What is Fentanyl?
Fentanyl is a synthetic opioid analgesic (or pain reliever). It is up to 100 times more potent than morphine, with 100 micrograms of Fentanyl approximately equivalent to 10 mg of morphine. It is fast-acting, relatively short-lasting and crosses the blood-brain barrier rapidly. The desired effects of fentanyl include a decrease in pain, euphoria and relaxation.
Fentanyl was first made by Dr. Paul Janssen, a Belgian chemist and physician, in 1960 as a strong pain reliever, its purest form being a white powder. Since then fentanyl has taken on a few different forms and roles. Fentanyl soon became available in patch form, then via a flavored lollipop soon being manipulated into sublingual tablets and, sublingual and nasal sprays. Following this, many other fentanyl analogues, or compounds with a similar molecular structure, were developed and introduced into the medical practice. Some but not all include sufentanil, alfentanil, reminfentanil, and lofentanil. Making headlines recently is carfentanil, which is even more potent than fentanyl, and 10,000 times more potent than morphine. When handling something that could be fentanyl or carfentanil, one should be very careful because it can lead to life-threatening consequences. Even just touching and absorbing, or inhaling tiny amounts of these substances can lead to very severe reactions including overdoses.
Prescription Information and Use
In the United States, fentanyl is a schedule II prescription drug, meaning that while it is available with a controlled substance prescription, it is recognized as having a high potential for misuse because there is a high risk for psychological and physical dependence. Fentanyl is so strong it is used primarily to treat only severe pain, breakthrough pain, post-operative pain or with patients who have chronic pain and a tolerance to other opioids.
Sometimes it is given during surgery to heavily sedate patients. In 2005, the FDA issued safety warnings regarding fentanyl and reiterated how important it is for prescription regulations and guidelines to be followed when prescribing and dispensing this medication, necessary since in 2015, there were 6.5 million fentanyl prescriptions dispensed, with similar numbers for 2016. It can also be used in veterinary medicine due to its high potency which allows it to be effective for the sedation of large animals.
Some types of prescription fentanyl:
Actiq®: Oral transmucosal lozenges (commonly referred to as the fentanyl “lollipops”)
Fentora™: Effervescent buccal tablets
Abstral®: Sublingual tablet
Abstral®: Sublingual tablet
Lazanda®: Nasal spray
Duragesic®: Transdermal patches
Illicit Fentanyl Information
Fentanyl is mostly produced in China and Mexico and due to its increased availability internationally, criminal organizations are adding fentanyl to their products like Heroin to increase their strength. The first illicit fentanyl was discovered in the United States in 1990’s. The Drug Enforcement Administration (DEA) believes it to be one of the first examples of fentanyl actually made in the United States and traced it back to Wichita, Kansas and seized two labs and around 40 more pounds of fentanyl.
This specific fentanyl was known as “Tango and Cash,” and it was heroin mixed with about 12 percent fentanyl. This Fentanyl and Heroin mixture was responsible for approximately 126 overdose Opioid deaths. Other common street names for fentanyl are Apache, China Girl, China Town, Dance Fever, Friend, Goodfellas, Great Bear, He-Man, Jackpot, King Ivory and Murder 8.
Side Effects and Signs
Side effects include drowsiness, tiredness, feeling heavy, warm sensation or flushing, constricted pupils (pinpoint pupils), changes in mental awareness such as confusion, nodding off, slurred speech, delirium, disorientation, muscle stiffness, slowing of bodily functions such as constipation, slowed breathing, slowed heart rate, dry mouth, itching, nausea and vomiting, and more. Longer term effects can include insomnia, mood disturbances such as depression, suicidality, collapsed veins if used intravenously and systemic organ problems.
Signs of an Fentanyl Overdose
Signs of a fentanyl overdose include, but are not limited to, being unresponsive to voice or touch; slow, stopped or irregular breathing; extreme pinpoint pupils; blue or purple tint to fingernails and lips; slow heartbeat and low blood pressure.
Fentanyl Detox Symptoms
Detox symptoms will include chills, confusion, diarrhea, general weakness, irritability, joint and muscle pain, loss of appetite, restlessness, shaking or tremors, stomach pain, insomnia, anxiety and depression.
Signs of Fentanyl Abuse or Misuse
Signs of fentanyl abuse or misuse include paranoia, any marked behavior changes, social withdrawal, decrease in motivation, pinpoint pupils, constipation, long periods when the person is unaccounted for, decrease in performance at work or school, changes in spending habits or financial changes, mood swings or changes in peer group.
Fentanyl Addiction Treatment
AToN Center treats all opioid use disorders including fentanyl. Treatment involves a safe detox, intensive inpatient therapy, exploration of Medication-Assisted Treatment (MAT) medications, discharge planning and aftercare. At many addiction treatment centers, treatment is one-size fits all. At AToN, our approach is consistently individualized.
We offer 12 Step fellowship programs and many non 12 Step alternatives. We are supportive of whatever works for you to help treat your addiction to fentanyl and other substance use disorders or mental health concerns. We are knowledgeable and supportive of SMART Recovery, Refuge Recovery, Celebrate Recovery, LifeRing and any other community support group that works for you. We also support you in connecting with whatever spiritual pursuits might be helpful (if any) and we offer a range of holistic services such as massage, acupuncture, equine therapy, personal training, hypnotherapy, breath work and yoga.
Doing these behavioral holistic activities is so important to help get through the challenges of Fentanyl Withdrawal, fentanyl detox and the post-acute withdrawal syndrome (PAWS) which can derail people if they are not educated on the process. When you call AToN Center, a trained admissions specialist will walk you through the process and answer your questions.