The opiate epidemic continues to rage across America. One of the main contributors to this problem is fentanyl. Unlike heroin, fentanyl may not be widely known to the public, but it is one of the most dangerous drugs to go from the pharmacy to the streets due to its high potency.
What Is Fentanyl?
Fentanyl is a synthetic opiate, or opioid. Doctors prescribe fentanyl to cancer patients to manage their pain. Cancer patients use fentanyl when they are suffering from severe bouts of breakthrough pain while receiving regular pain management. These patients develop a high opiate tolerance and require fentanyl as a supplemental pain reliever. Fentanyl, like other opioids, binds to opioid receptor sites in the brain and spinal cord. This reduces the pain signal to the brain and changes the way a person experiences pain. Fentanyl is available in a variety of forms. Doctors can prescribe it in patches, tablets, and films. Cancer patients often use fentanyl patches that require constant attention and care.
Fentanyl Side Effects
Closely related to heroin and other opiates, but far more potent, fentanyl is a highly addictive drug. When ceasing usage of fentanyl, severe withdrawal symptoms can appear. The withdrawal symptoms can include restlessness, runny nose, watery eyes, nausea, sweating, and muscle aches. For this reason, physicians prescribe fentanyl for very specific uses, and it is dangerous if not taken exactly as directed.
Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, dry mouth, and headache are all common side effects of fentanyl. Redness, itching, and irritation may occur at the application site if the patient is using fentanyl patches. More serious side effects include anxiety, depression, unusual dreams, agitation, confusion, hallucinations, swelling, stomach pain, chest pain, difficulty urinating, irregular heartbeat, loss of appetite, unusual tiredness, uncontrollable shaking of a part of the body, and weight loss. Seek immediate medical attention if someone is experiencing fainting, seizures, or extreme drowsiness.
Fentanyl Strength Comparison
Many people wonder about morphine vs. fentanyl; which is stronger? Fentanyl is much stronger, and is, in fact, one of the most potent opioids in existence. In comparison to other opiates, it can be 10 to 100 times stronger. This fact, combined with its cheap manufacturing cost, makes it extremely dangerous. Here’s how 10 mg of morphine taken orally compare to the following drugs:
- Hydrocodone is equal to morphine in potency.
- Oxycodone is equal to 1.5 doses of morphine, or 6.67 mg.
- Methadone (acute) is equal to 3 to 4 doses of morphine, or 2.5 to 33 mg. Methadone (chronic) is equal to 2.5 to 5 doses of morphine, or 3.33 mg.
- Heroin is equal to 4 to 5 doses of morphine, or 2 to 5 mg.
- Hydromorphone is equal to 4 doses of morphine, or 1.5 mg.
- Oxymorphone is equal to 3 to 7 doses of morphine, or 1 mg.
- Buprenorphine is equal to 40 doses of morphine, or 0.4 mg.
- Fentanyl is equal to 50 to 100 doses of morphine, or 0.1 mg.
Different Brands Of Fentanyl
There are several brands of fentanyl, and each manufacturer produces different forms of the drug for a different intake method. Drug companies manufacture fentanyl for cancer patients, many of whom must be able to take fentanyl in quickly to manage their pain. None of these brands is interchangeable. They are very high dose and can be fatal in children. All types of fentanyl are extremely addictive and have a high chance for overdose.
Abstral is an oral fentanyl tablet. The patient allows the tablet to dissolve under the tongue. Abstral is available is six strengths. Combined with another non-fentanyl narcotic, physicians use it to manage breakthrough pain in cancer patients. The narcotic used with fentanyl is taken in regular doses, while Abstral is for response to breakthrough pain.
Actiq is a transmucosal lozenge of fentanyl citrate used by cancer patients. To obtain Actiq, a patient must register to the Actiq REMS Program. When registering, patients fill out paperwork stating that they recognize the health risks and benefits of the drug.
Fentora is tablet that dissolves between cheek and tongue. The tablet begins a reaction when it comes in contact with saliva, producing carbon dioxide, and the fentanyl is absorbed via the mucosa. Like Actiq, Fentora is only available through a special program. When patients register with Fentora REMS or the FOCUS Program, they are agreeing to all the benefits and risks of the drug.
Onsolis is a buccal-soluble film. The film releases fentanyl when it comes into contact with saliva, releasing an amount of fentanyl in relation to the surface area on the film. Onsolis is only available through the same programs as Fentora.
The Dangers of Fentanyl
Fentanyl is one of the largest contributors to the opioid problem. The cheap, potent drug has a heroin-like high that makes it highly sought after among drug users. Many heroin users are moving on to fentanyl to increase the high. Mexican cartels started trafficking it across the border to fill consumer demand. However, due to the potency of fentanyl, even an experienced heroin user can easily overdose. Not suspecting just how strong the drug is, hundreds of people without the opiate tolerance of a cancer patient take fentanyl and die of overdose every year. This number has been dramatically increasing in the past few years. Mexican cartels are even selling fentanyl as oxycodone or mixing it with cocaine and heroin.
An overdose of fentanyl is very fast-acting, due to the potency of the drug. Someone overdosing from fentanyl will suffer respiratory depression very quickly. The fentanyl causes the muscles around their lungs to stop moving. To reverse a fentanyl overdose, the victim needs a dose of naloxone. One dose may not be enough, depending on the situation. EMTs and other emergency responders now carry more naloxone due to the increase in fentanyl overdoses in recent years. Access to naloxone is a key factor in preventing death of fentanyl overdose.
Fentanyl Detox And Rehabilitation
Withdrawal from fentanyl begins 12 to 30 hours after the final dose. However, for someone using the fentanyl patch, the half-life is 72 hours, because the patch will increase the amount of fentanyl in the bloodstream for 12 to 24 hours. The detox timeline depends on other factors such as the level of dependency, dosage, length of addiction, and whether the patient abused other drugs and alcohol as well.
Once the fentanyl is out of the bloodstream, withdrawal symptoms will begin. Fentanyl withdrawal symptoms include yawning, sweating, restlessness, tearing up, runny nose, chills, backache, stomach cramps, joint or muscle pain, and goosebumps. The symptoms for fentanyl withdrawal are like those of most opioids. The symptoms are rarely life-threatening, but are extremely uncomfortable, especially considering the potency of fentanyl in comparison to heroin and other opiates.
The detoxification process will last five to 10 days, peaking at a few days in, and then leveling off. The safest and least uncomfortable way to go through withdrawal is through medically assisted detox. Medical professionals can assist in the process and relieve the painful symptoms. A medical professional will also manage the tapering down of opioids in the system. Quitting cold turkey is dangerous, so tapering down the dosage of opiates is recommended. Someone in detox will change from fentanyl to less potent opiates during tapering, such as methadone or morphine.
Seek Help Recovering From Fentanyl
Recovery does not need to be a lonely process. Reflections Recovery Center, a fentanyl rehabilitation center, can help those struggling with fentanyl and other opiate addictions. Reflections is a male-only rehabilitation center that is not the typical rehab facility. One of its focuses is outdoor activity, and lots of it. The center offers opioid addiction treatment, using safe and reliable methods to promote recovery from this dangerous and deadly drug.