What is Fentanyl?

• Fentanyl is a FDA approved schedule II prescription narcotic.
• It is 50 to 100 times more potent than morphine and 30 to 50 times more potent then heroin.    
• Fentanyl is usually prescribed to treat patients for pain management after surgery or people in chronic/severe pain who are physically tolerant to other pain medication. 
• Medical fentanyl is administered by injection, transdermal patch or in lozenge form. 
• Fentanyl was first synthesized in the late 1950’s in Belgium.  In the 1960’s it was introduced into medical practice but it wasn’t until the 1990’s that it became available in patch form.  The first generic version of the patch became available in 2005. 

 Fentanyl Patch

• The fentanyl patch is a clear patch that transfers a controlled dose of fentanyl through the skin into the bloodstream over a 72 hour period. 
• Duragesic was the first fentanyl patch.  It was made by the company Johnson & Johnson.  According to Pacific Law Center in La Jolla, California, Duragesic sales more than tripled from 2000 to 2004.  According to Johnson and Johnson website, worldwide sales were more than $2 billion in 2004.  Half of those sales were in the United States. 
• According to IMS Health, more than 5.7 million prescriptions were written for Duragesic patch in 2003. 

 Fentanyl Patch Abuse/Misuse

Since the government has made it more difficult to obtain other prescription painkillers such as OxyContin, addicts maybe turning to fentanyl patches. 

• According to the FDA patients should avoid excessive heat.  Excessive heat will release fentanyl from the patch and increase absorption through the skin which can result in fatal overdose.  The FDA also reports fentanyl as having “a high potential for risk of fatal overdose and for abuse and diversion from legitimate medical use”. 
• According to Bruce Goldberg, Ph.D, director of toxicology and an associate professor in the department of pathology, immunology and laboratory medicine and psychiatry in UF’s College of Medicine, “We have seen an increased use and abuse of the patch form of fentanyl for the past five years or so.” 
• Fentanyl addicts will often abuse the drug in the following ways…
  • Eating or sucking on a patch.
  • Applying multiply patches at one time.
  • Extracting the drug from a patch by mixing it with an alcohol solution and injecting it with a hypodermic needle. 
  • Fentanyl users need to be cautions of their discarded patches.  Abusers may attempt to obtain discarded patches and it could be dangerous to young children should they come in contact with them. 

 Effects

Fentanyl works like heroin, morphine, and other pain management drugs.  It binds to the body’s opiate receptors that control pain and emotion.  When fentanyl or any opioid drug binds to the receptors, dopamine levels in the brains rewards areas are increased causing a state of euphoria and relaxation.  Euphoria, drowsiness, respiratory depression (weak or shallow breathing), nausea, severe weakness, confusion, constipation, sedation, unconsciousness, coma, tolerance, addiction, and death are some of the effects of fentanyl abuse/misuse. 

 Fentanyl Names

• Brand/Commercial Names
  • Duragesic ®
  • Sublimaze ®
  • Actiq ®
  • Fentora ®
• Street Names
  • Apache
  • China Girl
  • China White
  • Friend
  • Patches
  • Dance Fever
  • Goodfella
  • Jackpot
  • Murder 8
  • TNT
  • Tango and Cash

Fentanyl Statistics

• According to the New York State Department of Health over 68,000 patients in NYS received prescriptions for fentanyl in 2006. 
• According to the U.S. Department of Health and Human Services emergency-room visits by people misusing fentanyl shot up to 8,000 nationwide between 2000 and 2004. 

 Non-Medical/Illicit Fentanyl

Drug Enforcement Agents have reason to believe that non-pharmaceutical fentanyl is being manufactured in clandestine labs in Mexico and elsewhere.  Non-pharmaceutical fentanyl has been mixed with heroin and cocaine and sold as street drugs, often causing fatal consequences. In 2006, the Department of Health issued a Health Advisory regarding fentanyl-related overdose deaths.  Illicit fentanyl was laced with heroin and cocaine and was responsible for over 1,000 deaths across the nation.      

Signs of Fentanyl Abuse/Misuse

If you know someone who is using fentanyl these may be some of the signs of abuse/misuse…

• Nausea/Vomiting
• Stomach Pain
• Constipation
• Dizziness
• Drowsiness
• Headaches
• Swelling
• Unconsciousness

If your fentanyl prescription is lost or stolen you are required to report it to the 
                                             Bureau of Narcotic Enforcement.

Sources:
About.com. Alcoholism (2005, July 07). Fentanyl Pain Patch Abuse Can Be Deadly. Retrieved from http://alcoholism.about.com/od/prescription/a/bluf050706.htm

CADCA. (2008, July 24). New Report Reveals More Than 1000 Died From Illegal Fentanyl Use. Retrieved from http://www.cadca.org/resources/detail/new-report-reveals-more-1000-died-illegal-fentanyl-use

DEA. Fentanyl. Retrieved from http://www.justice.gov/dea/concern/fentanyl.html

DOH. (2008, January 24). Important Health Advisory: Safety Warnings Regarding Use of Fentanyl Transdermal Patch. Retrieved from http://www.health.ny.gov/diseases/aids/harm_reduction/opioidprevention/docs/fentanyl_alert.pdf

 Drug Addiction.  McBride, Hugh C. Abuse of High-Potency Fentanyl Skin Patches Linked to Hundreds of Deaths. Retrieved from http://www.drug-addiction.com/fentanyl_abuse.htm

MSNBC. (2006, June 15). Rising deaths blamed on painkiller patch abuse. Retrieved from http://www.msnbc.msn.com/id/13344990/ns/health-addictions/t/rising-deaths-blamed-painkiller-patch-abuse/#

NIDA. Fentanyl. Retrieved from http://www.drugabuse.gov/drugs-abuse/fentanyl

The Partnership At Drugfree.org. (2011). Prescription and Over-the-Counter Drug Guide. Retrieved from  http://www.drugfree.org/wp-content/uploads/2011/09/drug-guide-2.pdf