have also been frozen, cut into pieces and placed under the tongue or in the cheek cavity for drug absorption through the mouth.
Fentanyl pharmaceutical products are currently available in the dosage forms of oral transmucosal lozenges, commonly referred to as “lollipops”.
Fentanyl is diverted via pharmacy theft, fraudulent prescriptions, and illicit distribution by patients and registrants. Theft has also been identified at nursing homes and other long-term care facilities.
Fentanyl Side Effects
The side effects from taking fentanyl, especially when abused, pose a serious and sometimes deadly risk. According to the Mayo Clinic, these might include the following:
- Respiratory depression or Hypoventilation – abnormally slow breathing, which result in a dangerous increase of carbon dioxide in the blood
- Nausea, vomiting and excessive sweating
- Irregular heartbeat, chest pains and light-headedness
- Convulsions, blurred vision, dizziness and coughs
- Mood changes, nervousness and thinking abnormalities
- Decreased awareness and responsiveness
- Difficulties with walking and balance
Fentanyl Withdrawal Symptoms
Physicians will occasionally prescribe fentanyl to patients with chronic pain who’ve developed a massive tolerance to other opioid painkillers, such as Oxycontin or hydrocodone. As with other Schedule II drugs, the chemical properties of fentanyl can quickly lead to full blown addiction. Healthcare professionals do not suggest that people battling addiction to fentanyl stop taking the drug “cold turkey” because the withdrawal symptoms are potentially fatal if not treated immediately.
Fentanyl withdrawal symptoms can include the following:
- Excessive vomiting, nausea, diarrhea, stomach cramps
- Rapid heartbeat and breathing
- Weakness and lethargy
- Anxiety, depression and irritability
- Restlessness, excessive yawning and insomnia
- Severe stomach cramps, muscle, joint and back pain
- Watery eyes and runny nose
- Extreme sweating and chills
Fentanyl Citrate contains fentanyl, a strong pain medication similar to hydromorphone , methadone, morphine, oxycodone, and oxymorphone.
Fentanyl Citrate is an oral lozenge prescribed as the licensed pharmaceutical product ACTIQ®. It is a prescription medicine that contains the medicine fentanyl. It comes in 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg and 1600 mcg doses. Fentanyl Citrate is generally used to manage breakthrough pain in adults with cancer who are already routinely taking opioid pain medicines for cancer pain. It is a lozenge that is attached to a “stick” that you place between your cheek and lower gum and suck on to dissolve, thus the term “lollipop”.
Illicit fentanyl has made its way across the country. Law enforcement officials say that on the east coast and in the Midwest, it often shows up in powder form and mixed with heroin. On the west coast, it’s typically in pill form. “They look like what you’re getting from a pharmacy,” Orange County forensic scientist, Terry Baisz told CNN. “I was shocked the first time I tested this stuff and it came back fentanyl.”
The counterfeit opioid pills appear as if a pharmaceutical company, sometimes even labeled as Xanax or other drugs, makes them. As a result, some users might have a false sense of security, a belief that the pills were manufactured in a measured and controlled setting. This leads to clusters of overdoses and deaths, a pattern that’s become all too familiar across the United States. In Sacramento County, more than 50 people overdosed on fentanyl pills in the first three months of 2016, and in one 12-day stretch, 10 people died.
As officials attempt to slow the influx of fentanyl into America’s neighborhoods, advocacy groups pressure state and local governments to improve harm reduction efforts. This is includes making Naloxone, an opioid overdose reversal agent, more available to first responders and the general public.
The Food and Drug Administration recently approved the medication in a nasal spray form, and a few states have even gone so far as to make it available as an over-the-counter drug.
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