In spite of all efforts, the opioid epidemic is growing to the point where the powers that be don’t know how to move forward. Some communities are hit harder than others, and local municipalities are collapsing beneath the weight of dozens of overdoses every day and the cost of medical treatment for addiction. Most importantly, more people are struggling with addiction than their communities can handle. Some have even decided to sue pharmaceutical companies that provide prescription opioids that sometimes lead to addiction. However, there are a lot of factors that have contributed to the rapid growth of the opioid epidemic, but recently, one thing has ramped up overdoses exponentially.
Fentanyl is a synthetic opioid that’s cheaper than heroin and much more powerful. Chronic heroin users can still take a dose of fentanyl and begin to overdose. The problem of fentanyl overdose has dramatically inflated the overall overdose death rates in the United States. But what makes fentanyl so deadly?
What Is Fentanyl?
Fentanyl is a synthetic chemical that binds to opioid receptors in the brain to produce pain relief and relaxing effects. It’s used in medical settings to ease severe pain symptoms, but it’s also used recreationally to produce feelings of euphoria and deep comfort. However, it’s about 50 times more potent than heroin and 100 times more powerful than morphine, both powerful opioids in their own right.
Fentanyl can be taken intravenously, transdermally (through the skin), by insufflating, inhaling, and ingestion. Intravenous injection and transdermal patches are the most common and most potent.
Fentanyl was synthesized in 1960 and quickly made its way into medical use as a general anesthetic. It was widely used in the 60s intravenously and later as a transdermal patch in the 1990s. Though there are cases of fatal overdose through illegal use of prescription fentanyl, much of the current illicit abuse comes from illegally produced fentanyl. In 2015, the most current count available, over 52,000 people died from a drug overdose, and 33,000 of those deaths were due to opioid abuse. Each year, the death toll grows, and the U.S. Centers for Disease Control and Prevention points to fentanyl and other synthetic opioids as the chief cause of the increase.
How Fentanyl Works
Fentanyl, like other opioids, works primarily on the brain and central nervous system by binding to opioid receptors as an agonist, which means it increases the activity of that receptor. Opioid receptors produce pain-relief, sedation, lowered blood pressure, euphoria, nausea, and decreased respiration. After prolonged or heavy use of an opioid, your brain will build a tolerance to it and begin to depend on the chemical to regulate brain chemistry. It will take more substantial or more frequent doses to achieve the same effects, and if you stop, you’ll experience uncomfortable withdrawal.
Fentanyl’s power comes from its lipophilicity, or its ability to be dissolved in fats. This allows it to penetrate the blood-brain barrier and enter the central nervous system more easily than some other opioids. It’s fast-acting and can begin to take effect within five minutes of its administration. This makes it useful as a pain reliever in situations that requires quick management of extreme pain, like emergency rooms.
Fentanyl can also be efficiently absorbed through the skin, which is what makes patches an effective means of administration. It has a high transdermal bioavailability, which means that 92 percent makes it through the skin and into your system. As a powerful opioid, it has a very high dependence liability and can quickly lead to addiction if abused.
Who Uses Fentanyl?
Though fentanyl is an extremely potent drug, it is still used in medical settings for fast-acting pain relief. It can also be used with other sedatives, like benzodiazepines to induce sleep for quick or simple procedures like endoscopy, oral surgery, or emergency room scenarios. It’s sometimes used to manage chronic or long-lasting pain. Normally, a dose of fentanyl will only last for about an hour. However, the patches release fentanyl slowly over a longer period, for pain management. It can be used during labor as an epidural anesthetic. Since timing can be unpredictable in labor, strong fast-acting pain relief is useful.
Recreational users typically gain access to fentanyl through illegal production. It is relatively easy to make and cheap to buy. Some opioid users seek out fentanyl for a more intense high, but many take the drug without knowing until it’s too late. Since it’s so cheap, dealers use it to cut heroin and other more expensive illicit drugs.
Where Does Fentanyl Come From?
China is currently among the chief sources of fentanyl that’s shipped to North America. Clandestine Chinese laboratories have even created their own variations of the chemical, the most famous being a street drug known as “China White.” Since it’s so potent, even in tiny amounts, packages can be small and hidden in decoy packages like iPhone boxes, or even silica packets. The image of the back alley drug deal may no longer be very accurate. As with other synthetic designer drugs, it can be sold online and delivered by mail.
Why Fentanyl Kills
Fentanyl comes with a host of adverse effects including nausea, constipation, drowsiness, dizziness, and confusion. However, like other opioids, it has the potential to cause respiratory depression during overdoses. Opioid receptors are responsible for slowing breathing when activated, and fentanyl has shown to produced longer episodes of slow, shallow breathing when compared to other opioids. Respiratory depression can lead to medical complications like hypoxia, which can damage the brain. Overdose can also lead to unconsciousness or coma.
Fentanyl’s danger comes from its availability as much as its chemical composition. The fact that it’s cheap and easy to buy makes it more available than less volatile illicit drugs. Cutting heroin and other drugs with fentanyl is a major cause of opioid overdose. Heroin is active at five to seven milligrams, and regular users can take up to 35 milligrams. Fentanyl is active at five micrograms, and anything over 100 micrograms is an extremely heavy dose. It’s more difficult to measure dosage bellow a single gram accurately. Dealers who increase profits by cutting heroin with fentanyl dramatically increase the lethal dose potential of their product.
The fentanyl problem is growing. Last year the pop music icon, Prince is believed to have fatally overdosed on fentanyl which he self-administered to deal with hip pain. But it doesn’t take rock-star clout to get your hands on this potent, deadly drug.
Getting Out of Addiction
The best way to avoid the adverse effects of accidental fentanyl overdose is to get out from under the cycle of opioid addiction. If you, or someone you know, is caught in a pattern of addiction, call California Highlands at 888-969-8755 to learn more about detox and treatment options.