Fentanyl

Fentanyl is a powerful pain medication. It is an opioid, like codeine, oxycodone, heroin, etc.  

Fentanyl now being made illegally in street labs and is causing a rise in overdose deaths across the country and here in San Benito County. 

Pictured is a lethal dose of fentanyl for an average adult.  

What is fentanyl?

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Fentanyl is a powerful, fully synthetic (lab made) opioid that is similar to morphine. It is 50 to 100 times stronger than morphine. When being prescribed by a provider as a medication typically used for end of life care, or for severe acute pain such as after surgery. It comes in several forms like patch,  

More recently fentanyl is being used and made illegally. Drug traffickers manufacture fentanyl and sell it illegally. It is sold in several forms such as powder and sold as fentanyl but is added to other drugs like cocaine, and made to look like prescription pills like OxyContin, Percocet, and Xanax (which is commonly used by young adults and youth and is not an opioid but a Benzodiazepine which can increase risk of overdose).  

More Info: National Institute on Drug Abuse https://www.drugabuse.gov/publications/drugfacts/fentanyl

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Illicit fentanyl is typically sold as a powder or hidden in counterfeit pills made to look like prescription pills. In San Benito County we commonly see fentanyl as counterfeit Xanax and Percocet pills.

Prescribed fentanyl comes in different forms such as in a lozenge or patch dosed in extremely small amounts, micrograms.

How do people use fentanyl?

When prescribed as a medication it is to be taken as the medical provider prescribes and typically can be given as a patch or as lozenges that are sucked like cough drops. Fentanyl is most often prescribed as a slow-release patch to people with long-term, severe pain. When used in this way, it can be very effective and safe.  

Illicit fentanyl is most commonly sold as a powder or made into pills that look like prescription medications. Street fentanyl may be swallowed, smoked, snorted or injected. The pills or powder have more recently been used by smoking the substance.

More Info: https://www.forbes.com/sites/janetwburns/2021/09/07/study-some-fentanyl-users-in-ca-choosing-to-smoke-vs-inject-raising-lots-of-questions/?sh=2292276879c9 or https://www.sciencedirect.com/science/article/abs/pii/S0376871621004981  

 

It has also been getting added to other drugs that are not opioids like cocaine and methamphetamine and sold to the person using the substances and they are not told that fentanyl is added. This greatly increases risk of overdose. 

More Info: https://www.latimes.com/local/california/la-me-ln-fentanyl-deaths-20180515-story.html

How does fentanyl affect the body?

Like other opioids such as morphine, heroin, etc. fentanyl works by attaching or binding to the body's opioid receptors. These are found in areas of the brain that control pain and emotions. When prescribed by a health care provider and used properly Fentanyl is used to reduce feelings of pain and the emotional response to pain. Fentanyl blocks the sensation or feeling of pain in the brain providing relief. 

There is risk with use of opioids including fentanyl for long amounts of time. Even after taking opioids for a short amount of time, the brain adapts to the drug, building tolerance, lowering the brain's sensitivity, and increasing the risk to become dependent or addicted to fentanyl.  

Fentanyl's effects can include: 

  • extreme happiness 

  • drowsiness 

  • nausea 

  • confusion 

  • constipation 

  • sedation  

  • relaxation

  • difficulty concentrating

  • constricted pupils

  • slowed breathing

  • vomiting

  • loss of appetite

  • sweating

  • overdose

How does fentanyl cause an overdose?

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.

What to do if you suspect someone is overdosing on fentanyl?

As discussed above, many drug dealers are now mixing the cheaper and more powerful drug, 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 or Narcan  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.  

To learn more about Naloxone look at our Naloxone Page

Can someone become addicted or dependent on fentanyl?

Fentanyl is highly 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.

 

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 also occur with other opioids. These symptoms include:

  • muscle and bone pain

  • sleep problems

  • diarrhea and vomiting

  • cold flashes with goose bumps

  • uncontrollable leg movements

  • severe cravings for Fentanyl  

                                                                           This video discusses how the body becomes dependent on opioids. 

What are treatment options for fentanyl addiction/use disorder?

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

 

Medications such as Buprenorphine and Methadone are prescribed by a health care provider. These medications work by binding to the same opioid receptors in the brain as fentanyl, and can help the person by reducing cravings and withdrawal symptoms.

Counseling or behavioral therapies for addiction to opioids like fentanyl can help people in combination to the medication to focus on modifying their attitudes and behaviors related to using fentanyl or other drugs, work to increase healthy life skills, and encourage using the medication prescribed by their health care provider.  

For more info on treatment visit our page Treatment Resources