Across the United States, reports continue to emerge of a fentanyl epidemic. The Los Angeles County Department of Public Health recently reported that fentanyl-related deaths have risen 50% since 2013, while nearby Sacramento has experienced a string of 51 overdoses over the past month. Learning about fentanyl and its dangers can help raise awareness of this powerful opioid drug.
What Is Fentanyl?
Fentanyl is the trade name of the drug N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylpropanamide. It also goes by the names Duragesic, Actiq, Lazanda, and Sublimaze, among others. Fentanyl is a synthetic opioid medication, meaning that it is produced in a laboratory. This is in contrast to opioids such as heroin, which are derived from natural sources such as the opium poppy. The ability to manufacture fentanyl in the lab means that it is less costly and labor intensive to make.
What Is Fentanyl Used For?
Fentanyl was first discovered in the 1960s as a potential opioid analgesic. It is prescribed in medical settings as a painkiller, typically for breakthrough pain for individuals who are taking other opioid painkillers that cannot fully manage their pain symptoms. When used for legitimate medical purposes, fentanyl can be an effective painkiller.
Fentanyl is available in several forms of action. For example, intravenous fentanyl is often administered with a hypnotic medication for anesthesia. Intranasal applications and lozenges are also available. Perhaps the most common form of fentanyl is the fentanyl patch. In transdermal patch form (brand names Matrifen or Duragesic), fentanyl provides an option for chronic pain management. The fentanyl plaster (pflaster) slowly releases the drug into the bloodstream via the skin. Patches come in different sizes and dosages, but most provide pain relief for 48 to 72 hours.
Earlier forms of fentanyl allows people to extract the drug for illicit use. However, today’s transdermal patches contain a special mesh that makes it more challenging for people to extract the drug. As a result, much of the fentanyl sold illegally in the United States is manufactured in China. This has given rise to the street names of fentanyl, “China girl” or “China white.”
The Difference Between Fentanyl and Oxycodone
Fentanyl and oxycodone are both opioid analgesics. Despite their similarity of purpose, these drugs differ in several ways. First, fentanyl is typically prescribed only for very severe pain in individuals who have tried other painkillers first. Oxycodone, on the other hand, is commonly given for short-term pain relief. Oxycodone is also more likely to come in pill or extended release pills, whereas fentanyl is typically administered as a patch. Finally, oxycodone and fentanyl differ in their potency. Oxycodone is approximately 1.8 times as potent as morphine, according to research published in the European Journal of Clinical Pharmacology. Fentanyl, on the other hand, is 50 to 100 times more potent than morphine.
Why Fentanyl is More Deadly than Heroin
Both heroin and fentanyl cross into the brain and bind to mu opioid receptors. The activity of these receptors triggers the painkilling effects of these drugs. However, fentanyl is 25 to 50 times more potent than heroin. Because of its chemical properties, it easily crosses the blood-brain barrier in large amounts. Once there, it binds very strongly to opioid receptors and triggers a release of neurotransmitters that lead to sedation and euphoria.
The potency of fentanyl makes it significantly more deadly than heroin. Particularly alarming for opioid users, fentanyl is often cut into heroin or made into pills that are sold under other drug names. Thus, many users are unprepared for the potency of the drug they take. This significantly increases risk of deadly overdose.
Fentanyl Side Effects
Understanding the fentanyl side effect profile is essential for anyone taking this drug. Some of the most common side effects include:
- Slowed breathing rate
- Decreased heart rate
- Nausea or vomiting
- Muscle stiffness
- Problems with vision
- High blood pressure
Fentanyl overdose does not occur because of drug toxicity per se, but because of the strength of the drug’s central nervous system depressing effects. Fentanyl causes a massive slowing in breathing and heart rate. This respiratory depression is what often causes users to die from an overdose.
When used appropriately under medical supervision, fentanyl can be an effective form of pain management. However, it is important to avoid taking other drugs that are central nervous system depressants when you are under the influence of fentanyl. Taking sleeping pills, other narcotic pain pills, muscle relaxers, or anti-anxiety medications could have dangerous or even fatal consequences.
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