Fentanyl Abuse and Addiction

Fentanyl is a strong synthetic analgesic which belongs to the class of opioids. The drug has a chemical similarity with morphine but it is many times stronger than it. The potency of Fentanyl is fifty to hundred times more than the morphine. It is a schedule II drug which is prescribed to treat the patients with a severe pain. The pain of surgery is managed with Fentanyl.  The chronic pain of various cancerous diseases is also treated with it. Trade names of the drug include ‘Actiq’, ‘Sublimaze’ and ‘Duragesic’. Fentanyl has a high potential for abuse and the addiction. The drug is used for the medicinal purposes but the euphoric effects of the drug have led to its wide misuse by the people. It is a very notorious street drug. The 2015 statistics of USA showed that about 9,580 people died from drug overdose, Fentanyl was one of those drugs contributing a greater percentage of death from overdose.

It is a synthetic painkiller which has a chemical structure similar to meperidine. It is prescribed by the doctors for the severe pain management. The reputation of the drug as an effective painkiller has contributed to its use for relieving the pain of resistant stages of terminal cancer. The high euphoric effect of the drug is one of the reasons for its abuse and addiction. Just like other Schedule II drugs, Cocaine, Vicodin, OxyContin, and Adderall, it is an extremely dangerous substance and isn’t prescribed by the doctors unless there is an extreme need of the drug. The pain of a critical disease that can’t be relieved with the other non-narcotic analgesics is then treated with Fentanyl. The different formulations of the drug available are:

• Intravenous
• Skin patch
• Dissolving Tablet
• Oral Lozenges
• Sprays, mouth and nasal

The different street or slang names given to Fentanyl include:

• Apache
• China White
• China Girl
• Dance Fever
• Cash
• Goodfella
• Friend
• Murder 8
• Jackpot
• Tango
• TNT

Fentanyl works in a way similar to the other opioid drugs. It binds to the opioid receptors which are present in a region of the brain. The opioid receptors are responsible for controlling the pain sensations and the related emotions. When the Fentanyl binds to the opioid receptors, it increases the levels of dopamine in the brain. The brain reward center gets activated and the feelings of relaxation and euphoria are initiated. Opioid receptors are also present in the areas of respiratory control centers. Fentanyl abuse can lead to complete cessation of breathing which is a fatal condition.

The IV form of Fentanyl is used for the anesthesia. During the anesthesia, Fentanyl is combined with other hypnotics like Propofol. The drug is also combined with Benzodiazepines for the procedures like endoscopy, oral surgeries, and cardiac catheterizations. It causes sedation and reduces the pain of these procedures. The chronic pain of cancer is often managed with Fentanyl. The drug is also given intrathecally for the spinal anesthesia. Fentanyl can also be administered in the epidural space for the epidural analgesia.

Fentanyl is an extremely potent drug so even exceeding a little amount from the prescribed doses can be fatal. The dosage of the drug varies between the patients according to their genetic makeup and the pain management needs of the person. Even the doses of 0.25mg can be deadly for some individuals. The usual prescribed doses of Fentanyl for the pain management are 25 – 100mcg. The clinical or medicinal use of the drug isn’t even safe from the side-effects. So caution and proper monitoring are necessary even with the prescribed doses.

Fentanyl is a highly addictive drug. The therapeutic doses of the drug can also cause the addiction. It causes the feelings of euphoria by activating the reward centers. The brain produces the sensations of intense happiness, relaxation, and satisfaction. These feelings are highly addictive that force the person to keep abusing the drug. The continued abuse of Fentanyl leads to the development of tolerance within a few weeks duration. A person will require the higher amounts of the drug to produce the similar euphoric effects. The development of ‘Tolerance’ can be regarded as an early sign of addiction. The chances of addiction increase when the drug is snorted or injected intravenously. The Fentanyl addiction develops within a short duration. Psychological dependency can develop even with the first intake of the drug. However, a number of doses are required to develop the physical dependency.

Fentanyl is combined with the other drugs to achieve a better High. The most common combination is with heroin and is called as ‘bomb’ or ‘magic’. It is also combined with cocaine and methamphetamine. These combinations are very dangerous and can prove to be fatal. Fentanyl is mostly crushed in a fine powder form to snort or inject the drug, which increases the risk of life-threatening problems like respiratory arrest and coma.