Impact, abuse and treatment
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Fentanyl is a highly addictive painkiller used primarily to treat severe, chronic pain – just like the painkiller morphine. It is related to heroin and morphine, but much more dangerous as it is much stronger and even a small dose can be lethal.
Unfortunately, too many people mix fentanyl with other drugs, so unfortunately few are aware that they could be injecting a lethal dose before it’s too late.
Want to know more about fentanyl? And why addiction or abuse of the painkiller can have fatal consequences for both the addict and the relatives? If so, read on, where we review the painkiller, its use and insights into its addiction treatment.
What is fentanyl?
Fentanyl is a powerful painkiller used for severe and long-lasting chronic pain. It is mainly used when less potent remedies are no longer sufficient.
Fentanyl is a synthetic painkiller in the opioid group, and it is related to heroin and morphine, which are all depressants. However, the drug is far more dangerous and powerful than both heroin and morphine.
Fentanyl, for example, is 50 times more powerful than heroin and as much as 100 times more powerful than morphine.
Fentanyl is much stronger than heroin and morphine because of clear differences in the chemical structure. Fentanyl binds to the mu-opioid receptor in the brain. But because the drug passes more easily through the fat in the brain, it gets there faster than morphine and heroin, for example. It also grips the receptor much better, which means it triggers opioid action in the body very easily.
Fentanyl is not yet widely used in Denmark, but many American people use the addictive drug, which is why fentanyl abuse has resulted in a number of deaths in the US. In this country, attention has started to be paid to fentanyl addiction, so that a situation like the American one can be avoided.
Read also: What is Tramadol?
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How does fentanyl work?
Fentanyl is a morphine-like drug that acts on the areas of the brain that detect pain.
It is used both to relieve severe chronic pain, but in some cases it is also used for acute trauma patients.
Patients in need of fentanyl will receive it through fentanyl patches, from which the drug is released continuously over a few minutes or several days, depending on the dose. Usually, patients in need of additional pain relief are given a fentanyl patch containing enough medication for three days (72 hours).
A fentanyl patch can deliver anything from 12 and 25 micrograms to 50, 75 and 100 micrograms of fentanyl per hour. How long the drug works depends on its half-life, which is the time it takes the body to halve the concentration of fentanyl in the blood. The half-life of fentanyl in the blood is about 20-27 hours once the fentanyl patch is removed.
The dosage of fentanyl is individual and depends on each patient’s pain and previous opioid use.
Where to use fentanyl?
Fentanyl is primarily taken through a patch. Also known as fentanyl patch and fentanyl “Sandoz”, which is placed on a flat part of the upper body or upper arm. It must not be placed over a joint.
In hospitals, however, liquid injectables containing the drug are also used, such as fentanyl “B. Braun” and “Hameln”, which are used for operations and for patients in intensive care units.
However, if a patient needs it as an outpatient, the patient will typically get a prescription for fentanyl patches from the doctor. A fentanyl patch typically contains enough medicine for three days (72 hours), and the patch should therefore be changed every three days unless the doctor has told you otherwise. The used fentanyl patch should always be removed before a new one is applied, and the patch should always be changed at the same time every three days. This minimises the risk of an overdose.
In some cases, the patient may need to apply more than one patch, and in such a case, all the patches must of course be applied and removed at the same time.
If the patient applies too many patches to the skin or uses a fentanyl patch at the wrong dose, the patch should be removed immediately and medical attention sought immediately. Signs of overdose include:
- Road training problems
- Extreme sleepiness
- Inability to speak normally
- To think clearly and walk normally
- Sudden and constant feeling of confusion, dizziness and weakness in the body.
What are the side effects of fentanyl?
Fentanyl makes you more drowsy than usual and your breathing will also become slower and more shallow. In very rare cases, breathing problems can be life-threatening and, in the worst cases, fatal. This is especially true in patients who have not used strong painkillers before, such as fentanyl and morphine, and patients who take a fentanyl overdose.
Fentanyl, like any other medicine, naturally has side effects, but first of all, not everyone has side effects, and secondly, the degree of side effects varies.
Among the very common side effects are:
- Nausea, vomiting and constipation
- Sleepiness and drowsiness
In addition, allergic reactions, loss of appetite, difficulty sleeping, depression, feelings of anxiety or confusion, muscle cramps, high blood pressure, itching, skin rashes and redness of the skin are also among the more common side effects, although in many ways they resemble morphine side effects.
Patients who receive both antidepressants and fentanyl should be aware that the risk of side effects increases. Fentanyl can affect certain antidepressants. The patient may experience changes in their state of mind in the form of agitation or being able to see, hear and smell things that are not there. However, it is important to point out that these are not hallucinations.
There are a multitude of side effects from taking fentanyl, and you can find the full list of side effects in the leaflet for the medicine.
Uncontrolled discontinuation and increased dose can lead to abuse
If you suddenly stop using fentanyl, you may experience withdrawal symptoms such as vomiting, diarrhoea, nausea, anxiety, depression and chills. These withdrawal symptoms are not only life-threatening; they also make it incredibly difficult to let go of painkillers, increasing the risk of addiction and abuse.
The fear of unpleasant side effects and physical symptoms alone can lead some people to continue abusing fentanyl. The more often you use a fentanyl patch, the less effective the drug also becomes, and more people will therefore need a higher and higher dose to achieve the desired effect. If that happens, then you can develop what is called tolerance development.
If the patient wants to stop the medication, a tapering plan should be drawn up in consultation with the doctor. You should never take a cold turkey, as the subsequent withdrawals can be fatal. Instead, in consultation with the doctor, a tapering plan should be drawn up to ensure that the patient is slowly given a lower and lower dose of fentanyl.
Why use fentanyl?
Fentanyl is mainly used to treat severe pain, and it can be used by both children and adults.
Fentalnyl patches help relieve pain that is long-lasting and very severe, and cancer patients in particular are prescribed fentanyl by their doctor. Adults are prescribed it as part of ongoing pain management, while children over 2 who need ongoing pain management are only given fentanyl patches if they are already using opioid-containing medicines.
Read also: Treatment of OxyContin abuse
When to use fentanyl
Fentanyl is used when less powerful painkillers, such as morphine, can no longer relieve a patient’s pain sufficiently. The substance belongs to a group of powerful painkillers called opioids.
Opioids are drugs that have a painkilling effect because of their binding to the so-called opioid receptors in our central nervous system. When an opioid, such as fentanyl, binds to these receptors, the patient achieves an analgesic effect within a short time.
Who uses and abuses fentanyl?
The drug fentanyl is used to treat severe pain and is only available on prescription. It is thus a doctor who assesses whether a patient’s pain is so severe that it requires additional pain medication. Unfortunately, the body gets used to fentanyl quickly, and patients may find that they need larger and larger amounts to achieve the desired effect. In the worst case, this means that a patient slowly escalates their addiction, which can make it really difficult for relatives to detect it before it has ended in outright abuse.
Unfortunately, fentanyl is also available on the black market, where it is mixed with cocaine and heroin. The substance is a fine, white powder, which unfortunately makes it incredibly easy to mix into other substances. It’s identical to heroin, which is why drug users may not be aware that they’re in danger of injecting a lethal dose of heroin mixed with fentanyl directly into their bodies – before it’s too late. Due to its particular potency, very small amounts are needed to cause acute poisoning and it is easy to overdose.
What is the difference between a fentanyl patch and a fentanyl lollipop?
Fentanyl patches are mainly used for adults, while fentanyl lollipops are used for children. A so-called fentanyl lollipop is a tablet containing fentanyl that has been flavoured with berries. The tablet is attached to a stick, which is rubbed against the inside of the cheek or sucked on slowly so that the drug is absorbed through the mucous membranes – hence the nickname “fentanyl lollipop”.
A fentanyl lollipop takes effect 20-40 minutes after sucking or rubbing the inside of the cheek. A fentanyl lollipop is mainly used for children aged 3-12 who need to undergo a short but painful procedure.
Treatment and detoxification for fentanyl abuse
Do you or someone you know need help with treatment and withdrawal from fentanyl addiction? At Alfa Fredensborg, we offer both outpatient treatment, where the patient can manage his or her everyday life, and stay at home during the course of treatment. If the person is severely addicted, and therefore has a fentanyl addiction that is out of control, we recommend that the patient starts in our 24-hour treatment.
Please do not hesitate to contact us if you are concerned that you or someone you know is becoming or is in the process of becoming addicted to fentanyl. Contact us without obligation and get answers to any questions about fentanyl as well as advice and guidance.
We are ready to help with everything from confrontation to different types of treatment and rehab.
You are also welcome to contact us if you just want information on the subject.
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Do you want to get treatment or are you a relative of someone who is abusing strong painkillers? Call us or send us a message here.
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