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Strong pharmaceutical opioid pain reliever

Schedule II drug

Approved for treating severe pain, esp. cancer pain

Abuse and overdose are commonly related to illegally made fentanyl

Illegal fentanyl is often mixed with heroin or cocaine to increase effects

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Schedule II Drug

Synthetic

Opioid

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Fentanyl is used for treating extreme pain,  It is extremely powerful; up to 100x more powerful than morphine.

It has been used to relieve pain from contractions during childbirth, tooth extractions, and surgery, but the main use is for treating breakthrough pain in cancer patients.

It is used in many forms: transdermal patches, injections, oral lozenges, and lollipops.

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Illegal fentanyl is sold in several forms: as a powder, spiked on blotter paper, mixed with heroin, tablets. Sometimes lollipops are sold on the black market.
The drug can be ingested, injected, and absorbed.

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Actiq
Duragesic
Sublimaze
Fentora

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Analogs are the result of tinkering with the chemical compound to make stronger or other variations of the drugs.
Fentanyl has several analogs, all of which are produced illegally and classified as Schedule I controlled substances, so they have no medical use.

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Fentanyl N-(1-(2-phenethyl)-4-piperidinyl-N-phenyl-propanamide

C₂₂H₂₈N₂O

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Generic Name: fentanyl (injection) (FEN ta nil). Brand Name: Sublimaze
Brand names of other fentanyl dosage forms include: Abstral (sublingual tablet), Actiq (lozenge or "lollipop"), Duragesic (transdermal patch), Fentora (buccal tablet), Ionsys (transdermal device), Lazanda (nasal spray) and Subsys (sublingual spray).

What is fentanyl?

Fentanyl is an opioid medication. An opioid is sometimes called a narcotic.

Fentanyl is used as part of anesthesia to help prevent pain after surgery or other medical procedure.

Fentanyl may also be used for purposes not listed in this medication guide.

Important information

You should not receive this medicine if you are allergic to fentanyl or other narcotic pain medicines.

It is very important that you are monitored closely by your doctor when receiving fentanyl injection. This will allow your doctor to determine whether it is working properly and if you should continue to receive treatment.

Check with your doctor right away if you or your child have bluish lips or skin; chest pain; difficulty with breathing; a fast, pounding or irregular heartbeat or pulse; shortness of breath; or muscle stiffness after receiving fentanyl.

MISUSE OF NARCOTIC MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Before taking this medicine

You should not receive this medicine if you are allergic to fentanyl or other narcotic pain medicines.

Some medicines can interact with fentanyl and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure fentanyl is safe for you, tell your doctor if you have:

any type of breathing problem or lung disease;

history of head injury or brain tumor;

liver or kidney disease;

slow heartbeats;

if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others); or

if you have used an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine) in the past 14 days.

It is not known whether fentanyl will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether fentanyl passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is fentanyl injection given?

Fentanyl is injected into a muscle, or into a vein through an IV. A healthcare provider will give you this injection as part of the anesthesia given for your surgery or medical procedure.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving fentanyl.

You may be given other pain medications to use after your fentanyl treatment is discontinued.

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Since fentanyl is given as needed by a healthcare professional for only a short time, you are not likely to be on a dosing schedule.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving fentanyl?

Fentanyl can cause side effects that may impair your thinking or reactions. You should not plan on driving or doing anything that requires you to be awake and alert right after you are treated with this medication. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid drinking alcohol for several hours after you receive fentanyl.

Fentanyl side effects

Get emergency medical help if you have any signs of an allergic reaction to fentanyl: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Like other narcotic medicines, fentanyl can slow your breathing. Death may occur if breathing becomes too weak.

Your caregivers will watch for any side effects you have, which may clear up within minutes after stopping the fentanyl infusion or decreasing the dose:

Common fentanyl side effects may include:

slowed breathing;

slow heart rate;

muscle stiffness;

dizziness, vision problems;

nausea, vomiting;

itching, sweating; or

high blood pressure (confusion, anxiety, pounding in your neck or ears).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect fentanyl?

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

other narcotic medications - opioid pain medicine or prescription cough medicine;

drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or

drugs that affect serotonin levels in your body - medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with fentanyl, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your doctor or pharmacist can provide more information about fentanyl.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use fentanyl injection only for the indication prescribed.

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2018 Cerner Multum, Inc. Version: 8.04. Revision Date: 2016-09-30, 10:26:01 AM.

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fentanyl side effects pain narcotic anesthesia

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Fentanyl: Uses, Dosage, Side Effects & Warnings - Drugs.com

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Generic Name: fentanyl (injection) (FEN ta nil). Brand Name: Sublimaze Brand names of other fentanyl dosage forms include: Abstral (sublingual tablet), Actiq (lozenge or "lollipop"), Duragesic (transdermal patch), Fentora (buccal tablet), Ionsys (transdermal device), Lazanda (nasal spray) and Subsys (sublingual spray). Fentanyl is an opioid medication. An opioid is sometimes called a narcotic.

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Street Names for Fentanyl or Fentanyl-Laced Heroin

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Street Names for Fentanyl or Fentanyl-Laced Heroin

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Apache
China Girl
China White
Dance Fever
Friend
Goodfella
Jackpot
Murder 8
Tango
Cash
TNT

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Euphoria

Drowsiness/Sedation

Nausea and Constipation

Confusion

Respiratory depression/arrest

Addiction or Tolerance

Coma and Death

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The drug binds to the body's opioid receptors in areas of the brain that control pain and emotions. When bound to these receptors, it can increase the production of dopamine, the cause of the "rewarding" feeling. The sharp increase creates a sense of euphoria and relaxation. Like many other drugs, this is the desired effect on the user and can cause an addiction.

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Fentanyl's extremely high potency poses a greater risk of overdose.

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While teens may not be actively looking to take fentanyl, even a small dose can be fatal, and some street drugs like heroin are laced with the drugs, so teens procuring other drugs may be consuming fentanyl unknowingly.

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The dangers of the prescription pain medication fentanyl came into the collective public eye when Prince suddenly passed away due to an overdose last April. Fentanyl is the strongest prescription opiate pain killer on the market and is 30 to 50 times more potent than heroin. Research has shown that as little as ¼ milligram of fentanyl can lead to a fatal overdose. ¹ To put that into perspective, a standard ibuprofen tablet contains approximately 250 mg, which is 1,000 times the amount of the fentanyl dose that could take a person's life.

Though it has been on the market for years, fentanyl is now fueling a steady rotation of news headlines, and its startling, undeniable potential to cause widespread injury and death has prompted both the Drug Enforcement Agency (DEA) and the Centers for Disease Control and Prevention (CDC) to issue alerts concerning the drug.

In July 2016, the DEA issued a warning that fake prescription pain pills and sedatives that actually contained fentanyl were being sold illegally across the country and causing deadly overdoses in people unaware of what drug they were taking. In August 2016, the CDC also issued an alert regarding the increasingly large number of fatal fentanyl overdoses nationwide, many of which came from fentanyl-laced heroin and counterfeit prescription drugs sold as OxyContin, Xanax, and other popular sedatives and pain medications. ²

According to the DEA, 1 out of every 10 teens reported using prescription pain medications to get high at least once in the last year. From 2004 to 2010, emergency room visits resulting from prescription medication abuse in children younger than 20 years old rose by 45%. ³

Clearly, the lives of America's teenagers are increasingly endangered when they unknowingly purchase counterfeit medications on the streets that contain fentanyl, since it can be fatal in frighteningly small doses. Understanding what fentanyl is and how it lands in teenagers' hands, then, is of utmost importance in protecting them from its dangers.

Some Background on Fentanyl

Fentanyl, a powerful opioid pain medication, was first synthesized in 1960 for use as an anesthetic for patients undergoing certain heart surgeries. In the mid-1990s, the fentanyl patch was created for chronic pain relief and since then, other forms of fentanyl, such as sprays and tablets, have entered the market. ⁴ On the street, it is sold in a variety of forms, including powders, blotter papers, and tablets mixed with other prescription and non-prescription drugs. ⁵

Fentanyl was designed to only be prescribed in cases of chronic or breakthrough pain, typically experienced by cancer patients. Doctors also occasionally prescribed it to patients with severe or chronic pain who had become tolerant to milder opioid pain medications. ⁵

However, what doctors soon discovered is that many of these patients quickly developed a physical tolerance to fentanyl, in which the body becomes so accustomed to the drug that it needs increasingly higher doses of it to feel relief from their pain. In most drugs, physical tolerance develops after a person takes a medication for a long time, so the quicker dependence response began to alert doctors that a greater problem may have been looming.

Because opioids act on the brain's reward centers, the feelings of euphoria and pleasure they induced prompted people to abuse fentanyl to numb physical or emotional pain, as well as to merely get high. And once dependence had developed, when people tried to reduce or stop using fentanyl, painful and uncomfortable withdrawal symptoms surfaced. This often led users to relapse and start using again, even when they had every intention to quit. ⁶

As prescription pain medication abuse rose to epidemic levels in the United States (the number of unintentional overdose deaths from prescription pain medications has more than quadrupled since 1999 ⁶), fentanyl addiction too rose in dangerous popularity.

Teens and Fentanyl

Perhaps most disturbing is the trend of teens abusing fentanyl and experiencing its treacherous effects. Understanding how and why this powerful drug has lured so many adolescents is a powerful first step toward protecting them from harm.

Why do teens abuse prescription pain medications? Teens abuse prescription pain medications for a variety of reasons, and it's not always just to get high. Other reasons a teen may abuse drugs like fentanyl include: 3,7

Trying to fit in: Teens have a strong desire to fit in with their peers and may be more likely to cave to peer pressure than adults.

Physical pain relief: Some teens may start abusing painkillers seeking genuine relief from physical pain, and then the drug use quickly spirals out of control.

Emotional pain relief: Prescription painkillers can temporarily numb emotional pain as well. Many teens may unknowingly self-medicate for other underlying mental health issues such as unresolved childhood traumas, anxiety, and depression.

Call Us Today

Fentanyl abuse can quickly turn fatal. Getting help right away can make all the difference. Call us today to find out what your treatment options are: 1-888-287-0471 Who Answers? .
How do teens access fentanyl?
Teens obtain fentanyl in a variety of ways, sometimes beginning to abuse the drug after receiving a prescription by a physician to relieve pain due to an injury or illness. More often, however, teens get drugs from their friends, family members, or acquaintances. According to the DEA, 70% of youth report getting prescription medications from friends or family. Many teens have also reported stealing drugs from their parents' medicine cabinets, while still others use the internet to research and obtain both legal and illegal drugs using online pharmacies, some of which are legal, yet many are not. ³
How does prescription pain medication abuse impact teens?
Prescription pain medication abuse rates have soared among adolescents and teens in the past several years. According to the American Society of Addiction Medicine, 467,000 adolescents ages 12 to 17 reported nonmedical use of prescription pain relievers, and of those, 168,000 reported being addicted. ⁸

While teens are not typically prescribed fentanyl, it is possible that they may obtain the drug illegally, either intentionally or unintentionally. Many people, including teens, end up unknowingly taking fentanyl after purchasing fentanyl-laced heroin or counterfeit prescription drugs containing fentanyl. There have been a significant number of recent fentanyl-related overdose deaths-an 18-year-old boy in Sacramento, California, and a 17-year-old girl in Rochester, New Hampshire. 9,10

How to Protect Teens from Falling Prey to Fentanyl

The risks of teen drug abuse are incredibly high, and fentanyl overdose creates a serious cause for concern. Using the drug just once, intentionally or not, could cost a teen their life. It is crucial that we, as a society, take action now to combat teen drug abuse and protect teens from falling prey to fentanyl.

Where do we begin?

Education/life skills training: There are several educational programs that provide teens with the knowledge and skill sets needed to help them avoid drug abuse and misuse. One such program is the Life Skills Training (LST) prevention intervention program that takes place in 7th-grade classrooms. The program is designed to help adolescents and teens avoid misusing prescription opioids throughout their teenage years. This program has been shown to statistically reduce opioid abuse up until the senior year of high school.¹¹

Talk to your children about drugs and their dangers: Talking openly and honestly with your children may be one of the best means of teen drug use prevention-and it won't cost you a dime. According to the DEA, teens who talk to their parents about the risks of using drugs are half as likely to abuse them than those who do not. Yet only 16% of teens reported having discussed prescription medications with their parents within the last year.³

Make a point to take time and sit down with your kids to let them know the dangers of drug us e. Make sure they understand that just because it is a prescription drug doesn't make it a safer option. Be open about the perceived benefits as well as the risks. Let them know the reasons people choose to abuse drugs as well as the dangers of doing so. If your argument is well-rounded and grounded in facts, your teen may be more receptive.

Get specific about fentanyl: When you talk with your son or daughter, don't leave out the details. Be specific about the drug fentanyl and the dangers of its use. Let your child know that it is being sold as counterfeit OxyContin, Xanax, and other prescription drugs.2 If your child knows that he may be unknowingly ingesting a substance that could easily kill him, he may consider it too risky to try any of them.

Set a good example for your children: If your teen sees you misusing or abusing drugs, they may think it's okay. Research has shown that parents, just as much as teens, are increasingly abusing prescription medications. Approximately 18% of parents use a prescription medication that was not prescribed to them at least three or more times in their lifetime, 15% of which reported doing so within the past year.³

If you don't want your teens to abuse drugs, make a healthy choice for them and choose to abstain yourself. If you are using prescription drugs, do so responsibly. If possible, do it out of your child's sight. If your child does see you, model responsible drug use and consider explaining the purpose of your medication, as well as the risks of using it.

Do not keep your prescription medications readily accessible: Many teens have reported obtaining prescription drugs from their parents' medicine cabinets.³ Keep your drugs hidden, both out of sight and out of reach for your children to ensure they don't take any medications from you.

Be proactive in your teen's life: While you may not want to be "that parent," being involved in your teen's life can go a long way in potentially saving their life. Ask your children questions. Find out who their friends are, where they're going, and what kind of activities they are participating in. Openly ask them if they have ever been around any drug use. Consider showing genuine interest and curiosity without coming off as being too judgmental or overprotective, since many teens will clam up and hide information if they fear that their parents may react negatively.

Keep your teen active: Encourage your children to engage in hobbies and extracurricular activities that both interest them and keep them occupied. Research has indicated that extracurricular activities may reduce many risky behaviors in teens and adolescents, from drug use to skipping school.¹²

Get them treatment if they need it; actively participate as a family: If your teen has developed an addiction to fentanyl, consider seeking professional treatment immediately and commit to actively participating as a family. Your involvement is beneficial to yourself and your teen, as well as any other family members who may be affected by your child's drug use. Most treatment centers offer family therapy as well as support groups for parents and other family members of addicted loved ones.

The dangers of fentanyl use and abuse are abundant and clear, from the miniscule amount needed to be fatal to the many subversive ways it shows up in other drugs. It a serious risk worth taking seriously, especially when it comes to your teens. Educate yourself and then sit down with your kids and educate them as well. Together you can begin to end this tragic epidemic.
If you or someone you love is struggling with fentanyl addiction or other prescription drug abuse, reach out for help today. Getting professional addiction treatment could mean preventing a potentially fatal drug overdose. For more information about your treatment options, call our recovery hotline at 1-888-287-0471 Who Answers? .
Sources

1. NBC News: Johnson, A. (2016). What is Fentanyl? The Drug That Killed Prince Has Killed Thousands of Others.

2. National Institute on Drug Abuse. (2016). Emerging Trends and Alerts.

3. Drug Enforcement Administration. (2012). Prescription for Disaster: How Teens Abuse Medicine. 2nd Ed.

4. Stanley, T.H. (1992). The history and development of the fentanyl series. Journal of Pain Symptom Management. 7(3-S), 3-7.

5. National Institute on Drug Abuse. (2016). DrugFacts-Fentanyl.

6. National Institute on Drug Abuse. (2014). America's Addiction to Opioids: Heroin and Prescription Drug Abuse.

7. NIDA for Teens. (2016). What is Prescription Drug Abuse?

8. American Society of Addiction Medicine. (2016). Opioid Addiction. 2016 Facts & Figures.

9. The Sacramento Bee. (2016). Fentanyl overdose cases rise to 29, including death of El Dorado Hills teen.

10. New Hampshire Union Leader: Haas, K. (2015). Rochester teen died of fentanyl OD; mother among 3 charged.

11. National Institute on Drug Abuse. (2015). Life Skills Training Shields Teens From Prescription Opioid Misuse.

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Fentanyl, Teens, and the Deadly Consequences

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Fentanyl abuse is becoming increasingly widespread and fatal. And teens are not immune from its dangerous effects. Learn more about what fentanyl is, how it's abused, and how teens are gaining access to it so you can help keep them safe.

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Source - Encyclopedia of Drugs and Addictive Substances

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Source - Encyclopedia of Drugs and Addictive Substances

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"Fentanyl." UXL Encyclopedia of Drugs and Addictive Substances, edited by Barbara C. Bigelow, vol. 3, UXL, 2006, pp. 333-347. Gale Virtual Reference Library, Accessed 10 Mar. 2018.

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Fentanyl was developed in 1959 and used mainly has an anesthetic and painkiller. In the 90s, it became available as a transdermal patch.

Now, illegal fentanyl mainly comes from China due to the lack of regulations on drugs. It can also come from Mexico or the US.

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Source - National Institute on Drug Abuse

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Source - National Institute on Drug Abuse

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National Institute on Drug Abuse. “Fentanyl.” NIDA, 3 June 2016,

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APA Style MLA Style AMA Style

NIDA. (2016, June 3). Fentanyl. Retrieved from https://www.drugabuse.gov/publications/drugfacts/fentanyl

Additional Drug Facts

Other Articles of Interest

Lesson Plan and Activity Finder

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APA Style MLA Style AMA Style NIDA. (2016, June 3). Fentanyl. Retrieved from https://www.drugabuse.gov/publications/drugfacts/fentanyl Other Articles of Interest Lesson Plan and Activity Finder

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“Fentanyl Drug Profile.” EMCDDA | Fentanyl Drug Profile. Accessed 10 March 2018.

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“Opioid Overdose.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 29 Aug. 2017.

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Source - Health and Wellness Resource Center

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Source - Health and Wellness Resource Center

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Carson-Dewitt, Rosalyn S., and Kevin Glaza. "Fentanyl." The Gale Encyclopedia of Prescription Drugs: A Comprehensive Guide to the Most Common Medications, edited by Kristin Fust, vol. 1, Gale, 2015, pp. 330-335. Health & Wellness Resource Center, Accessed 10 Mar. 2018.