Brand Names: Duragesic, Actiq, Fentora, Abstral, Onsolis.

FENTANYL (Duragesic®, E-TRANS® Fentanyl) is a powerful synthetic opioid stronger than Morphine. It is typically used to treat severe pain, to manage pain after surgery or to treat those suffering from chronic pain. Fentanyl is also used for patients who express a great physical tolerance to opiates. Much like Heroin, opioids, and other drugs, Fentanyl acts upon specific receptors in your brain and spinal cord to decrease the feeling of pain and to reduce your emotional response to pain. Fentanyl comes in many forms such as a patch, lollypop, and the traditional pill. One of the most potent opioid analgesics, Fentanyl is used to treat acute, chronic pain. This Schedule II controlled substance was introduced in the 1960’s as an intravenous anesthetic under the trade name Sublimaze. Chemical formula:

  • C22H28N2O∙ C6H8O7 – Fentanyl Citrate

Like Heroin, Fentanyl acts on receptors in the brain to reduce pain and create a euphoric state. Fentanyl has a noticeably lesser euphoric effect than Heroin. However, as a sedative, Fentanyl is 50 to 100 times stronger than morphine. The FDA warned that Fentanyl is “only intended for treating persistent, moderate to severe pain in patients who are opioid-tolerant.” When those who are not opiate-tolerant take Fentanyl, there is a very high chance of overdose. The FDA defines opiate tolerance as those who take “regular, daily, around-the-clock narcotic pain medicine” and are more “resistant to the dangerous side effects of narcotic pain medications than patients who only occasionally take these drugs.”

Fentanyl is a Schedule II controlled substance.  A study by the Division of Public Health Sciences, Wake Forest University School of Medicine, and the Institute for Safe Medication Practices showed that Fentanyl was the second most dangerous drug on the market and had the second highest rate of drug-related deaths.

Fentanyl Uses

In the mid-1990’s, the Duragesic Fentanyl patch was introduced to provide slow-release pain relief over a 48-72-hour period. Fentanyl also comes in lozenge form (Actiq), for fast-acting relief of breakthrough pain. Because Fentanyl, in all of its forms, can be habit-forming and has a high potential for abuse, the U.S. Food and Drug Administration has issued public health alerts regarding its use. The patch comes in five sizes, delivering between 12.5 and 100 micrograms per hour. The lozenges are berry- flavored lollipops that dissolve slowly in the mouth and are intended for opiate-tolerant users. It is available in six dosages, from 200-1600 micrograms.

Fentanyl can be used as a transdermal patch, lollipop, or in traditional pill form. It can also be injected into a muscle or given intravenously by a medical professional.

Fentanyl Warnings

The FDA said the transdermal patch is “only intended for treating persistent, moderate to severe pain in patients who are opioid-tolerant, meaning those patients who take a regular, daily, around-the-clock narcotic pain medicine.” The agency received several reports of deaths and life-threatening side effects despite a July 2005 advisory that emphasized safe use. The FDA said some doctors prescribe the patch inappropriately for pain following surgery, headaches and occasional or mild pain. Fentanyl has similar biological effects to that of heroin but is thought to be a stronger sedative and much more potent than street heroin. Some heroin dealers mix Fentanyl with low-grade heroin to add bulk and make it more powerful. A combination of Fentanyl, with either cocaine or heroin, has caused an outbreak of overdoses in different parts of the country.  Regular users may quickly become addicted.  The drug is often used orally, but like heroin can be smoked, snorted or injected. On the black market, Fentanyl is mostly sold in a patch form. The patch can be cut up or eaten, and the gel extracted from the inside can be smoked. FDA reports have shown that some patients use the patch incorrectly, by replacing it more frequently than prescribed or applying a heat source to the patch, which can cause a dangerously high level of the drug in the bloodstream.

A study by the Division of Public Health Sciences, Wake Forest University School of Medicine, and the Institute for Safe Medication Practices declared that Fentanyl was the second most dangerous drug on the market and had the second highest rate of drug-related overdose deaths.

Fentanyl Side Effects

Side effects may include:

  • diarrhea
  • nausea
  • constipation
  • dry mouth
  • confusion
  • sweating
  • abdominal pain
  • headache
  • fatigue
  • weight loss
  • dizziness
  • hallucinations
  • anxiety
  • depression
  • flu-like symptoms.

In 2006, the FDA began investigating several respiratory deaths linked to Fentanyl use.  Because the effects are 50 to 100 times stronger than morphine, when used by people who are not tolerant to opioids the consequences can be dire. Even those with a tolerance are at risk of an overdose when improperly used.

Some medications can interact with Fentanyl to cause Serotonin Syndrome; this is particularly the case for SSRIs and other antidepressant medications.   Even when taken as directed by a doctor, patients using the patch have suffered the effects of “leaky” patches. A leaky patch will release the medication much more quickly than the desired 72 hours, what can cause an accidental overdose. In 2004, 2.2 million defective Duragesic patches had to be recalled.

Fentanyl Withdrawal Symptoms

Faced with the mounting emotional and physiological risks that Fentanyl Dependence brings, many people began the search for the best substance abuse treatment available. Many have tried to quit on their own but were not able to handle the distress caused by the withdrawal symptoms. The extreme discomfort of an acute opioid withdrawal can become too difficult and sometimes too risky for a person to bear, and as a result, relapse during this difficult phase is quite common.

Withdrawal symptoms may include:

  • Chills
  • Anxiety
  • Extreme restlessness
  • High blood pressure
  • Insomnia
  • Irritability
  • Muscle and bone pain
  • Nausea
  • Stomach pains
  • Sweating
  • Watery eyes

Fentanyl Tolerance and Dependence

Opioids are still considered the most powerful and effective drugs available for the treatment of pain. They naturally bind to the mu-opioid receptors which are distributed throughout the brain and spinal cord, and responsible for reducing or inhibiting symptoms pain.  The abuse of opioid drugs causes a euphoria in an area of the brain known as the nucleus accumbens. This euphoria becomes repeatedly craved by the user and often the reason for the development of a dangerous and, compulsive fentanyl use.

Physical tolerance to the drug quickly develops because of a continued pattern of use that decreases the response to the drug effects and the duration of its action. The patient begins to need higher doses to achieve the same original effect. This repeated pattern often results in a combination of physical and emotional negative consequences.  When the access to the drug is limited or prevented, the emergence of panic, anxiety, and irritability becomes prevalent. At this point, one will notice signs of dependence and addiction. After the realization that Fentanyl dependence and addiction are present, the next step is to identify the most effective drug treatment available.

Fentanyl Addiction Treatment

Withdrawal from Fentanyl without the adequate medically-assisted detoxification is not only very uncomfortable but can also be potentially dangerous for the patient.  Inpatient medical monitoring during fentanyl detoxification is essential to minimize the risks of relapse and possibly a fatal overdose. People with a history of opioid dependence may additionally be dealing with different known and unknown health issues, warranting the consideration of a close medical supervision and an individualized treatment plan.

Waismann Institute, in its exclusive location based in So. California has been a forerunner in advancing medical Fentanyl detoxification and rapid detox for almost 20 years. This commitment to providing results for opiate dependent patients is just as strong today as it was two decades ago. Our physicians and staff are fully committed not only to provide the best opiate detox available but also to patient safety and comfort. We strive to ensure that the highest level of professional standards is maintained and that our patients are treated in a compassionate, dignified, and private manner.

We provide our patients with superior medical care, individualized attention, quadruple board-certified medical director, facility credentials and our exclusive, comprehensive and private recovery retreat.

For more information on the best opioid addiction treatment options, call us today at 1-310-205-0808


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