Search Results for: fentanyl

Fentanyl: The Newest Lethal Injection Ingredient

Fifty times stronger than heroin, the synthetic opioid fentanyl is flooding the drug market – and heightening the danger of overdose. In search of cheaper mixes and stronger highs, dealers now lace heroin and cocaine with this potent drug.

We’ve already talked about how potent fentanyl is, but the latest use of this drug really hammers that point home. Believe it or not, policy makers have chosen to add fentanyl to the cocktail mixture used for lethal injections.

Yep, people are voluntarily taking a drug that’s literally being used to kill people.

Nevada’s New 3-Drug Cocktail

Convicted of murder, Scott Dozier is scheduled for execution in Nevada. This would be the state’s first execution in more than ten years, and, as it turns out, they’re out of lethal injection supplies. Their previous two-drug injection protocol expired, so the state has decided on a new three-drug mixture for the upcoming execution.

The new protocol is made up of fentanyl, valium and a muscle relaxant, cisatracurium. The valium and cisatracurium relax the body and reduce anxiety, while the fentanyl delivers the lethal effects. Barring legal complications or appeals, this new combination of drugs will eventually be used for Dozier’s execution at Ely State Prison.

Why have Nevada officials chosen this drug for their new lethal injection cocktail? It’s designed to kill.

The scary truth is that fentanyl is just as dangerous on the street as it is in the death chamber – if not more so. It doesn’t require the cocktail being used by prison officials to kill. In fact, that combination is designed to make the injection lethal, but humane. Drug dealers aren’t so considerate.

Popping up more and more frequently in street drugs, fentanyl is beyond dangerous. Last year, fentanyl and other synthetic opioids took over the number one spot for leading cause of drug overdose deaths in the US. The CDC reported more than 20,000 people in the US died from synthetic opioids in 2016. This is twice the number from 2015.

As fentanyl continues to spread, police officials are struggling to stop the drug before it hits the streets and unleashes deadly results. A recent drug seizure in New York took more than 140 pounds of fentanyl and nearly 50 pounds of fentanyl-laced heroin out of circulation. Seized from an apartment in Queens, this stash had the potential to kill millions.

The NYPD noted, “Given that a dose of fentanyl weighing two to three milligrams can be deadly, the [140 pounds] of pure fentanyl alone seized in this case could have yielded approximately 32 million lethal doses.” That’s enough to take out the entire state of New York, along with neighboring Pennsylvania. Let that sink in for a minute.

Beyond the Death Chamber

When we look at its potency, it’s easy to see why the number of fentanyl deaths are skyrocketing. Just a dusting of the powdery substance can be lethal. Even accidental exposure can cause death. Voluntarily consuming a dose of fentanyl is like walking into the death chamber with Dozier and asking the guard to “make that a cocktail for two.”



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True or False​: ​Ready to Put Your Fentanyl​ Knowledge to the Test?

Fentanyl. This potent opiate has added a whole new level of danger to the opioid crisis, causing a staggering number of overdoses and deaths. Part of its overall threat is the lack of public knowledge and awareness.

So, how much do you know about fentanyl? You’re about to find out…

True or False:  Fentanyl is 50 times stronger than heroin.

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True. Extremely potent, fentanyl is 50 times stronger than heroin and 100 times stronger than morphine. Dangerously strong, it has been responsible for a rising number of deaths. From 2014 to 2015, deaths involving synthetic opiates such as fentanyl increased by almost 75 percent.

 

True or False:   Fentanyl can’t be absorbed through your skin, so it doesn’t matter if you wear gloves when you come into contact with the powdery substance.

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False. Fentanyl can be rapidly absorbed through the skin.

Ohio police officer Chris Green learned this first hand. After a drug bust, he returned to police HQ to complete the paperwork. While there, a fellow officer pointed out a white powdery substance on Green’s shirt. Thinking nothing of it, he simply wiped it away. An hour later, he was unconscious. The brief contact with the fentanyl transferred to his shirt during the bust was enough to cause an overdose. Green was given multiple doses of Narcan and revived by emergency crews.

 

True or False:   Most heroin dealers will let you know if they’ve cut their product with fentanyl.

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False. Fentanyl is cheap and adds extra weight to baggies of heroin. Since most drug dealers aren’t exactly known for their moral compasses, they aren’t about to warn customers that their heroin is laced with fentanyl, which will inevitably put them at a high risk for overdose.

 

True or False:   Prescribed fentanyl patches are always safe.

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False. Used without caution, these patches can be deadly.

Fentanyl is frequently prescribed for patients suffering severe, ongoing pain (such as cancer patients). In need of continuous pain medication, these patients receive a transdermal patch. Patients using fentanyl patches must be cautious while taking this drug.

Two main areas are cause for concern. The first is heat. When a person gets hot, their skin dilates and absorption increases. A significant increase can be fatal, so patients must be cautious in hot weather, using saunas, hot tubs or heating pads or if they have a fever. Secondly, fentanyl patches must be disposed of carefully to protect children and pets. Dug from the garbage and mishandled, these patches can be lethal.

 

True or False:   As long as I have some Narcan nearby, I’ll be safe using fentanyl.

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False. Fentanyl is so fast-acting, a lethal dose may not allow time for administration of life-saving Narcan. This drug is also so strong, emergency crews equipped with Narcan have struggled to revive those who have overdosed. Often, they must use multiple doses of Narcan and, even then, not everyone makes it.


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First Responders Worry About Accidental Fentanyl Exposure

Fentanyl. It’s known to be 50 times more potent than heroin, and a speck the size of a few grains of salt can kill.

By now, you’ve probably heard of this beast and the toll it’s taken on so many lives around the country. A whopping 5554 people overdosed on the synthetic opioid in 2014, and deaths continue to surge into 2017 as street drugs like heroin and cocaine are unknowingly laced with fentanyl.

Proceed With Caution

But users aren’t the only ones urged to take extreme precaution. The danger extends to first responders, as well – especially when handling evidence intercepted from the scene of a crime.

The scary thing is, fentanyl can be absorbed through the skin or inhaled if it becomes airborne, putting responders – and even police dogs – in danger.

“With fentanyl, if the officer is simply patting somebody down, or if he’s getting a little bit out to try to do a field test and it accidentally comes in contact with his skin or the wind blows it in his face, he could have a serious problem,” said Tommy Farmer, special agent in charge of the Tennessee Bureau Investigation.

For those who come into contact with fentanyl, the onset of adverse health effects is rapid and profound. Symptoms, such as disorientation, coughing, sedation, and cardiac arrest, can occur within seconds after exposure. Since one wrong move could be deadly, agencies are now instructing officers to wear gloves and masks when handling any type of substance to protect their skin and lungs. After interception, they’re advised to bring the evidence directly to a drug lab without stopping to field-test it.

“A majority of our stuff has fentanyl in it,” said Dan Kallen, a New Jersey detective of 15 years. “We don’t even field test. It’s not worth it to open up those bags and put that stuff in the air or get it on your skin.”

Mandatory Safety Precautions

First responders are also being trained on how to self-administer the anti-overdose drug naloxone, just in case of accidental exposure. They’re also being educated on the risks associated with fentanyl, and agencies are stressing the importance of their officers developing awareness of their surroundings.

One thing’s for sure, though: The streets have only gotten more dangerous since fentanyl entered the picture. That’s why it’s crucial for first responders to be up-to-date with proper protocol for fentanyl exposure – measures that will hopefully prevent more unnecessary casualties.

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Fentanyl Overdose

fentanyl overdose

Fentanyl (brand names include Actiq, Duragesic, and Sublimaze) is a very powerful synthetic opioid painkiller medication that is 50 to 100 times more potent than morphine 1.

Individuals who abuse or struggle with addiction to fentanyl put themselves at high risk of overdose. In fact, in 2015 alone, 33,091 people died due to overdose on opioids like fentanyl 2. Learning how to recognize the indications of a fentanyl overdose and getting professional substance abuse treatment may save a life.


Signs and Symptoms of Fentanyl Overdose

Fentanyl overdoses can be deadly, so it is vital that you call 911 right away if you suspect an overdose may have occurred. A person overdosing on fentanyl may present with the following overdose signs and symptoms 3, 4:

  • Pinpoint pupils.
  • Weak muscles.
  • Dizziness.
  • Confusion.
  • Extreme sleepiness.
  • Loss of consciousness.
  • Profoundly slowed heart beat.
  • Very low blood pressure.
  • Dangerously slowed or stopped breathing.
  • Bluish tint to nails and lips.

The effects that a fentanyl overdose have on the user’s heart rate and breathing present the biggest risk of death or permanent damage. Even if a user survives a fentanyl overdose, these side effects may leave a lasting mark on the user’s body if not treated immediately. For example, respiratory depression can lead to hypoxia, which can cause permanent brain damage in the suffering individual 5, 6.


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Risk Factors

As an extremely potent opioid drug, fentanyl is very carefully prescribed and dosed by medical professionals. Those who abuse fentanyl may use the drug outside of prescription guidelines or without a prescription altogether, which can drastically increase their risk of lethal overdose.

Fentanyl abuse behaviors include:

  • Taking fentanyl in higher doses or more frequently than prescribed.
  • Using fentanyl in a way other than intended, such as snorting or injecting it.
  • Combining fentanyl with other drugs, such as alcohol, stimulants, or benzodiazepines, which can have compounding or contradicting effects.
fentanyl overdose

Abusing fentanyl can lead the user to build up a high tolerance for the drug, meaning they will need increasing amounts in order to get the same effects. For some opioid effects, tolerance develops non-uniformly, which can heighten overdose risks. For example, an individual may begin to escalate their fentanyl use due to a build-up of tolerance to effects such as pain relief and euphoria but, in doing so, heightened their risk of experiencing overdose effects less impacted by tolerance, such as respiratory depression.

In addition to the dangers imposed by differential tolerance development, relapsing into abuse after an extended period of abstinence—and an accompanying drop of drug tolerance—presents another major risk of overdose. When a person is abstinent for a while, their tolerance diminishes, meaning the high doses they were using before becoming abstinent may overwhelm their system should they be used again.


What to Do If You Overdose on Fentanyl

The first and most important step to take if a fentanyl overdose is suspected is to call 911 for emergency medical help. Medical professionals can help minimize damage caused by a fentanyl overdose and may save the person’s life. While waiting for an emergency crew to arrive, closely supervise the overdosing individual, making note of their condition to report to the emergency responders.

Never leave an overdosing individual alone; they should be kept awake and upright if possible.

If you suspect a fentanyl overdose in yourself, call 911 right away, tell them the situation, and try to stay conscious as long as you can until they arrive. If you are able, remain sitting upright, but if this is not an option, lay down on your side and wait for emergency crew to escort you to the hospital for more extensive treatment.

Once medical care arrives, the person will be carefully monitored for any irregularities in breathing, heart rate, blood pressure, and body temperature.  Fentanyl overdose cases may necessitate the use of naloxone, which is a medication that blocks opioid receptors and can quickly stop some of the dangerous opioid overdose effects 7.

Fentanyl overdose can be deadly; seeking immediate medical treatment is the best way to minimize the associated risks. One of the best ways to altogether avoid a fentanyl overdose is to get help with a fentanyl abuse problem as soon as possible.


Preventing Fentanyl Overdose

Fentanyl overdose can be prevented. By getting professional help for a fentanyl abuse or addiction problem, a person can drastically reduce their risk of overdose and its consequences. Substance abuse treatment programs help many individuals overcome their substance abuse problems with education, counseling, relapse prevention skills, and therapy.

Treatment programs come in many forms to fit each individual’s recovery needs. Some programs specialize in certain populations, such as particular age ranges, genders, sexual orientations, incomes, and substances of abuse.

In general, treatment programs will take place in the following settings:

  • Inpatient treatment: The recovering individual stays at a facility while engaging in treatment, offering an escape from the stressors of home life that may have contributed to the fentanyl abuse problem.
  • Outpatient treatment: The recovering individual works through treatment while living at home, checking in on a regular basis with the facility for treatment sessions.

Often incorporated into the framework of formal treatment programs, self-help groups also continue to be a resource used by many in recovery after the initial treatment period has ended. Many of these fellowships are founded on the 12-step principles first outlined through Alcoholics Anonymous. Those in recovery for fentanyl abuse can work through the 12 steps of recovery while building a network of sober peers through programs such as Narcotics Anonymous. Regular attendance at these group meetings helps encourage sobriety as recovering individuals work through formal treatment, and later, as part of a solid aftercare regimen.

It’s never too late to get help for a fentanyl abuse problem. Call us at 1-888-744-0069Who Answers? to speak with a treatment consultant who can help you find a program today.


References:

  1. National Institute on Drug Abuse. (2016). Fentanyl.
  2. National Institute on Drug Abuse. (2017). Overdose Death Rates.
  3. Massachusetts Department of Public Health. (2011). Opioid Overdose Education and Naloxone Distribution.
  4. National Library of Medicine. (2016). Fentanyl Transdermal Patch.
  5. National Institute on Drug Abuse. (2014). What are the possible consequences of opioid use and abuse?
  6. U.S. National Library of Medicine. (2014). Cerebral hypoxia. MedlinePlus.
  7. Substance Abuse and Mental Health Services Administration. (2016). Naloxone.

Snorting Fentanyl

snorting fentanyl

Fentanyl is a pain-relieving substance with two main uses 1:

  • Treating significant acute, post-operative pain following surgery.
  • Treating chronic or breakthrough pain in people that no longer respond to other narcotic medications.

Like morphine, fentanyl is an opioid substance that reduces the user’s perception of pain by acting on opioid receptors in the brain and body 2. Fentanyl is one of the most potent opioid medications, which is why it frequently reserved only for use in opioid-tolerant patients 3,4. Fentanyl is up to 100 times more powerful than morphine, an opiate that is addictive in its own right 1,3. In recent years, fentanyl has become a major health concern, as its popularity has increased due to its powerful high and the numbers of overdoses related to fentanyl-laced heroin have reached alarming heights. On the street, fentanyl is increasingly sought-after and is referred to by a number of names such as “apache,” “china girl,” and” china white” 1.

A substantial amount of fentanyl abused will be illicitly produced in clandestine labs 3. Using illegally-produced, non-pharmaceutical fentanyl is very dangerous due to lack of regulation, but misusing any fentanyl product (legally or illegally produced) by changing the dose, frequency, or route of administration can also be hazardous due to the potency and possible side effects 1,2. For example, snorting fentanyl will produce effects that are unpredictably dangerous and potentially deadly, especially compared to using the drug as directed.


Is Snorting Fentanyl Dangerous?

Anytime a substance is consumed in ways other than prescribed, the danger rises.

Snorting fentanyl is indeed very dangerous and poses numerous risks to the user. Non-pharmaceutical fentanyl is commonly found in powdered form, which makes snorting it a common option 1.

Even with a prescription, fentanyl use must be carefully monitored 4. Anytime a substance is consumed in ways other than prescribed, the danger rises.

Fentanyl and Heroin

Another significant concern is the link between fentanyl and heroin. Someone with a legitimate prescription may begin abusing and overusing the fentanyl, which means that they will likely run out of the substance before their next prescription is available. People looking for fentanyl on the street may find that it is prohibitively expensive and that heroin is a more affordable alternative that produces a similar high. In many areas, heroin is cheaper and easier to obtain than fentanyl and other prescription opioids, so it is not uncommon for users to transition from fentanyl to heroin 6.

The other link is that illegally-produced fentanyl is regularly mixed with other drugs without the user’s knowledge. When someone thinks they are snorting fentanyl, they might also be consuming heroin (or other drugs) 1,6.

  • The speed of onset.
  • Intensity.
  • Duration of effects.

Speed of onset. Snorting fentanyl allows the opioid to be absorbed into the bloodstream through the mucus membranes in the nasal passage before reaching the brain a few minutes later. This will be much quicker than oral ingestion 5.

Intensity. Snorting fentanyl also contributes to an intensified high compared to oral ingestion. A quicker route allows for the concentration of fentanyl in the brain to rise more quickly, leading to intense and dangerous effects that can overwhelm the body and cause many unwanted consequences like respiratory depression. The dangers rise if the person has a low tolerance to opioids 6. Additionally, snorting allows more fentanyl to reach the brain compared to oral consumption. Unlike snorting, when fentanyl is consumed orally, the stomach, intestines, and liver begin to break down some of the drug before it can reach the brain 5.

Duration. When a substance reaches the brain quickly, it may produce effects that are more intense but shorter in duration than when the substance reaches the brain in a slower, more controlled manner 5.

Can I Become Addicted to Fentanyl?

Another danger that comes with snorting fentanyl is the risk of addiction. Addiction is a major concern for all opioid users, even when the drug is taken as prescribed. However, the likelihood of an addiction developing is significantly increased anytime the drug is abused. Misusing any drug (for example, snorting non-pharmaceutical fentanyl) will further increase the risk of addiction 6. This is partly due to the changes that altering the method of administration produces; remember that snorting creates a rapid and intense high with a shorter duration. This leaves the user:

1) Feeling immediately euphoric.

2) Quickly coming down from the high and craving to use again.

This pattern of use is strongly linked to the development of addiction.


Side Effects of Snorting Fentanyl

Fentanyl carries a risk of side effects no matter how it is consumed. While using the medication as prescribed presents certain side effects, the user’s risk of experiencing these effects rises significantly with abuse of the drug. Someone snorting fentanyl may experience side effects like 4:

snorting fentanyl side effects headache
  • Sleepiness.
  • Weakness.
  • Diarrhea.
  • Nausea.
  • Vomiting.
  • Decreased appetite/weight loss.
  • Headache.
  • Impaired vision.
  • Dry mouth.
  • Sweating.
  • Pain in the chest or back.
  • Trouble with sleep.

Snorting fentanyl may also cause certain mental health side effects to arise, such as 4:

  • Anxiety.
  • Depression.
  • Hallucinations.
  • Unusual dreams.
  • Odd thoughts.

What Damage Does Snorting Cause?

Nasal insufflation of fentanyl also places the user at high risk of serious reactions—some of which may eventually turn fatal. These include 4:

  • Respiratory issues, e.g., slowed breathing.
  • Trouble swallowing.
  • Feeling dizzy and unsteady.
  • Confusion.
  • Fainting.
  • Seizures.

The previous effects are possible no matter the route of administration. Sniffing and snorting drugs, however, leads to a unique set of concerns apart from the normal side effects. Snorting opioid pain medications like fentanyl can lead to 7:

  • Facial and ear pain.
  • Nasal congestion or drainage with thick discharge.
  • Bloody nose.
  • Trouble swallowing.
  • Difficulty speaking.
  • Perforation of the septum or palate.
  • Mouth ulcers.
  • Swelling in the face.
  • Fever and chills.


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Can Snorting Fentanyl Cause an Overdose?

Yes. Fentanyl is extremely powerful, and misusing it even once can cause a potentially fatal overdose.

According to the National Institute on Drug Abuse (NIDA), 19,000 people died in 2014 from opioid pain reliever overdose 2. The signs of fentanyl overdose may include 2,4:

  • Cyanosis (blue tint to lips and nails).
  • Extreme drowsiness.
  • Profound disorientation and confusion.
  • Small pupils.
  • Cold, clammy skin.
  • Violent shakiness.
  • Uncontrollable vomiting.
  • Slowed, labored, or stopped breathing.

Fentanyl overdose is especially likely when someone who has not used fentanyl before uses it recreationally or unknowingly (e.g., in a laced or counterfeit drug). It is also likely to occur if someone who has become tolerant to the drug takes a larger amount to produce the kind of high that used to come with lower doses 6. Any dose increase outside the careful monitoring of a medical professional can be extremely dangerous 6. Overdose is also a risk for someone who has returned to fentanyl use after a period of abstinence during which their tolerance decreased 6.

Combining fentanyl use with alcohol or other drugs can increase the overdose risk. First, using fentanyl with other substances that affect breathing—including other central nervous system (CNS) depressants (e.g., benzodiazepines or another opioid like heroin)—poses extreme danger of respiratory depression and death 2,6. Second, non-pharmaceutical fentanyl is frequently laced with other drugs, such as cocaine or heroin. In these situations, the user is unprepared for the effects which may occur and may experience an overdose when taking what they thought was their “normal” fentanyl dose 1.

Opioid overdose can sometimes be reversed when the individual is given a medication called naloxone. This opioid antagonist (blocker) reduces the negative impact of fentanyl on breathing, and can save lives if administered early. Due to the potency of fentanyl, repeated doses might be needed to improve symptoms 1.


Signs That Someone is Addicted to Fentanyl

Addiction is marked by the continued, compulsive desire to acquire and use a substance even when negative repercussions are likely to occur. Someone addicted to fentanyl may show signs like 8:

  • Taking more fentanyl than expected and for longer periods than intended.
  • Failed attempts to stop or reduce use.
  • New or worsening problems meeting demands at work, home, school, or in the community.
  • Shifting interests and activities.
  • Changing relationships or increased conflict with established relationships.

Someone abusing fentanyl by snorting it may:

  • Have powder on their face, hands, or clothes.
  • Possess tools to tamper with and snort the substance.
  • Sniff, sneeze, and wipe their nose frequently.

Getting Help for Fentanyl Addiction

cognitive-behavioral therapy
Someone seeking help for fentanyl addiction should begin by seeking professional treatment because when use ends, very uncomfortable and potentially dangerous withdrawal symptoms can emerge that lead to relapse. Examples of fentanyl withdrawal symptoms include 6,9:

  • Widespread body aches and pains.
  • Diarrhea.
  • Nausea and vomiting.
  • Higher blood pressure and irregular heart rate.
  • Fever, chills, and sweating.
  • Runny nose and watery eyes.
  • Strong cravings to restart use.

A period of medically-assisted detoxification to manage withdrawal symptoms and help the recovering individual maintain abstinence can be extremely helpful for those attempting to end fentanyl use. Painkiller detox often occurs in an inpatient or residential setting so the patient can be continuously monitored and the symptoms can be managed on the spot to increase comfort and mitigate any risks 6,9.

Ongoing treatment may include a combination of medications and behavioral therapies to reduce cravings and promote recovery. Pharmacotherapies include 6,9:

  • Opioid agonists like methadone that trigger a response in the brain similar to fentanyl but in a more controlled way to reduce addictive behaviors.
  • Opioid partial agonists like buprenorphine (or the combination product, Suboxone—buprenorphine + naloxone) that work like an agonist but create a less intense response, thus minimizing the potential for abuse.
  • Opioid antagonists like naltrexone that diminish the impetus for continued opioid abuse by blocking the opioid high.

Behavioral therapies include 9:

  • Cognitive-behavioral therapy (CBT)focuses on identifying and changing negative coping mechanisms into positive skills that support recovery. Also helps to develop strategies to limit cravings.
  • Contingency management (CM)works to provide desirable rewards to the individual when drug-free behaviors are completed. Helps to counteract the reinforcing sensations of fentanyl use by rewarding behaviors that promote abstinence.

Making the choice to end fentanyl use and beginning recovery is a challenging time. To improve your recovery experience and potentially increase treatment outcomes, seek professional rehabilitation services. To find effective options for you or a loved one, call 1-888-744-0069Who Answers? today.


References:

  1. National Institute on Drug Abuse. (2016). DrugFacts: Fentanyl.
  2. National Institute on Drug Abuse. (2016). Prescription Pain Medications: Opioids.
  3. Drug Enforcement Administration. (2015). Fentanyl.
  4. U.S. National Library of Medicine: Medline Plus. (2016). Fentanyl.
  5. National Institute of Health. (2010). The Brain: Understanding Neurobiology.
  6. National Institute on Drug Abuse. (2014). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.
  7. Alexander, D., Alexander, K., & Valentino, J. (2012). Intranasal Hydrocodone-Acetaminophen Abuse Induced Necrosis of the Nasal Cavity and Pharynx. The Laryngoscope, 122(11), 2378–2381.
  8. National Institute on Drug Abuse. (2016). What to Do If Your Adult Friend or Loved One Has a Problem with Drugs.
  9. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.

Is Fentanyl More Deadly Than Heroin?

Fentanyl and money in hand

Fentanyl, a drug previously unheard of by many, has become notorious in recent years due to the spike in overdose deaths from heroin laced with the potent prescription narcotic. It gained even more notoriety when the April 2016 death of iconic singer, Prince, was attributed to an accidental fentanyl overdose.

As an extremely strong painkiller that produces effects similar to heroin, fentanyl has made its way from the hospital to the street, and the consequences are often deadly.


Where Does Fentanyl Come From?

What Are Opiates/Opioids?

Opiates are derived from the opium poppy plant, nicknamed the “flower of joy.” There are roughly 20 different opiate alkaloids that are derived from the plant, including heroin, morphine, and codeine. Opioids are a class of drugs with similar pharmacological properties to opiates; however, the opioids are either partially or fully synthetic substances 9.

The human body produces its own supply of opioid peptides. Perhaps the most commonly known are the endorphins (the others are the enkephalins and dynorphins). Endorphins bind to opiate receptors in the body, blocking pain. If you get hurt, your body will release endorphins to provide you with pain relief.

When opiates and opioids bind to opioid receptor sites throughout the brain and spinal cord, they influence how a person perceives pain, effectively diminishing the pain signal sent from the body to the brain. In essence, opiate and opioid drugs don’t make your pain go away, they just change the experience of pain.

Fentanyl is a synthetic opioid that is 50 times more potent than heroin and 100 times more potent than morphine. The FDA approves this powerful painkiller for 1,2:

  • Use before surgery as an adjunct to anesthesia, and in some cases, during postoperative recovery.
  • Treating chronic or acute pain in opioid-tolerant individuals, or those individuals who have become tolerant to their narcotics and need a stronger analgesic.
  • Managing advanced cancer pain.

The United States is in the middle of a fentanyl public health crisis. Today, there is more fentanyl available than at any other time since 1959 when the drug was first created. From 2013 to 2015, the Drug Enforcement Administration (DEA) seized 239 kilograms of illegal fentanyl 3. Although this may seem small compared to the amount of other illicit substances seized by authorities, fentanyl is more lethal than many of these other drugs because even an extremely small dose (2 milligrams) can be fatal 3.

Illegal, non-pharmaceutical fentanyl (NPF), also called illicitly manufactured fentanyl (IMF), is made in clandestine labs. NPF is sold illegally, and it is highly sought after because it produces heroin-like effects 1 and can be cheap for manufacturers to make. On the street, it is sold under various names, such as “China Girl” and “China White” 4.

NPF is often laced with heroin or cocaine without the buyer’s knowledge. This phenomenon of adding chemical adulterants to street drugs contributes to the rising number of fentanyl-related deaths in the United States because users are unaware of their drug’s potency 5. According to the Centers for Disease Control and Prevention (CDC), in 2015, 55% of people who died from an overdose of fentanyl additionally tested positive for heroin or cocaine, compared to 42% between 2013 and 2014—a concerning uptick that may reflect an increase in the widespread availability of an adulterated street product.

Within the illegal drug market, fentanyl provides the opportunity for manufacturers and dealers to make a substantial sum of money. A kilo of NPF is reported to sell for roughly $1.3 million dollars, whereas a kilo of heroin will sell for a relatively mere $271,000 3.

Opioid Deaths DEA Graphic

There has been a spike in the number of fentanyl drug seizures in the past 2 years. In 2012, the DEA reported 618 seizures; in 2013, they reported 945 seizures; in 2014, the DEA reported 4,585 seizures. The problem seems to be somewhat localized, with more than 80% of the seizures occurring in just 10 states, with Ohio, Massachusetts, and Pennsylvania leading in the number of seizures 6. Of those states affected, Florida and Ohio are of extreme concern due to sharp increases in the number of fentanyl deaths in these states 1.


The Little Devil

According to an article in the New York Times, Mexican cartels are producing fentanyl and smuggling the drug into the United States to meet the high consumer demand for this drug that produces a stronger high than heroin. Part of the allure of producing non-pharmaceutical fentanyl is that it is easy to make—it can be made in a lab and does not require growing a poppy plant. In 2015, Mexican authorities seized 27 kilograms of fentanyl – in terms of drug potency, the dosage equivalent of one ton of heroin – as well as 19,000 tablets of fentanyl that were marked as oxycodone during a raid in Sinaloa. It was during this raid that the drug kingpin, “El Chapo,” was seized 7.

Fentanyl is cut and mixed into many forms by the cartels, and in Mexico, the combination of heroin and fentanyl is known as “el diablito,” or “the little devil.”  While there is minimal information on the amount of fentanyl being trafficked into the United States, there are a number of reports of drug seizures at the border. In February 2016, a 19-year-old man was stopped at the California-Mexico border carrying nearly 2,000 pills in his underwear that were marked as oxycodone 7. According to DEA lab results, the pills contained fentanyl and not oxycodone 8.

The following documentary clip sheds more light on El Chapo’s fentanyl stronghold:

Credit: Fusion


The Hidden Killer

While some people knowingly seek out fentanyl for its extremely potent high, fentanyl use often occurs unwittingly, as it is often disguised as heroin or other opioid narcotics 1. Those believing they are buying their normal drug of choice (e.g., heroin) may be getting a substance that is much stronger than their bodies can handle.

Fentanyl can heighten the potency of heroin and lead quickly to fatal respiratory depression. It may also compound the toxic influence of cocaine.

Some buyers may hear of certain brands of heroin as being potent or a strong high and use it without realizing fentanyl has been added to it. This can result in immediate overdose, especially if someone uses their normal amount and expects the same effects.

Opioids like fentanyl work directly on the respiratory center of the brainstem. This can result in a depression of a person’s ability to breathe properly. In the case of fentanyl, it can kill a person rapidly by paralyzing muscles in their chest that help them breathe <10. This effect is called sudden onset chest wall rigidity, or “wooden chest”.

Heroin Laced with Fentanyl

A recent study published by the Guardian reported that the only supervised injection site in Canada found 90% of the heroin used there tested positive for fentanyl.

The clinic performed 173 drug checks for fentanyl, and 90% came back positive for the drug. The clinic was checking for fentanyl as part of a pilot program, which was inspired by similar drug checks offered at music festivals 11.


Is Fentanyl Deadlier than Heroin?

What Does Potency Mean?

Opioid medications work by attaching to opioid receptors in the brain, producing the therapeutic pain-relieving effect. Potency at a receptor level is measured as the amount of the opioid necessary to elicit the intended response.

The amount of fentanyl required to provide an equal painkilling effect to that of 10mg of morphine is a mere 0.1 mg (or 100 millionths of a gram)—making fentanyl 100 times more potent than morphine 12 and extremely dangerous for non opioid-tolerant individuals.

Although heroin is known as one of the most dangerous and addictive drugs on the market, fentanyl is even more potent and can cause rapid death.

Fentanyl’s popularity among illicit drug manufacturers and some opioid users has skyrocketed in recent years due to its ability to provide a profoundly intense euphoric high. However, this high can easily turn deadly.

The risks inherent to any form of opioid abuse, such as respiratory depression and coma, are not only present with fentanyl, but are even higher as a result of the drug’s potency.

First-time (or drug-naïve) users are especially susceptible to overdose risks. Fentanyl can be deadly any time it is used, but may be especially so in those who’ve never used it, or have opioid tolerances adjusted for lesser potency drugs (including even heroin). In fact, in March and October 2015, the DEA and CDC issued alerts that illegally manufactured fentanyl (IMF) is a threat to public health and safety. This was due to the spike in the number of fentanyl-related deaths in 2014 1.

Fentanyl is extremely dangerous not only to users, but to first responders, as well. This stems from the fact that fentanyl can easily absorb through the skin when it comes in direct contact with it, and it can also be inhaled as a powder. During a field test, police officers reported feeling dizzy and short of breath after coming into contact with a substance containing fentanyl 6.

Fentanyl Overdose

Overdose is a major concern for those abusing fentanyl. While there is an “antidote” treatment helpful in the event of a fentanyl overdose, action must be taken extremely quickly. In many cases, fatal respiratory depression occurs too quickly before help can intervene.

Fentanyl was responsible for more than 700 deaths in the span of one year, and the DEA noted that the actual number may potentially have been higher since many coroners’ offices do not specifically test for fentanyl 6.

In 2014, Ohio reported 514 fentanyl-related overdoses, compared to just 92 in 2013 6.

Fentanyl and money in hand

 Reversing Fentanyl Overdose with Naloxone

Due to rising numbers of overdoses from fentanyl and other opioids, the CDC recommends that law enforcement officers and first responders increase the amount of naloxone they have on hand.

Naloxone (brand name: Narcan) is an opioid antagonist. Naloxone temporarily blocks opioid receptor sites in the central nervous system. Naloxone can reverse the potentially fatal effects of fentanyl. While naloxone doesn’t always immediately reverse an opioid overdose, it can help victims to regain consciousness so they can breathe on their own.

If a person is given naloxone and they slip back into unconsciousness, medical personnel may continue administering the drug so that the person can breathe again. If a person overdoses from a high dose (or multiple doses) of fentanyl, it may require multiple doses of naloxone to reverse the effects.

Naloxone is administered through 9:

  • Intramuscular (IM) route: When naloxone is administered through IM, the effects can take place within 2-3 minutes.
  • Intravenous (IV) route: This is the quickest route of administration. The effects can take place within 1-2 minutes.

Naloxone may also be administered subcutaneously (SQ), should lack of IV access be an issue, or via an endotracheal tube (ET), if airway management has already begun.

There are some reported side effects of naloxone use. Possible side effects can include 9:

  • Acute opioid withdrawal syndrome (if the individual is addicted to narcotics).
  • Vomiting.
  • Non-cardiogenic pulmonary edema (a catecholamine neurotransmitter-mediated shift of fluid from the vascular space to the lungs).

Repeated use of naloxone can be fatal in individuals who develop pulmonary edema.

The CDC and DEA have called for increased access to naloxone, especially among community members. In Ohio, emergency medical services responded to 82% of fentanyl deaths—and there was at least one bystander at the scene in 72% of those cases. Reportedly, only 41% of people who died from a fentanyl overdose received treatment in the field with naloxone 1. Providing better access to naloxone can prevent tragic numbers of fentanyl overdoses.

Laypersons in a Position to Reverse Overdose

People who use drugs, family members, and other “laypersons” are more likely to witness an opioid overdose, and thus may be in a better position to combat high overdose rates. According to a national survey conducted by the CDC, in 82.8% of overdose cases, naloxone is administered by other drug users 13.

Although the number of organizations that provide naloxone kits to laypersons has increased dramatically since 2010 (an 183% increase), 30% of organizations reported trouble keeping an adequate supply, and 54% of organizations reported inadequate resources to expand their naloxone programs and give out naloxone kits 13. In May 2016, the Senate passed several bills that include measures to combat the opioid epidemic—one of which is to expand the availability of naloxone.


Fentanyl and the Opioid Epidemic

In recent years, there has been an increase in the number of prescriptions for opioid painkillers written, as well as the number of overdoses from opioids. According to the CDC, overdose deaths involving opioids have quadrupled since 1999. In 2014, over 14,000 people died from overdosing on prescription opioids like fentanyl 14.

Ambulance services noted that since the mid-90’s, overdoses from prescription painkillers and heroin have been increasing. In the 1980s, ambulance operators in the U.S. may have seen only a few cases each year but are now seeing dozens to hundreds per year 9.

Both prescription and recreational use of oxycodone, hydrocodone, and fentanyl are increasingly common, and the use of heroin is on the rise (partly due to the transition to heroin by many prescription drug abusers)—all contributing to the “opioid epidemic.” According to the 2015 Substance Abuse and Mental Health Services Administration (SAMHSA) nationwide survey, 3.8 million Americans aged 12 or older reported currently misusing prescription painkillers. The survey also found that about 329,000 people were regular users of heroin in 2015 15.

Users of opioids are often on the lookout for an even more potent high, which makes drugs like fentanyl an attractive option, despite its dangers. There have even been reports of people chewing or eating fentanyl patches to receive a stronger high 9.

Are Prescription Drug Companies to Blame?

Some pharmaceutical companies have come under fire for contributing to the opioid epidemic with potentially unethical practices. INSYS (the supplier of Subsys—a sublingual spray formulation of fentanyl) is under investigation for putting profits ahead of patients. Since June 2015, Subsys has brought in $147.2 million in sales.

Subsys is sold as an oral spray, and one package can cost between $900 and $3,000. The oral spray is intended to treat patients with cancer pain; however, former employees of the company have come out publicly about INSYS’s unlawful sales tactics. According to this article in CNBC, the drug company has been marketing Subsys for off-label use and they have even paid doctors to write more prescriptions for the drug 16.


Help for Opioid Addiction

When people use drugs like fentanyl when they are not experiencing pain, they can experience an intense rush of euphoria. When someone continually seeks this euphoric state, it can result in addiction.

Those who struggle with opioid dependence often fear the onset of acute opioid withdrawal, which will inevitably occur when attempting to quit. Withdrawing from fentanyl is seldom life-threatening; however, it can be extremely uncomfortable. The withdrawal symptoms can vary from person to person, but may be quite severe.

Treatment centers offer inpatient and outpatient resources to help individuals who are addicted to fentanyl wean themselves off of the drug safely. Medical supervision during detoxification can help manage withdrawal symptoms and lessen the odds of relapse after leaving treatment.

Inpatient treatment programs often last between 30 and 90 days. If your addiction is severe and your environment is unsafe or full of triggers to use fentanyl, inpatient treatment may be the more appropriate option for you. Inpatient treatment offers access to 24/7 care.

Outpatient treatment is an appropriate option if your addiction is less severe and you think that it is possible for you to live at home while you get treatment. Outpatient programs require that you go to the clinic periodically throughout the week for treatment and therapy. Group therapy is at the crux of outpatient treatment and it can help you create a support network that is drug-free.

Call us today at 1-888-744-0069Who Answers? for help in finding a treatment center that is best for you.


References:

  1. Centers for Disease Control and Prevention. (2016). Increase in Fentanyl-Related Overdose Deaths – Florida and Ohio, 2013-2015.
  2. UptoDate. (2016). Fentanyl: Drug Information.
  3. Drug Enforcement Administration. (2016). Counterfeit Prescription Pills Containing Fentanyls: A Global Threat.
  4. National Institute on Drug Abuse. (2016). Fentanyl.
  5. Centers for Disease Control and Prevention. (2016). Fentanyl.
  6. Centers for Disease Control and Prevention. (2015). Increases in Fentanyl Drug Confiscations and Fentanyl-related Overdose Fatalities.
  7. New York Times. (2016). Drug That Killed Prince Is Making Mexican Cartels Richer, U.S. Says.
  8. United States Department of Justice. (2016). Hundreds of Counterfeit Oxycodone Tablets Seized at Port of Entry Contained Ultra-Deadly Fentanyl
  9. Barker, K., & Hunjadi, D. (2008). Meet Narcan. The amazing drug that helps save overdose patients. JEMS: a journal of emergency medical services,33(8), 72.
  10. Burns, G., DeRienz, R. T., Baker, D. D., Casavant, M., & Spiller, H. A. (2016). Could chest wall rigidity be a factor in rapid death from illicit fentanyl abuse?. Clinical Toxicology54(5), 420-423.
  11. The Guardian. (2016). Safe injection clinic says 90% of clients’ heroin had dangerous drug additive.
  12. Pharmacist’s Letter. (2012). Equianalgesic Dosing of Opioids for Pain Management.
  13. Centers for Disease Control and Prevention. (2015). Opioid Overdose Prevention Programs Providing Naloxone to Laypersons – United States, 2014.
  14. Centers for Disease Control and Prevention. (2016). Prescription Opioid Overdose Data.
  15. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.
  16. CNBC. (2015). The pain killer: A drug company putting profits above patients.

Watch the Fahrenheit With Your Fentanyl

Fentanyl is an opiate (narcotic) pain reliever typically prescribed to people for severe, ongoing pain or after surgery. This medication is 50 times stronger than heroin and, needless to say, it can be very addictive.

Fentanyl can be delivered in many different ways – including IV, intranasal, lozenge, pill and transdermal patch forms. Currently, the most frequently prescribed form of fentanyl (in the US) is the transdermal patch. Patients place one patch an area of the body and it’s worn for a period of up to three days; the medication is absorbed by the skin at a slow, steady pace over those 72-hours.

Too Hot to Handle

Fentanyl’s high potency makes it dangerous, so the dosage needs to be monitored closely and never exceeded. Unfortunately, when using a fentanyl patch, high temperatures can make this process a little tricky.

When you get hot, your pores open to cool your body through sweating. This process increases blood flow to your skin, which results in increased absorption of the drug. It’s a process that can quickly be fatal.

Because of this danger, doctors warn anyone wearing a fentanyl patch to exercise caution in situations that increase body temperature. Our normal skin temperature is just under 90 degrees. If this increases to 102, the fentanyl absorption rate can quadruple in less than 30 minutes!

If you use a fentanyl patch, avoid the following dangerous situations:

  • Hot Weather: Extremely warm temperatures in summer and early fall can easily result in overdose. If you don’t have access to air conditioning, keep your body cooled with fans and loose clothing. And if you’re wearing a fentanyl patch, it’s definitely not the time for sunbathing.
  • Heating Pads: Those struggling with pain often use heating pads for relief, but combining a heating pad with a fentanyl patch can be fatal. The added heat can skyrocket the dosage released. Using a heating pad on other parts of your body (especially if you fall asleep with it on) can also raise your overall body temperature. To play it safe, avoid the use of heating pads or electric blankets.
  • Whirlpools and Saunas: While these pampering luxuries sound inviting, they’re way too hot for anyone wearing a fentanyl patch. Sitting in a hot tub or sauna (or even a long, hot bath at home) quickly raises your body temperature, rapidly elevating the amount of medication in your body. If you get the opportunity to relax in one of these spots, do so when you aren’t wearing the patch.
  • Fever: In some cases, the rise in body temperature might not come from an outside source. When you’re ill, your body temperature increases internally due to fever. Let your doctor know if your temperature increases. Adjustments to your medication need to be made to avoid serious side effects.

Image Source: iStock

Actiq (Fentanyl) Lollipop Abuse

Man suffering from Actiq abuse

ACTIQ is the brand name of a prescription opioid medication that is only to be used for the treatment of breakthrough pain in cancer patients. ACTIQ is only recommended for those patients with cancer who 1) already take and have developed tolerance to another opioid painkiller but continue to have uncontrolled pain and 2) are at least 16 years old 1.

Fentanyl, the active ingredient in ACTIQ, is between 50 and 100 times stronger than morphine.

The active ingredient in ACTIQ is fentanyl citrate 1, a manmade opioid pain medication that is between 50 and 100 times stronger than morphine 2. Fentanyl is prescribed in a number of forms and brand names, including sublingual tablets (Abstral), patches placed on the skin (Duragesic), and injections 2,3,4:

ACTIQ, in particular, uses a novel method to deliver fentanyl to the individual. ACTIQ is an oral transmucosal lozenge on the end of a stick. The fentanyl is combined with inactive ingredients like citric acid or confectioner’s sugar to create a sweet, berry-flavored medication sometimes referred to as 3:

  • Fentanyl lollipop.
  • ACTIQ lollipop.

Special care must be taken when beginning treatment with ACTIQ. It is intended to be used only in cases of unmanaged cancer pain and should not be used within 4 hours of the previous dose 1. Use of this substance outside of these parameters is considered misuse/abuse and may cause an array of health risks and may even be fatal.


ACTIQ Abuse

Prescription drug abuse and addiction is a growing epidemic, with 6.5 million people currently abusing prescription medications and approximately 66% of those abusing opioid pain relievers like fentanyl 5.

The potent narcotic, fentanyl, which used to be relatively unknown, is becoming one of the most talked-about and deadly drugs in this epidemic.

What Does It Mean to Abuse Fentanyl?

Any time an individual takes ACTIQ outside of the strict prescription guidelines, it is considered abuse. This includes 6:

  • Taking more of the substance than prescribed (more often or in higher doses).
  • Taking the substance for reasons other than prescribed.
  • Taking the substance without a valid prescription.

Now commonly referred to as “the drug that killed Prince,” fentanyl produces effects similar to that of heroin but is actually a much more potent drug. These effects include 2,3:

  • A euphoric “high.”
  • Pain relief.
  • Mental and physical relaxation.
  • Drowsiness.

Misusing ACTIQ is incredibly dangerous due to 3:

  • The strength of the substance.
  • The rapid onset of effects.
  • The short duration of effects.

Someone that is abusing ACTIQ may be unprepared for the strength of the substance and experience serious health consequences or overdose, which can cause serious respiratory depression and death 1.


Signs and Symptoms

Aside from the ACTIQ “high” described above, someone abusing ACTIQ may also exhibit the following physical signs and symptoms 1,3,4:

  • Pain.
  • Fever.
  • Weakness.
  • Headache.
  • Indigestion.
  • Diarrhea.
  • Dehydration.
  • Constipation.
  • Sleep changes.
  • Rash.
  • Weight loss.
  • Changes in sexual functioning or desire.

While many of these are normal side effects of fentanyl, if these symptoms arise in someone without a valid prescription or increase in frequency and severity for someone with a prescription, ACTIQ abuse and/or addiction may be present or developing.

ACTIQ abuse may also produce numerous psychological symptoms such as 1,4:

  • Irritability.
  • Anxiety.
  • Depression.
  • Mood changes.
  • Disturbed thoughts and dreams.
  • Psychotic symptoms like seeing or hearing things that are not there.

Serious Symptoms

The most serious side effect of ACTIQ is respiratory depression, which can quickly be fatal; however, other potentially dangerous effects include 1,4:

  • Changes in heart rate.
  • Difficulty swallowing.
  • Confusion.
  • Extreme sedation.
  • Dizziness,
  • Fainting.
  • Seizures.

ACTIQ Overdose

ACTIQ overdose may occur in individuals taking the drug outside prescription guidelines or in those using it recreationally. The risk can be significantly heightened in individuals combining ACTIQ with other substances, especially other depressants such as alcohol or sedatives.

ACTIQ overdose symptoms include 4,7:

  • Slowed or stopped breathing.
  • Blue lips and fingers.
  • Cold, clammy skin.
  • Shakiness.
  • Vomiting.

ACTIQ overdose can be treated with naloxone, but due to the potent nature of the painkiller and the fact that ACTIQ is prescribed to individuals with a baseline opioid tolerance, greater doses of naloxone may be required 2.


Effects of ACTIQ Abuse

Once fentanyl is consumed, it attaches to opioid receptors in the brain 2,6. This triggers the release of a neurotransmitter called dopamine—a physiologic response that underpins many of the positive effects associated with opioids 2.

The artificially high rewards produced by the fentanyl in ACTIQ cannot be matched by natural rewards like food or sex.

A marked sense of reward becomes linked with this dopamine surge, which can lead to the desire, if not an eventual compulsion, to reproduce the sensation. The artificially high rewards produced by the fentanyl in ACTIQ cannot be matched by natural rewards like food or sex 2,6.

With time, ACTIQ use can lead to tolerance, dependence, and addiction.

ACTIQ Tolerance

Like many other drugs of abuse, continued use of ACTIQ can lead to tolerance. When tolerance has developed, the medication can no longer produce the same effects in the user at the same dose 1,6.

It is common for individuals to increase their doses and/or combine the drug with other substances like alcohol to augment the effects, both of which put them at continually increasing risks of drug toxicity, related injury, and death.

ACTIQ Dependence

Over time, an individual may also become dependent on ACTIQ, and their body will require the drug to feel or behave normally. Dependence can occur in those taking the drug as prescribed; however, it is closely intertwined with addiction, as well. Those dependent on fentanyl will need to keep using fentanyl in order to avoid extremely uncomfortable withdrawal symptoms. This pattern of use and avoidance of withdrawal is common to addiction.

Woman laying on couch experiencing Actiq abuse symptoms

ACTIQ withdrawal symptoms include 6,8:

  • Restlessness.
  • Anxiety.
  • Bone and muscle pain.
  • Insomnia.
  • Nausea.
  • Diarrhea.
  • Vomiting.
  • Cold flashes.
  • Higher body temperature.
  • Involuntary muscle twitches.
  • Faster pulse/ higher blood pressure.
  • Sweating.

ACTIQ Addiction

ACTIQ addiction may develop in a shorter amount of time when compared to other opioids due to the strength of the substance. Addiction is marked by the strong desire to consume the substance despite the mounting negative impact of use. Someone addicted to ACTIQ may:

  • Seek out multiple prescriptions from multiple doctors.
  • Not use or dispose of the product correctly.
  • Continue using the drug longer than directed.
  • Encourage others to sell, trade, or obtain the product for them.
  • Have increased conflict with others in their life.
  • Be unable to perform normal tasks and activities of daily living like household chores.
  • Fall behind on bills or report financial trouble.
  • Have noticeable deficits in self-care.

ACTIQ Statistics

According to the National Institute on Drug Abuse (NIDA) for Teens, 19,000 people died in 2014 from overdose of opioid pain medications like fentanyl 7.

The Drug Enforcement Administration (DEA) reports that:

  • More than 20,000 people presented to emergency departments for symptoms of fentanyl abuse in 2011.
  • In 2014, about 3,300 examples of illicitly distributed fentanyl were obtained by law enforcement, which was more than 3 times the amount from the previous year.

Teen ACTIQ Abuse

Teens that abuse prescription pain medications typically acquire the substance from a friend or relative 6. To prevent teen ACTIQ abuse:

  • Keep your prescriptions in a safe place.
  • Track your medication usage.
  • Dispose of all medications appropriately.
  • Educate yourself and your teen regarding the dangers of prescription opioid abuse.
  • Monitor your teen’s behavior and their access to ACTIQ and other medications.
  • Praise your teen for good decision-making.

Resources, Articles, and More Information

For more information, check out the following articles:

To join the conversation, visit our Forum today.


References:

  1. S. Food and Drug Administration. (2011). ACTIQ.
  2. National Institute on Drug Abuse. (2016). DrugFacts: Fentanyl.
  3. Drug Enforcement Administration. (2015). Fentanyl.
  4. U.S. National Library of Medicine: Medline Plus. (2016). Fentanyl.
  5. Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
  6. National Institute on Drug Abuse. (2014). Research Report Series: Prescription Drug Abuse.
  7. National Institute on Drug Abuse for Teens. (2016). Prescription Pain Medications: Opioids.
  8. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.

The F-Word: 3 Fast Fentanyl Facts to Remember

With his heart pounding, Officer Harrison approached the warehouse. His dreams of fighting crime never included this scene. He wasn’t chasing a fugitive; he wasn’t even trying to arrest anyone. The other officers had already taken the dealers down to the station for booking. Harrison simply had to go in and confiscate the remaining drugs.

The problem, however, was there was nothing “simple” about it. Covered from head to toe in a hazmat suit, Officer Harrison was about to come into contact with a huge stash of fentanyl.

The Deadly Rise of Fentanyl Abuse

Officer Harrison’s “level A suit” is the same kind officials used for protection against Ebola contamination. He was pretty confident he’d be safe, but he’d also heard enough horror stories about the power of this drug to make him nervous anyway. The captain’s earlier warnings still echoed in his head:

“Don’t touch it. You can easily absorb fentanyl through your skin or eyes. Just a few grains can kill you.”

Harrison’s captain isn’t alone in his warnings. This scenario is becoming commonplace. Aware of the potency of fentanyl, these hazmat precautions are now standard when law enforcement seize fentanyl.

Fact One: It can be absorbed through the skin…quickly.

Shannon’s doctor prescribed fentanyl patches to relieve Shannon’s breakthrough pain. The cancer had been attacking her body for two years and the pain could be unbearable. Shannon could wear the patch for two days and receive constant administration of the drug. After 48 hours, she threw the patch away.

Nothing seems wrong with this process…until we examine the last step. Shannon simply placed the patch in a waste basket. This might be okay in some situations, but Shannon has two small children and a dog. Discarded patches are still impregnated with the medicine and they’re still highly potent – even if they’re pulled out of the garbage days later. If little Aiden or curious Spot get their paws on the patch, it could be deadly.

Fact Two: Even the FDA has gone out of its way to convince people NOT to abuse fentanyl.

When Tom picked up his fentanyl prescription, he noticed something different on the label this time. On the box was a notice stating the drug had a new black-box warning. Since Tom wasn’t sure what this “black box” thing meant, he asked the pharmacist, who politely provided a medication guide explaining the risks of the drug.

Tom went home and looked up the manufacturer’s website, curious for additional details. His research revealed that the “black box” is the FDA’s strongest warning, and it cautions about the risk of abuse, addiction, overdose and death.

Fact Three: Abusing fentanyl or mixing it with other drugs can be deadly.

Gary was looking for a new, more powerful high. He decided to try fentanyl because he heard it was 100 times more powerful than morphine and 50 times stronger than heroin. He thought he’d hit the jackpot.

What Gary didn’t learn very much about were the potential side effects of fentanyl, including anxiety, dizziness, dry mouth, headache, nausea and vomiting. And he certainly didn’t know about the harsher reactions, like experiencing tightness in the chest, seizures, irregular heartbeat, trouble breathing and death.

Another key piece of information Gary missed was that fentanyl should never be mixed with benzodiazepines. This combo drastically increases the side effects of fentanyl and, unfortunately for Gary, he was already abusing Xanax. Fortunately, Gary’s roommate was home when he overdosed and administered a life-saving dose of naloxone when Gary stopped breathing.

Thousands of others this year haven’t been as lucky.

Image Source: Shutterstock/iStock

Fentanyl Abuse

crushed Fentanyl pill

What Is Fentanyl?

Fentanyl is a synthetic opiate pain reliever. It’s typically prescribed to patients for severe pain or injury, or after a patient has undergone surgery. It works quickly to eliminate any pain in the body. However, it can also be very addictive. Fentanyl is much more potent than heroin and 100x more potent than morphine.

Fentanyl was originally synthesized by Paul Janssen of Janssen Pharmaceuticals in 1960. It works to relieve pain quickly, and its effects don’t last long. Users of fentanyl may experience a state of euphoria and relaxation and may abuse it in attempt to seek these feelings on a regular basis.

There are several methods of taking fentanyl. It is often formed into:

  • Patches.
  • Lollipops.
  • Dissolvable tongue film.
  • Pills that dissolve in the cheek.

Because Fentanyl is frequently administered in a hospital setting, people with easier access to the drug (those working in or around a health care setting) may fall prey to fentanyl addiction. Others may start taking fentanyl as prescribed, but become dependent on it.

Fentanyl is often sought out for illicit purposes due to its powerful pain-relieving and relaxing effects. Fentanyl is sometimes mixed with heroin or cocaine to heighten their effects. Combining these drugs is extremely dangerous, as while the effects are heightened, so are the dangers.

NOTE: Many prescriptions are designed to release their effects over time for safety; however, like many drugs there are ways users manipulate fentanyl to release the effects more quickly, e.g, by adding heat to a fentanyl patch. Doing so is dangerous because it sabotages the slow-release mechanism and can lead to overdose.

Fentanyl Abuse question 2 Fentanyl Abuse question 3

Signs and Symptoms

There are many common signs that someone is abusing fentanyl, as well as symptoms of fentanyl abuse. These signs and symptoms of fentanyl abuse include the following:

  • Confusion.
  • Depression.
  • Difficulty walking.
  • Muscle stiffness.
  • Slowed/altered heart rate.
  • Labored breathing.
  • Weakness.
  • Dizziness, lightheadedness, and fainting.
  • Shaking.

  • Sleepiness.
  • Slurred speech.
  • Weight loss.
  • Visual hallucinations.
  • Nausea and vomiting.
  • Itching & scratching.
  • Pinpoint pupils.

In some situations, fentanyl use can also lead to unconsciousness, coma, or even death.

If you recognize the signs and symptoms of fentanyl abuse in yourself or a loved one, don’t wait to seek help. Call 1-888-744-0069Who Answers? to learn how about addiction treatment and the road to recovery.

Is Fentanyl More Deadly Than Heroin? Fentanyl Abuse question 4

Effects of Fentanyl Abuse

When someone has a long-term fentanyl problem, that person will likely experience several adverse effects. There are serious mental and physical side effects of prolonged fentanyl abuse in addition to the signs and symptoms of abuse listed above.

Physical Effects

  • Severe gastrointestinal problems, including bowel obstruction and perforation.
  • Weakened immune system.
  • Difficulty breathing.
  • Seizures.

Mental Effects

  • Paranoia.
  • Social withdrawal.
  • Lack of motivation.
  • Delusions and personality changes.

Lethal Combinations

When combined with other street drugs like heroin that depress the central nervous system, the user is at increased risk of:

  • Respiratory distress.
  • Coma.
  • Death.
Fentanyl Abuse question 5

Fentanyl Abuse Treatment

Treatment is an essential component of the recovery process from addiction to Fentanyl. Drug addiction treatment involves a number of components typically starting with detox.

Detox

Because fentanyl is both physically and psychologically addictive, a fentanyl addict will experience physical, emotional and mental withdrawal symptoms upon quitting the drug, which can include:

  • Chills.
  • Confusion.
  • Diarrhea.
  • General weakness.
  • Irritability.
  • Joint and muscle pain.
  • Loss of appetite.
  • Restlessness.
  • Shaking and tremors.
  • Stomach pain.

Due to the severity of withdrawal symptoms that may occur, it’s important to work with a qualified medical professional to detox comfortably and safely. Detoxing under the supervision of a qualified professional decreases the risk that the user will stop detoxing and sabotage his own recovery in an attempt to alleviate withdrawal symptoms.

Fentanyl Abuse question 6

Drug Rehabilitation

Drug rehab centers are an effective way to treat fentanyl abuse. However, opiate dependency is a tenacious condition with a high relapse rate and not all treatment centers are equipped to handle fentanyl addiction. Before choosing a rehab center, find out if they understand and are equipped to treat someone with a fentanyl addiction.

Holding hands

In general, there are a wide variety of treatment options for those seeking rehabilitation from drug use. These options include:

Residential rehabilitation programs usually last anywhere from 30 to 90 days — some programs last up to a year when treating severe cases, which opiate addiction tends to be.

12-step programs offer lifetime support for addicts, both those looking to obtain sobriety and those seeking to maintain it.

If you or someone you love is ready to seek help because of fentanyl abuse, we can help. Call 1-888-744-0069Who Answers? to discuss your treatment options.


Fentanyl Statistics

Fentanyl is a highly addictive substance that has many inherent dangers. Note the following statistics:

Opiates to heroin stat (NIDA report)

  • According to the Drug Enforcement Administration (DEA), between 2005 and 2007, fentanyl abuse killed more than 1,000 people in the U.S.
  • According to the American Association of Nurse Anesthetists (AANA) Journal, nurses and anesthesiologists have a higher probability of abusing Fentanyl than the general public.
  • Per the DEA, over 12 varieties of drugs currently being trafficked have been produced illicitly in labs to resemble fentanyl.
  • Per a report by the CDC, those addicted to opiate painkillers are 40 times more likely to abuse or become dependent on heroin.

Teen Fentanyl Abuse

Teens are rarely prescribed fentanyl; however, they may get access to a parent or other relative’s prescription. It’s extremely important to secure all narcotic prescriptions in a locked cabinet or other secure location.

Using a relative’s fentanyl is arguably the most common way a teen can obtain the drug; however, fentanyl is sold on the street in powder form under the street names listed above. Again, it is often mixed with other drugs to increase their effects.

You can help prevent Fentanyl abuse in your teen by:

  • Having a discussion with your teenage children about drug abuse
    • Make sure to underscore the risks of prescription drug abuse.
  • Keeping medicines in a secure, locked location.
  • Keeping tabs on the amount of Fentanyl you have used.
  • Listening for mention of the street names for fentanyl, such as “Tango” or “China white.”

Additional Resources

To learn more about the dangers of fentanyl addiction and how to get help, see the following articles:

You can also visit our DrugAbuse.com Forum to join the conversation about fentanyl addiction and the path to recovery.