Fentanyl Addiction

Fentanyl Addiction

Fentanyl Addiction

Fentanyl AddictionIn November 2011, Blake Seamonson was visiting his great-grandmother at a nursing home in Deerfield, Wisconsin. As the adults chatted, the two-year-old played with toy trucks on the floor. A tiny piece – less than one inch square- of transparent paper something like adhesive tape attached on one of his toys, and ended up stuck on Blake’s neck. A few days later Blake died of fentanyl poisoning. Scant traces of the narcotic painkiller left on the tiny bit of its wrapping was enough to kill the child. Fentanyl is that potent.

Blake became one of 26 children -eleven of them under two years old– to die of accidental fentanyl poisoning in the past 15 years. Just as troubling are the facts that about 500 adults die from fentanyl every year and that the U.S. Drug Enforcement Agency says fentanyl abuse is increasing.

Fentanyl is easily the strongest legal narcotic available. The U.S. government classifies it as a Schedule II Controlled Substance, highly addictive with some medical purposes. There are about 12 illegal analogues of fentanyl sold on the street, and these are classified as Schedule I Controlled Substances, highly addictive with no medical purpose.

Of all the hundreds of narcotics available, fentanyl is the one that gives experts the most nightmares. It may be a vision of the future -a manmade drug thousands of times more powerful than morphine, a drug that can hook people within just a few usages, and a drug that can kill them if they mistake the dosage by just a few micrograms. When you think in terms of micrograms, think grains of salt.

What Is Fentanyl?

Paul Janssen was working in Belgium with analogues of Demerol in the late 1960s, trying to find a manmade substitute for heroin, which was originally supposed to be a manmade substitute for morphine. He was the first to synthesize fentanyl, which is 80 times stronger than morphine and 1,000 times stronger than heroin. Carfentanil, a fentanyl analogue used on large animals, is 10,000 times stronger than morphine. By the mid-1990s, Janssen Pharmaceutica was making Actiq and other fentanyl products.

Fentanyl is water soluble and made of hydrogen, oxygen, nitrogen and carbon. The chemical formula is C22H28N2O.

Fentanyl, like other narcotic/opioid painkillers, works by binding to the body’s opioid receptors concentrated in the brain area that controls pain and emotion. When you experience pain, your body naturally produces its own “morphine” called endogenous morphine or endorphin. Fentanyl releases endorphins more quickly than any other opioid, making it the most addictive and hardest to quit. Another reason fentanyl is so highly addictive is that its effects start within minutes, especially a feeling or “rush” of instant euphoria.

How Is Fentanyl Used Medically?

Because it is so strong, fentanyl’s use is limited to one-time only use during surgeries, or for the breakthrough pain of terminal cancer patients who have built up a tolerance to weaker painkillers and will not live to face addiction. It is only used in controlled settings like hospices and hospitals.

Fentanyl comes as a skin patch, a tablet that dissolves slowly in the mouth, a liquid that is injected, or as a “lollipop.”

Duragesic is a skin patch with fentanyl stored as a gel between two blue plastic matrixes that stick to the skin. It releases 75mg of medicine per hour. ts manufacturer Janssen has paid out millions of dollars for lawsuits resulting in Duragesic deaths, most often through mishandling.

Fentora is a white pill that dissolves in the upper cheek, not swallowed or chewed. It comes in a blister pack and is taken every four to six hours. Sublimaze is injected during the majority of surgeries performed in the United States because its effects are fast-acting and go away quickly. Fentanyl also comes as Ionsys, a pain relief system post-operative patients can work themselves by pushing a button.

Actiq, made by Celephon, Inc, is a berry-flavored lollipop that comes in six strengths from 200mg to 1600mg. It was designed for terminally ill cancer patients who often have trouble swallowing.

Fentanyl is slightly harder to detect in the urine when compared to heroin.

What Drugs Interact With Fentanyl?

Hundreds of drugs react with fentanyl, some fatally.

You should not take fentanyl with any drug that slows breathing or causes sedation, such as alcohol, anti-histamines, anti-depressants, barbiturates, anxiety medications, cold and allergy medicines, muscle relaxants, tranquilizers, sedatives, sleeping pills, and MAO inhibitors. The Duragesic patch reacts with antifungal medications, clarithromyscin, nefazodone, nelfinavir, and ritonair.

Exposing a Duragesic patch to heat, such as using it with an electric blanket, can increase its effect.

What Are The Side Effects Of Fentanyl?

Side effects for fentanyl are similar to other narcotic painkillers, including lightheadedness, dry mouth, euphoria, difficulty urinating and breathing, constipation, dizziness, weakness, drowsiness, and fatigue. The skin patch does not usually cause constipation, but is associated with skin irritations. Rare side effects are severe nausea, confusion, deficiency in red blood cells, anxiety, stomach pain, headache, mouth sores, swelling, paralysis, and shaking of the head, arms and legs.

Who Should Not Take Fentanyl?

People who have never tried opioids before or are unsure if they are opioid intolerant should not take fentanyl. People with breathing disorders such as asthma or chronic obstructive pulmonary disorders, head injuries, brain tumors, mental illnesses, histories of alcoholism or drug addiction, liver or kidney diseases, seizures, low blood pressure, and irregular heart rhythms should not take fentanyl.

What Are The Risks Of Taking Fentanyl?

The two main risks are accidental death by overdose or allergic reaction and addiction.

Doctors introduce fentanyl gradually because some patients cannot tolerate it. It is supposed to be prescribed only to those who already have shown they are not allergic to opioids. The first dose is usually 200mg and then you wait four hours before increasing it. During the first 72 hours of using fentanyl even as a skin patch, a new patient with allergies or health problems can have serious or life-threatening side effects, such as difficulty or stoppage of breathing, swelling of the face and throat, hives, and so forth.

It is easy to overdose on fentanyl because it only takes a tiny amount to be too much.

It is not known if fentanyl causes cancer, and it may impair fertility.

What Are The Symptoms Of A Fentanyl Overdose?

Overdose from fentanyl can occur almost instantly, and some people have been found dead with needles still stuck in their arms. Children have died by touching fentanyl and then touching their eyes or noses.

Symptoms of fentanyl overdose can be slow breathing, extreme weakness, pinpoint pupils, cold and clammy skin, fainting, low blood pressure and heart rate, coma, drowsiness, blue fingers and toes, and unconsciousness.

Immediate medical attention is needed, and usually doctors administer an antidote called naloxone. Some cities such as Chicago provide naloxone to intravenous drug addicts as a way to save their friends’ lives.

Two celebrity musicians who died recently from fentanyl overdoses are Jay Bennett, a guitarist with Wilco, and Paul Gray, a member of the band Slipknot.

How Is Fentanyl Abused?

The first fentanyl addicts surfaced in the 1970s, and they were doctors, nurses and other members of the medical community. A 1995 study found that 60% to 70% of anesthesiologists were abusing opioids, and the most popular was fentanyl. Today the Drug Enforcement Agency still believes that the chief way medical fentanyl is diverted for illegal uses is through medical personnel stealing it from hospitals, falsifying medical records, and even pulling patches off patients. Abuse of medical fentanyl is increasing because doctors are writing more prescriptions for it, making it more available. Also, some OxyContin addicts are turning to fentanyl after their drug was reformulated in 2011, which made it impossible to crush or inject.

The most common way to be addicted to fentanyl is to use it as an additive in your heroin or other street drug. Using fentanyl this way is the most dangerous, addictive, unpredictable and deadliest path for any drug abuser. Just a few micrograms extra of fentanyl can kill you, and the people mixing your drugs are not trained pharmacists. Street names for fentanyl and heroin laced with it are Apache, China White, China Girl, goodfellas, capone, tsunami, jackpot, king ivory, chinatown, Tango and Cash, friend, and murder 8. Fentanyl’s other slang names indicate how deadly it is: DOA, tombstone, murder 8, flat line, and lethal injection. Some of these drugs contain laxatives and are often laced with anti-histamines.

Signs That You Are Addicted To Fentanyl

If you can answer yes to one or more of these questions, it may be time to consult your family doctor about your problems with fentanyl.

  1. Are you a medical professional who is using fentanyl and/or other opioid drugs?
  2. Are you using heroin mixed with fentanyl?
  3. Have you tried quitting fentanyl on your own unsuccessfully?
  4. Do you have health symptoms such as constipation and drowsiness that you know are caused by fentanyl?
  5. Do you have trouble meeting your obligations at work, school or home because of your fentanyl use?
  6. Do you spend too much time thinking about fentanyl and how to obtain it?
  7. Do you need more drugs than you’ve used in the past to achieve the same “high”?
  8. Do your family members and/or friends complain that you are moody or withdrawn? If they know about your drug use, do they criticize you and try to get you to stop?
  9. Have you put yourself in danger by driving under the influence of drugs?
  10. Do you feel guilty about your use of fentanyl?
  11. Have you put yourself at risk for legal problems or have you had legal problems because of your fentanyl use?
  12. Do you sometimes use fentanyl and other drugs in greater amounts than you want to?
  13. Do you experience withdrawal symptoms when you don’t use fentanyl?
  14. Do you keep using fentanyl even though you think it is bad for you?

Fentanyl Withdrawal Syndrome

People often crave fentanyl after just using it once, because it produces a quick rush of euphoria and then a dreamlike state without pain. They may experience a hangover the next day, with a headache and dizziness, and then crave the warm feeling the drug provided.

Withdrawing from a fentanyl addiction is unpleasant and similar to other opioid addictions. Once the drug is stopped, “brain scramble” occurs because of disruptions to the endomorphic system. Some people benefit from taking an opioid substitute the first few days to get through that. Symptoms last three to five days, and may first be abdominal pain, cravings, confusion, anxiety, constipation, irritability, loss of appetite, tremors, and hot flashes. Later symptoms may be extreme nausea, muscle and joint aches, headaches, cramps, and tremors.

Other drugs can be used after detoxification is complete, such as naltrexone, a long-lasting opioid receptor blocker; and naloxone, a short-acting opioid receptor blocker that is also used to treat overdoses. Buprenorphine is a man-made opioid sometimes prescribed to ease addiction. Suboxone is a combination of buphrenorphine and naloxone used in maintenance programs.

Fentanyl Addiction Treatment

The greatest challenge of overcoming an addiction to fentanyl or any other opioid drug is to give up a big, short-term benefit for more worthwhile long-term goals. In the short run, fentanyl provides you with a physical high and the avoidance of withdrawal symptoms. In the long-run, however, life without fentanyl would mean you wouldn’t be thinking about drugs all the time. You could have loving relationships and goals for your career or education, feel healthy all the time, and handle stress in a normal way. You could have fun with people who do not do drugs, and you could take up hobbies and sports you do not even know you like. Fiving up drugs does leave a vacuum in your life that has to be filled up with new people and pursuits or else you will go back to drugs.

It is extremely hard to do this on your own, which is why so many of the people who succeed use residential treatment. You can start your new lifestyle with others on the same new journey. Your entire day will be devoted to the challenges you are facing, and you will receive help on a 24-hour basis until you are ready to try out your new skills in everyday life. You can get help from counselors, who will meet with you individually, in group settings, with your partner or spouse, and family members. These addiction specialists can help you set and accomplish your goals, even if you just have to take baby steps at first.

Certain kinds of therapies have proven to be more effective than others, including cognitive behavioral therapy, relaxation training, working with art, music, drama and/or animals, becoming physically fit through good nutrition and exercise, developing an understanding of the science and behaviors of drug abuse, and returning home to a supportive environment of good relationships, 12-step programs, and continued counseling. A good residential center will offer all of these.

The Future Of Fentanyl

The DEA tracks fentanyl use by the number of fentanyl-related deaths and emergency room visits. Fentanyl was popular on the West Coast in the 1980s, killing 100 people in just a few years, and then again in the early 1990s in New York. Another wave of popularity is occurring today, because of an increase in heroin and prescription painkiller abuse. Today’s illegal fentanyl is most often made in Mexican laboratories and added to heroin to enhance it. The DEA estimates that between 800,000 and one million Americans are heroin addicts.

About a dozen known Illegal fentanyl analogs are being made in kitchen laboratories, and the newer versions are becoming stronger. One gram of pure fentanyl can supply 7,000 street doses with 28 grams equaling an ounce.

Fentanyl use will probably increase in the next few years as prescription opioid painkillers become more tamper-proof, making them impossible to snort, crush, chew or inject. The Actiq version of fentanyl is particularly desirable in street markets.

Fentanyl first became known to the public as an illegal way to stimulate horses and fix races. In 2002, it made the international news when Chechen rebels took an entire theater of 700 people hostage in Moscow. The Russian government responded by inserting fentanyl gas into the building, and 117 died.

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