When there is severe pain, one of the remedies given by medical practitioners are opioids, which include fentanyl.
What is Fentanyl?
This synthetic opioid is often used to treat excruciating pain caused by cancer or after surgery.
Based on studies, fentanyl is a lot more potent compared to morphine. In fact, its effect is said to be 50 or 100 times higher than the latter.
Prescription fentanyl is known with the brand names Sublimaze, Actiq, and Duragesic.
Apart from being a popular opioid in the medical field, it is also being sold on the streets. It is made available in the illegal markets with the names of China White, China Girl, Apache, Tango & Cash, Dance Fever, Goodfellas, Friend, He-Man, Murder 8, King Ivory and Jackpot.
With its highly potent properties, reports of its misuse and overdose have been observed. Accordingly, this is among the substances used in drug addiction, especially in the United States.
It was developed and produced in 1959. In the 1960s, it already reached the market.
How is Fentanyl Used?
To administer this type of medicine, doctors provide it in the form of lozenges, transdermal patches or shots.
Meanwhile, it is in the form of powder when offered on the streets. And this powder can be placed in nasal sprays and eye droppers. There are also cases wherein fentanyl powder is put on a blotter paper or sold in pill form to make it look like a legit opioid drug.
Its popularity as an abused substance could have emanated from the effect it gives, which is likened to heroin’s. In addition, it is combined with other drugs to make it even stronger and increase its euphoric effect. Usually, it is mixed with cocaine and heroin by illegal laboratories.
How does Fentanyl Work?
Just like other opioids, fentanyl works by boosting certain chemicals in one’s brain. By doing so, the brain blocks the pain, thus, the patient feels calm and experiences pleasure.
The drug’s chemical structure makes it capable of acting rapidly on the patient’s brain and body. With just a small amount, it can already create the expected impact.
How Does Someone Become Addicted to Fentanyl?
Drug addiction can happen if someone becomes used to taking it and develops resistance to it. Thus, there is a tendency for him to take beyond the recommended dose to experience the same effect.
When this happens, the person starts to increase his doses and is at risk of getting overdosed.
What is Fentanyl Overdose?
Back in 2016, fentanyl was reported to be involved in the death of renowned musician Prince. Reports suggested that the then 57-year-old “Purple Rain” singer overdosed accidentally.
Fentanyl overdose takes place when the patient takes more than the prescribed dose. It must be put in mind always that this is a highly potent opioid. Therefore, the risk of being overdosed is too high as well.
Symptoms of Fentanyl Overdose
When a patient has been known to have been taking this drug, it would be better to supervise the administration. This is advised especially if he has a history of substance abuse.
As the one takes care of the patient, possible symptoms of fentanyl overdose can be looked into. The doctor, nurse or anyone in-charge of him, must be conscious of these things.
According to the Drug Enforcement Agency, among the fentanyl overdose effects are the following:
- Changes are observed in the pupillary size
- The person becomes near unconscious or gets stupor
- Skin becomes clammy or cold
- Skin gets bluish or discolored due to cyanosis
- Death due to respiratory failure
Also, the government of New South Wales in Australia identified some more. Below are some of the symptoms it has listed:
The person experiences fainting
At times, he could likewise feel confusion
Low oxygen which results in bluish nails, aside from skin
Fentanyl Overdose in Figures
The Centers for Disease Control and Prevention reported that cases of fentanyl overdose have been on the rise in the United States. It was even pointed out that it has been the major cause of opioid overdose-related deaths in the country.
From 2012 to 2015, an increase of 264 percent in the number of cases was recorded. Meanwhile, a leap of 73 percent was noted from 2014 to 2015.
It was further revealed that from 2014 to 2015, Ohio drug submissions that tested positive for fentanyl manufactured illicitly grew. An escalation of 196 percent was observed in the number of reported cases.
The Centers for Disease Control and Disease Control shared that New York City posted an increasing trend in opioid overdose-related deaths.
The available toxicology data showed that from 2000 until 2012, two percent of deaths involving opioid overdose was caused by fentanyl.
The situation got even worse in 2017. The rate of deaths due to fentanyl overdose rose. It reached 57 percent during the said year.
Fentanyl and Pregnancy
Just like other opioids or narcotics, the use of fentanyl during pregnancy may pose risk both to the mother and the fetus. The United States National Library of Medicine listed the following adverse effects:
- Birth defects particularly in the spinal cord, spine, and brain or the so-called neural tube
- Newborns may experience withdrawal symptoms, which could include vomiting, seizures, and diarrhea. This is medically known as neonatal abstinence syndrome
- Miscarriage or stillbirth. The former could happen before the 20th week of pregnancy. The latter, on the other hand, may happen after that period
- The low weight of the baby upon birth
- The baby may be delivered earlier, usually before the 37th week of pregnancy
**What if the Pregnant Patient Needs to Take Fentanyl?
If the patient really needs to take fentanyl during pregnancy, certain precautions must be observed. This is to ensure that the risk it entails is minimized. Furthermore, its risks must be weighed concerning its benefits.
**Treatment for Fentanyl Addiction
Recent advancements in medicine have made it possible to address Fentanyl addiction effectively. In fact, three types of medications have already been given the green light to treat this form of substance abuse. These latest medications have been described as the first line of treatments against the addiction.
These treatments include: 1) agonists (methadone) which are meant to activate opioid receptors; 2) partial agonists (e.g. buprenorphine) which are also designed to activate opioid receptors although it produces a diminished response; and 3) antagonists (e.g. naltrexone) which aim to block opioid receptors by taking away its rewarding effects.
Clinical trials of these medications have shown that they can help Fentanyl dependents abstain from the substance. Moreover, these treatments help reduce the symptoms of opioid abuse, drug use through injection, and HIV transmission. In order to increase the efficacy of these medications, behavioral counseling and psycho-social interventions must also be carried out.
According to a surgeon general report released in 2016, treatment for Fentanyl addiction has been largely inaccessible to the public. To address this concern, there is a need to provide dependents more access to medications such as buprenorphine and methadone. These two are considered the top treatments for substance abuse.
Aside from these medical treatments, patients can also cut down on their prescribed painkiller medication. This can help avoid drug overuse and at the same time, still, give them access to it when needed. Moreover, harm reduction strategies such as needle exchanges and the wider distribution of the drug naloxone can also help.
Meanwhile, the hub-and-spoke system has also been effective in lowering the number of opioid abuse-related deaths. With the expansion of this system, the mortality rate among dependants dropped by six percent in 2017. In Massachusetts, a public health campaign stressed the need for more types of addiction treatments such as those done in emergency rooms.