Fentanyl was developed as a powerful painkiller for patients who developed resistance to narcotic pain medication. It is powerful opioid that is 100 times more powerful than morphine and 50 times more potent than heroin. Fentanyl is usually prescribed to cancer patients and those with terminal, painful conditions. The drug is delivered to a patient by injection, orally, or by the use of a transdermal patch. These patches are designed to deliver medication over the course of 3 days before they need to be changed. Fentanyl can remain in the bloodstream 13-24 hours after the patch is removed. These patched are very powerful and can be life-threatening if used incorrectly.
Fentanyl works by binding to the opioid receptors in the brain. This increases the release of dopamine that is flooded into the central nervous system. Abusers of fentanyl usually use it as a substitute for heroin. Fentanyl depresses the respiratory centers in the body. It can also depress the cough reflex and constrict the pupils. There is often a very small difference between a therapeutic and a fatal dose of fentanyl.
Forms of Abuse
The fentanyl patch provides pain relief to many. Unfortunately, the potential for fentanyl patch abuse is well recognized. Those who abuse fentanyl patches usually remove the gel and ingest the three day supply all at once. They often apply a variety of methods of extracting the fentanyl from the patch including:
- Injecting – Many abusers remove the gel from the patch, heat to melt it and mix it with water. The liquid is then injected into the bloodstream with a hypodermic needle.
- Smoking – Like heroin, fentanyl can be smoked. After the gel is removed it is burned and the resulting vapor enters the bloodstream quickly through the thin membranes of the lungs.
- Snorting – Fentanyl is most often snorted as when it is the illicit powder version found on the street. But some snort the gel from the patch without any preparations to it.
- Drinking – Fentanyl patches are steeped in hot water to extract the drug. This liquid is then ingested and absorbed through the digestive system. While this takes longer to take effect, overdoses have still been reported from drinking fentanyl.
- Chewing – Chewing the whole patch to extract the fentanyl allows the drug to be absorbed through the mucous membranes in the mouth. This method can lead to rapid overdose.
Dangers of Overdose
Large doses of fentanyl depress and stop breathing functions. This happens because the opioid receptors in the brain are the same ones that control breathing. After overdose the user can slip into a coma and die.
Naloxone is an antidote to fentanyl overdose, but it needs to used immediately to reverse the effects of fentanyl. Since fentanyl is such a powerful opioid it is hard to determine how much has been taken. Restoring normal breathing functions takes a high dose of naloxone and EMT or emergency room personnel must learn to recognize symptoms of fentanyl overdose to act quickly.