What is Fentanyl?
Fentanyl is an exceptionally powerful synthetic opioid painkiller used before, during, and after surgery, and in patients suffering from painful chronic illnesses such as cancer. It is 50 times more potent than heroin and 100 times more potent than morphine in its capacity as an analgesic. Fentanyl has been classified by the DEA as a Schedule II drug – possessing a high abuse and addiction potential but still offering a legitimate medical use - and is available in its licit form by prescription only.
History of Fentanyl
Fentanyl was first synthesized in 1959 by Dr. Paul Janssen of the Janssen Company (based in Beerse, Belgium) as an intravenous analgesic to be used strictly for clinical purposes. Dr. Janssen had long been fascinated by palliatives, and was determined to create a powerful, effective, fast- acting analgesic which would offer relief to those experiencing acute pain.
The two most widely used anesthetics in the mid-1900s were morphine and meperidine – both relatively weak and slow-acting drugs. After years of research and experimentation, in 1957, the Janssen Company introduced phenoperidine to the world as a potent, rapid-acting yet short-lived analgesic. Dr, Janssen and his team continued to investigate and toy with their creation until, in 1960, fentanyl was born – a novel compound which was 10 times more potent than phenoperidine and 100 times more potent than morphine, and far quicker in onset. Its acceptance and medical use grew slowly but surely until it became the most popular and widespread analgesic worldwide, a position it holds until today. [1]
What is Fentanyl used for Medically
Since conception, fentanyl has earned a distinguished place in the world of pain management. It is used to effectively treat severe pain caused by invasive surgery, great physical trauma, or chronic illnesses such as cancer. It operates by binding directly to opioid receptors throughout the central nervous system and interrupting the transmission of pain signals between the body and brain. For many, it provides real and lasting relief from debilitating pain, greatly improving their quality of life. Fentanyl is available in a wide variety of forms – including but not limited to intravenous drips, injections, tablets, sublingual strips, transmucosal lozenges, and transdermal patches. Each is best used in specific situations as each provides a different amount and length of pain relief. For example, fentanyl is commonly administered via injection/ intravenous drip for pain relief before, during and after surgery, while it is best used as a transdermal patch when intended to provide long-term palliative care in chronically ill patients.[2]
What is Fentanyl used for Surgically
A mentioned before, fentanyl is widely used to manage pain before, during and after surgery. It is oft administered in tandem with other anesthetics to hasten and increase sedation during surgery, and then given independently to alleviate pain post-op.
Interestingly, fentanyl has recently been explored as a method of intravenous conscious sedation, a surgical approach now commonly used in simpler outpatient procedures. When given jointly with propofol (another numbing agent), it has proven to manage pain effectively and safely in conscious patients undergoing brief skin and soft tissue surgeries.
A study was conducted in which 20 patients aged 25 – 65 requiring conscious sedation received a standard dosage of fentanyl and propofol. Average onset (of sedation) time was 52.5 seconds, the average procedure length was 40 minutes and 37 seconds, and the average interim until recovery was 3 minutes and 43 seconds. It was concluded that fentanyl used in conjunction with propofol is a safe, fast, and effective method of achieving intravenous conscious sedation.[3]
Benefits and Risks of Fentanyl use
Fentanyl is indisputably one of the most efficacious and practical analgesics that exist today. It has saved millions of individuals from hours of misery and pain, and enabled physicians to successfully perform numerous lifesaving procedures while ensuring the patient’s comfort and safety. It is largely safe, rapid-acting and effective, and available in many practical forms.
That said, there are several pitfalls and dangers that accompany this wonder drug. In a worrying turn, patients who have been prescribed regulated doses of fentanyl by responsible physicians have been reported to develop dependence and even addiction to the opioid. Although administered for legitimate reasons, in a controlled environment, when taken for too long it can desensitize patients and saddle them with a crippling dependency. Many patients who had zero history of substance dependence or abuse began abusing narcotics (specifically fentanyl) after receiving fentanyl in a hospital setting for legitimate pain relief purposes.[4][5]
Additionally, as with any powerful opioid, fentanyl has been widely exploited by the world of substance abusers and drug dealers and has wreaked an unprecedented trail of pain and destruction across society. Thousands of licit fentanyl prescriptions are diverted for recreational use each year, and hundreds of home-grown fentanyl labs have sprung up as well. Fentanyl is the favorite child of almost every drug creator, dealer, and user due to its possession of a few precious charms: It is easy and cheap to produce, has no identifying scent and taste, and is exceptionally potent even in tiny amounts. It is readily found on the street in its pure form and can be found laced into virtually every common drug. Fentanyl overdose deaths have spiked terrifyingly in recent years and constitutes a silent epidemic which continues to claim countless precious lives.
Fentanyl is a powerful tool which can either be constructively used or abused. If you or a loved one has developed a fentanyl dependence or addiction, don’t suffer in silence! At Avenues Recovery, we treat people with Fentanyl addictions every day, and we help them find lasting recovery. Reach out today to find out how we can help you and set you on your journey home.
Sources
[1] jpain.org
[5] nida.nih.gov