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fentanyl is a synthetic drug, meaning it is man made and is very potent

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causes feelings of euphoria, relaxation and relieves pain. it affects everyone differently but for some may affect their weight, size and overall health and mental health

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many different forms to consume like pills, lollipops or injections. and some may use for anesthesia for sick patients or pain relief

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It is cheap and everyone looks for the best bang for their buck, a very common case is people do not know they are taking fentanyl as it is laced in a lot of other drugs like xanax. Also, it is cheaper to make than a lot of other drugs like heroin.

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fentanyl is so addictive because the potency is so much higher than many other drugs. Also people do not know they are consuming fentanyl but something else like Xanax so they do not actually know what they are taking and getting addicted to. when getting off fentanyl the withdrawals can be horrible.

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Detox in a facility is the best option so you are being accompanied, and continuing treatment for at least a year they say like going to meetings and someone to talk to is very beneficial in staying sober.

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The Michigan Poison Center at the Wayne State University School of Medicine is issuing a warning concerning the public health threat related to a recent spike in fatal fentanyl-related overdoses in both Cass and Van Buren counties. These deaths have already equaled or surpassed totals from 2020.

Fentanyl is a highly potent synthetic opioid used to treat patients with severe pain. It is approximately 100 times more potent than morphine and 50 times more potent than heroin.

Fentanyl can cause severe symptoms, including sedation, slowed or absent breathing, and coma. Users may not be aware of the presence of fentanyl in recreational and illicit drug supplies, including heroin and cocaine. Fentanyl has been substituted for various opioids such as oxycodone bought illicitly or on the Internet. Unexpected fentanyl, especially when mixed with or substituted for other medications, puts the unexpecting user at high risk for drug-related respiratory failure with subsequent brain damage or death.

The Michigan Poison Center strongly suggests obtaining the opioid antagonist naloxone in case of inadvertent overdose. Please contact the Substance Abuse and Mental Health Services Administration at 800-662-4357 to find resources and connect with local substance abuse treatment centers. You may also callNever Use Alone at 800-484-3731or visit NeverUseAlone.com for help.

Call 911 immediately if you suspect someone has used a fentanyl-laced substance and is not breathing. Naloxone may be life-saving, but is not a replacement for emergency medical care. For questions regarding fentanyl or any other substances, call the Michigan Poison Center at 1-800-222-1222. Health care professionals seeking information and/or treatment recommendations for symptoms related to this or any other substance can request to speak with board-certified toxicologists.

Clinicians who suspect cases that may be related to fentanyl should call the Michigan Poison Center. Please also report any cases to the Michigan Department of Health and Human Services Drug Poisoning Surveillance Team at MDHHS-MODASurveillance@michigan.gov.

The Michigan Poison Center is available day or night, every day of the year. If you have questions or concerns about substance use, drug safety, or any other poison-related issue, call 1-800-222-1222.

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Michigan Poison Center issues fentanyl overdose warning

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The Michigan Poison Center at the Wayne State University School of Medicine is issuing a warning concerning the public health threat related to a recent spike in fatal fentanyl-related overdoses in both Cass and Van Buren counties. These deaths have already equaled or surpassed totals from 2020.

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Fentanyl is roughly 100 times more potent than morphine and 50 times more potent than heroin. In fact, it is the most potent opioid pain reliever available for use in medical treatment.

This information comes from the Centers for Disease Control and Prevention (CDC). Although healthcare professionals consider fentanyl safe and effective when a person uses it in a monitored medical setting, the drug still carries a high potential for misuse, also known as abuse.

Some people make designer fentanyl analogs, which are nearly identical to the original drug. Since fentanyl and its analogs are incredibly potent, accidental overdoses and deaths are increasingly common.

People often either mix analogs with, or substitute them, for heroin. Because fentanyl is much more potent than heroin, there is also a hugely increased risk of overdose and death.

In this article, we will discuss the medical uses of fentanyl and its side effects. We will also cover misuse of fentanyl, addiction, and the risk of overdose.

Fentanyl is a Schedule II prescription narcotic analgesic that is as much as 50-100 times more potent than morphine and 30-50 times more potent than heroin.

As a prescription, fentanyl is under the brand names Actiq, Duragesic, and Sublimaze. People with prescriptions for the drug typically take it as a shot or a patch on their arm. A person may also take it through a throat lozenge.

People with substance use disorders can also use synthetic fentanyl illegally. For example, they can get it as powders or pills or put it into containers such as eyedroppers or nasal sprays. Street names for the drug include Apache, China Girl, Goodfellas, Great Bear, Poison, and Tango & Cash.

How does fentanyl affect the brain?

As with other opioid drugs, fentanyl binds to the receptors in the brain that affect pain and emotions. This causes feelings of well-being (euphoria) and relaxation, and it also relieves pain.

Fentanyl affects everyone differently. The effects are dependent on an individual's:

The effects are also dependent on:

the amount a person takes

whether they take it in combination with other drugs

whether the person is used to taking opioids

Over time, however, the brain adapts to fentanyl, making it hard for a person to experience positive emotions from anything but the drug. This can lead to addiction.

Medically prescribed fentanyl is available in a variety of formulations, including:

Medical uses for fentanyl include:

anesthesia for patients undergoing heart surgery or for patients with poor heart function

management of breakthrough cancer pain in patients who are already receiving opioid medication for underlying, persistent pain

pain management in people who have persistent, moderate-to-severe chronic pain requiring continuous, around-the-clock opioids

pain relief for people who are already taking narcotic analgesics or who are already opioid-tolerant

Fentanyl patch

For continuous delivery, fentanyl is administered through a transdermal patch that adheres to the skin. The patch works by slowly releasing fentanyl through the skin into the bloodstream over 20-72 hours.

Doctors can only administer the fentanyl patch to people who are already tolerant to opioid therapy of similar strength. Because it has already been absorbed through the skin, fentanyl can continue to be effective for 13-24 hours after the patch is removed. However, this depends on how each person's skin absorbs the drug.

Older people are more likely than younger individuals to experience adverse effects, especially the respiratory depressant effects of fentanyl. Healthcare professionals must exercise extreme caution and regularly monitor people in this age group.

Side effects of fentanyl include:

Adverse effects associated with transdermal fentanyl patches include:

discoloration

rash

itching

swelling at the site of application

People with substance use disorders can obtain fentanyl by diverting it from legitimate medical supplies, or by manufacturing it in illegal laboratories. They may take it orally, smoke it, snort it, or inject it. No one method of use is safer than another.

Even discarded fentanyl patches can still contain significant amounts of the drug. People with opioid use disorders can remove the gel contents from discarded patches and eat it, place it under the tongue, smoke it, or inject it.

Many fentanyl analogs much more potent than heroin, making the former even more dangerous than the latter.

Often, other illegal drugs, such as heroin and cocaine, may be mixed with fentanyl, making them much more potent. People with substance use disorders may not know about the addition of fentanyl, which puts them at a higher risk of accidental overdose or death.

Treatment options for fentanyl addiction

Treatment for fentanyl addiction is the same as for any opioid use disorder and depends on the severity of the addiction. Treatment may include inpatient or outpatient detox, medication treatments for managing cravings and relapse, and residential and outpatient behavioral treatment programs.

Medications may include buprenorphine and methadone, which affect the same receptors in the brain that are impacted by fentanyl. This helps reduce the symptoms of withdrawal. A doctor may also choose to prescribe naltrexone, which is a different medication that stops fentanyl from affecting the body.

Which medication is right for a person may depend on many factors. A person should discuss the best course of treatment with their doctor. They may also want to consider talking with a therapist.

This may also help them develop a healthier lifestyle and support them in their consistent medication use, if medication is part of their treatment. Therapy options may :

cognitive behavioral therapy, which works on changing behavior and managing triggers and anxiety.

contingency management, which gives point vouchers for negative drug tests

motivational interviewing, which counsels the individual based on their unique needs and their conflicting feelings regarding their need to change in order to overcome addiction

As with any opiate, there is a risk of dependency, tolerance, misuse, and addiction. Physical dependence results in withdrawal symptoms when individuals abruptly stop taking the drug.

Withdrawal symptoms usually start within 12 hours of the last dose of fentanyl and can last 1 week or more. An individual in withdrawal may experience:

People who use fentanyl swiftly develop a tolerance to high doses, meaning that more of the drug is needed to achieve the desired effect.

Repeated opioid use often results in addiction, which is a chronic relapsing condition that goes beyond physical dependence and is characterized by uncontrollable drug-seeking behavior despite harmful and negative consequences.

Opioid-dependent individuals sometimes use fentanyl as a substitute for heroin. However, it is a very dangerous substitute because of its marked potency and the inability for people to gauge dosages, resulting in frequent deadly overdoses.

Pure fentanyl powder is also very difficult to dilute appropriately, often resulting in a dangerously strong mixture. It can be deadly even for people who have a high opioid tolerance. In some cases, death occurs so quickly that people are found with a needle still in the site of injection.

Fentanyl use can result in accidental death even with just one dose, especially if a person accidentally takes it incorrectly.

Signs and symptoms of a fentanyl overdose include:

slow or shallow breathing

slow heartbeat

severe sleepiness

cold, clammy skin

trouble walking or talking

feeling faint, dizzy, or confused

unresponsiveness

Many fatal overdoses thought to be from heroin have actually been from fentanyl. Even a small dose of fentanyl, such as 2 milligrams, can be lethal depending on how tolerant someone is and their body size. Coroners' offices and state crime laboratories do not test for fentanyl or its analogs unless given a specific reason to do so.

The Food and Drug Administration has warned that deaths and overdoses have occurred in people using both the brand-name product Duragesic and generic transdermal fentanyl patches. Most recently, it warned that children are at particular risk for accidental death from exposure.

Treatment

An overdose of fentanyl is an emergency. A person exhibiting the symptoms of overdose should get immediate medical attention. If they do not, they may get hypoxia. This means a person's brain is not getting enough oxygen. The condition can lead to coma and even death.

The treatment for overdose is usually naloxone. However, someone will need to administer it as soon as possible. The medication will block the effect of the fentanyl. However, since fentanyl is very strong, a person may need several doses of the drug.

Fentanyl is an extremely potent opioid that offers significant pain relief to those who live with severe acute or chronic pain conditions. However, it is also capable of causing considerable harm or death to people with opioid use disorders or people who are accidentally exposed to the drug.

Fentanyl key facts

What it is: Fentanyl is an opioid analgesic that is 100 times more potent than morphine.

How it is used: It is taken legally in prescription form to treat severe pain or illegally in synthetic form. People can also find it mixed with other illegal drugs. However, they may not always know that it is present.

How it feels: Fentanyl reduces pain and causes euphoria and relaxation.

What it causes: It carries a high risk of dependence and addiction, as well as risk overdose due to extreme potency.

Some patients and healthcare professionals may not be fully aware of the dangers of this very strong narcotic. All of society, including families, schools, the medical community, law enforcement, and government officials, should be aware of the potentially lethal outcomes of improper medical and illicit fentanyl use.

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What is fentanyl? Uses, abuse, and side effects

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Fentanyl is roughly 100 times more potent than morphine and 50 times more potent than heroin. In fact, it is the most potent opioid pain reliever available for use in medical treatment. This information comes from the Centers for Disease Control and Prevention (CDC) .

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What is fentanyl?

Fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine that is typically used to treat patients with severe pain, especially after surgery. It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. Tolerance occurs when you need a higher and/or more frequent amount of a drug to get the desired effects.

In its prescription form, fentanyl is known by such names as Actiq ®, Duragesic ®, and Sublimaze ®.

Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States. In 2017, 59. percent of opioid-related deaths involved fentanyl compared to 14.3 percent in 2010.

What are Opioids?

Opioids are a class of drugs naturally found in the opium poppy plant. Some opioids are made from the plant directly, and others, like fentanyl, are made by scientists in labs using the same chemical structure (semi-synthetic or synthetic).

How do people use fentanyl?

When prescribed by a doctor, fentanyl can be given as a shot, a patch that is put on a person's skin, or as lozenges that are sucked like cough drops.

The illegally used fentanyl most often associated with recent overdoses is made in labs. This synthetic fentanyl is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.

Some drug dealers are mixing fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl, making it a cheaper option. This is especially risky when people taking drugs don't realize they might contain fentanyl as a cheap but dangerous additive. They might be taking stronger opioids than their bodies are used to and can be more likely to overdose. To learn more about the mixture of fentanyl into other drugs, visit the Drug Enforcement Administration's Drug Facts on fentanyl.

How does fentanyl affect the brain?

Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. After taking opioids many times, the brain adapts to the drug, diminishing its sensitivity, making it hard to feel pleasure from anything besides the drug. When people become addicted, drug seeking and drug use take over their lives.

Fentanyl's effects include

extreme happiness

drowsiness

nausea

confusion

constipation

sedation

problems breathing

unconsciousness

Can you overdose on fentanyl?

Yes, a person can overdose on fentanyl. An overdose occurs when a drug produces serious adverse effects and life-threatening symptoms. When people overdose on fentanyl, their breathing can slow or stop. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can lead to a coma and permanent brain damage, and even death.

How can a fentanyl overdose be treated?

As mentioned above, many drug dealers mix the cheaper fentanyl with other drugs like heroin, cocaine, MDMA and methamphetamine to increase their profits, making it often difficult to know which drug is causing the overdose. Naloxone is a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. But fentanyl is stronger than other opioid drugs like morphine and might require multiple doses of naloxone.

Because of this, if you suspect someone has overdosed, the most important step to take is to call 911 so they can receive immediate medical attention. Once medical personnel arrive, they will administer naloxone if they suspect an opioid drug is involved.

Naloxone is available as an injectable (needle) solution and nasal sprays (NARCAN ® and KLOXXADO ®).

People who are given naloxone should be monitored for another two hours after the last dose of naloxone is given to make sure breathing does not slow or stop.

Some states have passed laws that allow pharmacists to dispense naloxone without a personal prescription. Friends, family, and others in the community can use the nasal spray versions of naloxone to save someone who is overdosing.

Read more in Naloxone DrugFacts.

Can fentanyl use lead to addiction?

Yes. Fentanyl is addictive because of its potency. A person taking prescription fentanyl as instructed by a doctor can experience dependence, which is characterized by withdrawal symptoms when the drug is stopped. A person can be dependent on a substance without being addicted, but dependence can sometimes lead to addiction.

Addiction is the most severe form of a substance use disorder (SUD). SUDs are characterized by compulsive drug seeking and drug use that can be difficult to control, despite harmful consequences. When someone is addicted to drugs, they continue to use them even though they cause health problems or issues at work, school, or home. An SUD can range from mild to severe.

People addicted to fentanyl who stop using it can have severe withdrawal symptoms that begin as early as a few hours after the drug was last taken. These symptoms include:

muscle and bone pain

sleep problems

diarrhea and vomiting

cold flashes with goose bumps

uncontrollable leg movements

severe cravings

These symptoms can be extremely uncomfortable and are the reason many people find it so difficult to stop taking fentanyl. There are medicines being developed to help with the withdrawal process for fentanyl and other opioids. The FDA has approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms. Also, the NSS-2 Bridge device is a small electrical nerve stimulator placed behind the person's ear, that can be used to try to ease symptoms for up to five days during the acute withdrawal phase. In December 2018, the FDA cleared a mobile medical application, reSET®, to help treat opioid use disorders. This application is a prescription cognitive behavioral therapy and should be used in conjunction with treatment that includes buprenorphine and contingency management.

How is fentanyl addiction treated?

Like other opioid addictions, medication with behavioral therapies has been shown to be effective in treating people with a fentanyl addiction.

Medications: Buprenorphine and methadone work by binding to the same opioid receptors in the brain as fentanyl, reducing cravings and withdrawal symptoms. Another medicine, naltrexone, blocks opioid receptors and prevents fentanyl from having an effect. People can discuss treatment options with their health provider.

Counseling: Behavioral therapies for addiction to opioids like fentanyl can help people modify their attitudes and behaviors related to drug use, increase healthy life skills, and help them stick with their medication. Some examples include:

cognitive behavioral therapy, which helps modify the patient's drug use expectations and behaviors, and effectively manage triggers and stress

contingency management, which uses a voucher-based system giving patients "points" based on negative drug tests. They can use the points to earn items that encourage healthy living

Motivational interviewing, which is a patient-centered counseling style that addresses a patient's mixed feelings to change

These behavioral treatment approaches have proven effective, especially when used along with medicines. Read more about drug addiction treatment in our Treatment Approaches for Drug Addiction DrugFacts.

Points to Remember

Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. In its prescription form it is prescribed for pain, but fentanyl is also made illegally.

Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths.

Illegal fentanyl is sold in the following forms: as a powder, dropped on blotter paper like small candies, in eye droppers or nasal sprays, or made into pills that look like real prescription opioids.

Illegal fentanyl is being mixed with other drugs, such as cocaine, heroin, methamphetamine, and MDMA. This is especially dangerous because people are often unaware that fentanyl has been added.

Fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. Its effects include extreme happiness, drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma, and death.

The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains it. They can underestimate the dose of opioids they are taking, resulting in overdose.

Naloxone is a medicine that can be given to a person to reverse a fentanyl overdose. Multiple naloxone doses might be necessary because of fentanyl's potency.

Medication with behavioral therapies has been shown to be effective in treating people with an addiction to fentanyl and other opioids.

Learn More

For more information about fentanyl and other opioids, visit:

For more information about the opioid reversal drug naloxone, visit: https://www.drugabuse.gov/publications/drugfacts/naloxone

References

1. Volpe DA, Tobin GAM, Mellon RD, et al. Uniform assessment and ranking of opioid Mu receptor binding constants for selected opioid drugs. Regul Toxicol Pharmacol. 2011;59(3):385-390. doi:10.1016/j.yrtph.2010.12.007

2. Higashikawa Y, Suzuki S. Studies on 1-(2-phenethyl)-4-(N-propionylanilino)piperidine (fentanyl) and its related compounds. VI. Structure-analgesic activity relationship for fentanyl, methyl-substituted fentanyls and other analogues. Forensic Toxicol. 2008;26(1):1-5. doi:10.1007/s11419-007-0039-1

3. Nelson L, Schwaner R. Transdermal fentanyl: Pharmacology and toxicology. J Med Toxicol. 2009;5(4):230-241. doi:10.1007/BF03178274

4. Garnock-Jones KP. Fentanyl Buccal Soluble Film: A Review in Breakthrough Cancer Pain. Clin Drug Investig. 2016;36(5):413-419. doi:10.1007/s40261-016-0394-y

5. Drug and Chemical Evaluation Section, Office of Diversion Control, Drug Enforcement Administration. Fentanyl Fact Sheet. March 2015. http://www.deadiversion.usdoj.gov/drug_chem_info/fentanyl.pdf.

6. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108(3):776-789.

7. Drug and Chemical Evaluation Section, Office of Diversion Control, Drug Enforcement Administrati

8. on. Acetyl fentanyl Fact Sheet. July 2015. http://www.deadiversion.usdoj.gov/drug_chem_info/acetylfentanyl.pdf.

9. Gutstein H, Akil H. Opioid Analgesics. In: Goodman & Gilman's the Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill; 2006:547-590.

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Fentanyl DrugFacts | National Institute on Drug Abuse

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Fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine that is typically used to treat patients with severe pain, especially after surgery.