America’s opioid crisis is the unwanted gift that keeps on giving.
With newer, synthetic versions of typical street drugs burgeoning through communities, availability soars and the opioid epidemic worsens. One of the opiate offenders is fentanyl – a synthetic pain reliever – which works quickly to eliminate sources of severe pain or injury in the body.
A close cousin of heroin, fentanyl is extremely potent. According to Centers for Disease Control and Prevention (CDC), between 50-100 times more potent than heroin or morphine. Even in relatively small doses, fentanyl can kill.
The drug has flooded the marketplace as street dealers and international cartels have discovered that it delivers heroin’s high at a fraction of the cost. The result: fentanyl is poised to become the catalyst for spiralling opioid addiction in the United States.
Fentanyl was originally used as an anesthetic for patients, but was found to be effective for pain in small doses and often used to prevent extreme pain after surgery or surgical procedure. Because of its original use, fentanyl is regarded as one of the strongest opiate drugs on the market.
Administered in a variety of ways such as a skin patch, injection or orally through a ‘lollipop’, fentanyl acts on the same receptors in the brain that painkillers, like oxycodone or morphine, and heroin, do. However, the difference in strength between heroin and fentanyl is due to their chemical structures. The chemicals in both bind to the opioid receptors in the brain. But fentanyl reaches the brain faster than morphine – morphine being the broken down by product of heroin.
The strength of fentanyl, makes it extremely popular, and therefore profitable for dealers. But it also makes it extremely dangerous for users, whether they intended to use the drug or not. Unintentional use can occur as increasingly heroin is cut with fentanyl, so someone who thinks they are using heroin, may in fact be taking a deadly cocktail of a drug seemingly similar, yet stronger. More recently, pills made to look like the painkiller oxycodone or the medication Xanax have been found to contain fentanyl.
The dichotomy is that while many are completely unaware of what it is they are purchasing, or from where, not everyone is quite so naive in that some users actually seek fentanyl, again due to its heightened sensations and as part of the way addiction manifests itself into chasing that next high.
The CDC reported that most fentanyl-related overdoses and deaths are linked to an illicit version of the drug that’s often mixed with heroin or cocaine. In March 2015, the Drug Enforcement Administration (DEA) issued a national alert classifying fentanyl as a threat to health and public safety. In some states, accidental deaths are surpassing the number of deaths from heroin abuse.
The problem is that just a few hundred micrograms is enough to trigger a euphoric sensation tantamount to the physical and mental effects of heroin. This means the line between euphoria and fatal overdose is alarmingly flimsy. For example, an amount of fentanyl the size of two grains of salt can easily kill a healthy average-sized adult male.
Drug users up and down the country are inadvertently taking deadly doses of the substance. In addition, while dealers try to include fentanyl to improve potency, measurement isn’t always accurate, again paving the way to possible overdose. Plus, the fentanyl sold on the street is less pure than the pharmaceutical version, and thus its effect on the body is unknown.
By all appearances, heroin and fentanyl look identical, and with drugs purchased on the street, it’s impossible to know exactly what you are putting into your system. Since fentanyl is often sold to clueless buyers as heroin, prescription painkillers or even Xanax, it is a stealth killer.
A person overdosing on fentanyl may present with the following overdose signs and symptoms:
- Pinpoint pupils
- Dizziness and confusion
- Extreme sleepiness
- Loss of consciousness
- Profoundly slowed heart beat
- Dangerously low blood pressure
- Slowed or stopped breathing
- Bluish tint to nails and lips
It is important to note that if a user survives a fentanyl overdose, long-term 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 as a result of lack of oxygen.
If you suspect an overdose may have occurred, it is important to get emergency medical assistance immediately. Although fentanyl is an opioid class, Naloxone (known by its trade name, Narcan) which usually counteract the effects of an opioid overdose, may not work quite so easily. Naloxone easily knocks morphine off of the receptor, but does that less so to fentanyl.
In the longer-term, 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 in a drug rehab center.
However, opiate dependency is complex with a high relapse rate. Before choosing a rehab, find out if they understand and are equipped to treat someone with a fentanyl addiction.