What side effects does fentanyl have? Side effects are typical of all opioids, except that fentanyl is far more potent. Fentanyl is a synthetic opioid analgesic first created by master chemist Dr. Paul Janssen in 1959. At first, through the 1960s or so, the drug was only used in a hospital setting for extreme pain and as a surgical pain reliever and anesthetic induction agent. In the 1990s, fentanyl became more available for pain relief in the form of a skin patch that gradually released the drug over a period of three days.
Fentanyl is highly addictive and very powerful. It’s about 100 times stronger than morphine and 30 to 50 times more potent than heroin. In fact, it’s so strong that the dose is in micrograms, not milligrams. A microgram is one-millionth of a gram. That’s like taking a quarter teaspoon of salt and trying to divide it into one million little piles. Its power is hard to truly understand. Not surprisingly, the drug is responsible for many overdose deaths, from both pharmaceutical fentanyl and that smuggled into the United States from rogue labs mainly located in China.
Recently, “one-pot” methods of making the drug at home, literally in a kitchen, have surfaced on the internet. Even if this synthesis is successful, there is still the problem of dosage of such a powerful drug. Without laboratory analysis, there is no way to be sure of either potency or purity. Dangerous unreacted compounds could also be present. Those who failed to learn the lesson of irreversible brain damage from the MPTP disaster of the early 1980s may very well find themselves victim of the same thing. Without the proper knowledge and equipment, it’s well-nigh impossible to safely prepare such a powerful drug for accurate dosing.
Forms of Fentanyl
Fentanyl has a very short half-life and period of activity. It’s broken down quickly by the body, so quickly that it cannot be taken by mouth with much duration of effect. Fentanyl is particularly vulnerable to the first-pass effect. This refers to the liver’s actions on a drug taken by mouth. All drugs taken orally must pass through the liver before going anywhere else in the body. The liver clobbers the fentanyl especially well, leaving a bare 20 percent of the ingested dose to go on to the brain and bind to the opioid receptors located there. Fentanyl is available in the following dosage forms:
- Skin patch
- Sublingual tablets and spray
- Oral lozenge
- Nasal spray
- Buccal tablet
Oral lozenges, sublingual and buccal tablets all deliver the drug through the oral mucous membranes, helping to reduce the first-pass metabolism by the liver. The nasal spray has an excellent bioavailability of almost 90 percent, meaning only 10 percent of the dose is lost when it’s taken by the nasal route. Injectable fentanyl, such as that for intravenous use, is mostly restricted to hospitals, particularly for surgery and certain outpatient medical procedures.
Fentanyl Side Effects
The side effects of fentanyl are similar to those of any opioid but are typically more intense:
- Respiratory depression
- Drowsiness and sedation
A fatal dose of fentanyl for someone without an opioid tolerance is a mere 2 to 3 millligrams, about the same as two to three grains of salt. Even regular opioid users with an opioid tolerance high enough to protect them against overdose for weaker opioids can still fatally overdose on small amounts of fentanyl.
Fentanyl is an important tool in surgery and for the treatment of cancer pain and other intractable types of pain, but its casual use is dangerous and can easily lead to death. Even worse, the drug is appearing in black market sales of other opioids, particularly oxycodone. Dealers press pills to resemble the prescription product, but they really contain unknown amounts of fentanyl. Users then overdose on the pills because they don’t know they’re actually taking a far more powerful drug than what the pill represents.
Call us for Help
If you or a loved one has a problem with fentanyl, you need to seek help right away. It takes very little of this drug to kill. We’re a group of professional drug counselors offering hope and help. Just call us at 302-842-2390 anytime for a referral to the best drug treatment available in your area.