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Fentanyl – The Upsurge in the Opioid Crisis

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With opioids making daily headlines for the past four years it might be possible to become immune to the severity of the problem. But the problem persists and in fact, has become more deadly.
And now, a synthetic opioid—fentanyl—has come to the forefront as the leading killer in the class of opioids.

The National Vital Statistics Reports announced on Wednesday, December 12, 2018, that fentanyl is the deadliest drug in America, responsible for more than 18,000 deaths in 2016, the first year in which such statistics are available. That same year, synthetic opioids were the cause of more than 50% of all opioid-related deaths.
By definition, opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.

What makes fentanyl so alarmingly powerful is its potency. It is similar to morphine but 50 to 100 times more potent. Originally developed for its pain killing ability, it’s side effects include
euphoria, drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma, and death.

Fentanyl as Prescribed

As a painkiller, it is delivered in the form of transdermal (topical) patches, as a shot or a lozenge. It is particularly effective because it works around the clock for extreme on-going pain or pain after surgery. As a commonly abused illegal drug it can be swallowed, injected or snorted.

Fentanyl was developed in 1960 and later that decade became a prescribed as an anesthetic. It has been widely prescribed in cases of extreme pain, but the name was first known by most Americans related to the death of rock star Prince in April 2016. The cause of Prince’s death is still being investigated although his toxicology report showed the amount of fentanyl in his system at the time of death was “exceedingly high.” Fentanyl was also cited in 2009 as a possible contributor to the death of Michael Jackson.

Several things make fentanyl particularly frightening, especially in its “recreational use.” How much fentanyl it will take to get high, or cause an overdose, depends upon the person, their metabolism and their resistance to opioids. Fentanyl is also being laced into cocaine, heroin and other drugs making them more desirable among those who want the most for their illegal drug dollar. There’s an inherent and deadly problem with this: neither the person selling it, nor the person using it, know the exact composition of what they’re selling or using.

Even cocaine which the National Center for Health Statistics reported was waning in popularity has experienced an uptick in overdoses largely due to the prevalence of fentanyl in what is being bought on the streets.

Treating Fentanyl Use Disorder

In the wake of the bad news regarding the physical and psychological damage of fentanyl addiction, it is able to be treated.

First, the best defense is prevention. Within the medical community, there is heightened awareness and education to prevent dependence.

Second, those who’re taking fentanyl legally or illegally must recognize the signs and symptoms of abuse, which can occur even if a person has been prescribed fentanyl by a physician. They may include confusion, depression, difficulty walking, muscle stiffness, labored breathing, slurred speech, weight loss, weakness, and visual hallucinations. The mental side effects include paranoia, social withdrawal, lack of motivation, delusional behavior, and extreme personality changes.

Third, consult a physician promptly if you detect a fentanyl problem.

And lastly, follow the medical protocol precisely after the evaluation. A physician is likely to recommend opioid replacement therapy, closely monitored, for approximately two weeks to overcome the physical and psychological effects of dependence or addiction. Other elements of treatment will be prescribed and should be followed.

Addiction Is Not a Decision

It’s estimated that more than 100 million Americans suffer from ongoing pain which might make them a candidate for a fentanyl prescription. The most common reasons are lower back pain and neck pain. A person can be prescribed fentanyl, take it precisely as prescribed and still experience dependence.

The key to treatment is immediate consultation with a physician and strict adherence to their recommended course of action.