In 2020, more than 56,000 deaths involving synthetic opioids other than methadone (Dolophine) occurred in the United States, accounting for 82 percent of all opioid deaths. Fentanyl has now become one of the drugs most frequently responsible for overdoses.

Looking at death certificates from 2011 through 2019, researchers identified patterns in specific drugs most frequently involved in drug overdose deaths. They found that synthetic opioids, primarily fentanyl, were the main cause of drug overdose deaths, which have increased 14-fold from 2012 to 2019, greatly outnumbering all other types of drug overdose deaths.

What Is Fentanyl?

Fentanyl is a powerful, synthetic opioid that is part of the class of drugs called opioid analgesics. Developed in the early 1960s, fentanyl was first used as an intravenous anaesthetic but is now prescribed and administered to treat chronic severe pain, for instance, with cancer or end-of-life care.

Fentanyl is prescribed under the trade names Duragesic, Actiq, and Subsys. Names for illegally used fentanyl include Goodfellas, Dance Fever, and Apache.

The drug comes in several forms: a transdermal patch, a lozenge, a tablet that goes under the tongue, a nasal spray, and a sublingual spray. Side effects include euphoria, drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, and unconsciousness.

How Fentanyl Works in the Body

Fentanyl works by binding to nervous system proteins called opioid receptors. This blocks pain signals to the brain but boosts levels of dopamine, a chemical messenger between brain cells that controls the reward and pleasure centre in the brain.

Because of its high potency – it’s 50 to 100 times more powerful than morphine and 50 times more potent than heroin – fentanyl can quickly enter the brain tissue, causing an intense and euphoric “high.” Potent opioids such as fentanyl can cause breathing to stop completely, which can lead to death.

Why Is Fentanyl So Dangerous?

Fentanyl sold on the street is manufactured illegally in labs, primarily in countries like China or Mexico, where they synthesise a less pure, potentially more dangerous form of fentanyl. Since it comes in a fine powder, fentanyl is often added to fake prescription pills and illicit drugs like heroin, cocaine, or methamphetamine. Even 2 milligrams (mg) of fentanyl can be lethal for people who aren’t opioid-dependent.

The drug has also been used in counterfeit prescription pills, made to closely resemble oxycodone (Oxycontin), alprazolam (Xanax), and acetaminophen and hydrocodone (Norco).

The amount of fentanyl in each counterfeit pill varies, but it’s estimated that as many as 6 in 10 fentanyl-laced fake prescription pills now contain a potentially lethal dose of fentanyl.

“People can be unintentionally exposed to fentanyl,” says Lindsey Vuolo, MPH, vice president of health law and policy at the Partnership to End Addiction. “Overdoses can happen very quickly, in a matter of minutes.”



How and Why Is Fentanyl Abused?

Fentanyl can be injected, snorted, sniffed, smoked, taken orally by pill or tablet, or spiked onto blotter paper. Fentanyl patches are abused by removing its gel contents and then injecting or ingesting it.

Fentanyl is classified as a Schedule 2 controlled substance by the U.S. Drug Enforcement Administration (DEA). Schedule 2 drugs have a high potential for abuse and addiction, despite their specific medical uses.

What makes fentanyl so addictive is that it’s cheap and it can produce an intense high with just a small amount, even at a much lower dose than heroin. Abusing fentanyl can build up a tolerance to the drug, which increases the risk of overdosing. Many people may not even be aware they are abusing fentanyl. They may think they are taking heroin, Percocet, or Xanax.

An overdose can result in a stupor, cold and clammy skin, or even a coma and death.

SOURCE: Everyday Health