Fentanyl

1. Fentanyl By Rene Boyas

2. Names • Chemical formula is C22H28N2O • Its chemical name is N-(1-(2-phenethyl)-4-piperidinyl-N-phenyl-propanamide. • Like heroin morphine and other opium drugs fentanyl works by binding the body’s opiate receptors when it does this it can drive up dopamine levels in the brain’s rewards areas • Names of prescription forms of Fentanyl are • Sublimaze used to sedetate certain large animals., Actiq (lollipop), and (Duragesic patch) • Street Name; It is know by many names but the most popular include; China Girl, Dance Fever, Friend, Jackpot, Tango and Cash Tnt • China White because of its purity and potency

3. Classification • Fentanyl is a powerful synthetic opiate similar to morphine, although it is more potent. • Like heroin morphine and other opium drugs fentanyl woks by binding the body’s opiate receptors when it does this it can drive up dopamine levels in the brain’s rewards areas • Fentanyl if used correct could act as a pain killer. • Its effects are quicker than that of morphine and heroin • Its is a Schedule 2 drug controlled substance • Classified as a narcotic, it has a high potential for abuse and limited medical usage. • Typically used to treat patients with severe pain, and also to manage pain after surgery. • In 1990’s it was used to treat patients with a less severe of cancer • How does this drug Work? Fentanyl lowers the feeling of pain and how one reacts to pain. It is usually given in a form of a shot into the vein. • Transedermal patch • In lozenge form • However the type of fentanyl associated with recent overdoses was produced in clandestine labs and mixed with or substituted for heroin

4. History • It was first synthesized in Belgium in the Late 50’s by a chemist named Paul Jansennof his newly formed Janssen Pharmaceuticals in 1959. • In the 1960s, fentanyl was introduced as an intravenous anesthetic under the trade name of Sublimaze. • In the mid-1990s, Janssen Pharmaceuticals developed and introduced the Duragesic patch, which is a formation of an inert alcohol gel infused with fentanyl doses they are worn to provide constant administration of the opium over a period of 48 to 72 hours. After a set of successful clinical trials, Duragesic fentanyl patches were addedinto the medical practice. • Following the patch, a flavored lollipop of fentanyl citrate mixed with inert fillers was introduced under the brand name of Actiq, becoming the first quick-acting formation of fentanyl for use with chronic breakthrough pain. • Even More recently, fentanyl has been developed into an effervescent tab for buccal absorption much like the Actiq lollipop, followed by a buccal spray device for fast-acting relief • A new Fentanyl product has just been approved by the FDA for breakthrough cancer pain called Onsolis. This uses a new drug delivery technology called BEMA (fentanyl buccal soluble film) which is placed in the mouth on a small disc. There appears to be less abuse potential because the drug can not be crushed up and snorted like other Fentanyl product . It also has less of a chance of causing mouth ulcers • Introduced as an intravenous anesthetic in 1960’s • Unfortunately the potency of fentanyl has led it to become one of the most abused drugs in the United States. • Many people addicted to other opiates embrace the low cost and the high power of fentanyl, and over 12 illicit types of the drug are known to exist. • Unregulated fentanyl is extremely dangerous because its effects have a much shorter duration than heroin which causes abusers to crave more and more of it. • Fentanyl is a safe and effective drug, so long as the proper precautions are made to prevent overdose • The single largest accident involving fentanyl came in 2004 when certain Duragesic patches suffered a manufacturing defect that risked exposing patients to concentrated doses of the drug

5. Production • Fentanyl is created in labs since it’s a synthetic drug • People tend to mix it with heroin to get even a stronger effect • One of the ingredients given to women during childbirth to ease the pain of contractions • Oral surgeons have used it for tooth extraction. Heart surgeons use it in the most delicate operations • . A vast majority of people facing any kind of surgery receives at least one shot of fentanyl at the beginning stages of a procedure, to ease the tension of general anesthesia • DEA, prescription for fentanyl citrate have increased from half a million in 1994 to more than 5 million in 2003.

6. User • The most common abusers are those between ages 19- 44 • They abuse this drug because it is becoming an additional desired opium similar to oxycodone and methadone. • Fentanyl’s potency is 50-100 times of that of morphine • Duration after usage is between 30- 60 minutes • This drug was created for medical use so you can get a prescription for it at your local hospital for chronic pain it is also sold illegally in the black market so to obtain it you need some sort of type of connections. • Most people that started taking the fentanyl patch started out by taking a prescription that was of lesser potency • Addicts get fentanyl patches in hospital dumpsters, they are thrown out because they have been used already, but they still contain enough fentanyl to get that natural high. • Also stolen from people that have it prescribed • It can cost up to 40 dollars in the street depending on its strength

7. Side Effects for taking Fentanyl • analgesia • sedation • euphoria- said to be less than that of morphine • feelings of relaxation • pupil constriction • sweating • slowed reaction time • changes in focus, attention, and thought • impaired thinking, confusion • loss of appetite • hiccups • changes in vision • constipation • nausea, vomiting • dizziness, headache • itching • dry mouth • fatigue, weakness • nervousness • sleeplessness/insomnia • light-headedness, fainting • difficulty breathing • respiratory depression, respiratory arrest • Signs of overdose : trouble breathing, shallow breathing, extreme tiredness, inability to think, feeling faint, and confusion

8. Side Effects continued • You should check with your doctor if you experience any of the following: • Slow heart rate • Feeling like you might pass out • Vomiting • Unusual thoughts that includes unusual behavior • White sores around or inside your mouth Side Effects of the Nervous System are; mental and respiratory depression and even seizures. Cardiovascular side effects; hypotension arrhythmias • One Metabolic side effect is inappropriate hormone levels

9. Risks • Fentanyl is so powerful that it only takes a tiny difference in dosage to be extremely fatal. Injection is an extremely fast and efficient method with no recourse if the dose was too high, only excepting a naloxone injection which would have to be administered very quickly by trained medical professionals.  • Anyone who takes or is taking fentanyl at this time should be aware of the health risks. • Liver Damage • Addiction • Fatality • Lethal dose for this drug is unknown for humans, 3.1 milligrams per kilograms for rats, 0.03 milligrams per kilograms for monkeys

10. Detection • You can detect whether someone has taken fentanyl by checking the urine using a liquid to liquid extraction • Analysis is performed by liquid chromatography to mass spectrometry by using ion monitoring • Can be detected in the hair not in sweat even after patch is applied to skin

11. Consequences • Treatment programs include Detoxification Process to remove all the harmful toxins and the effects of this drug. They will monitor their patients for 24 hours each day until they have successfully changed their evil ways . • Residential rehab will give the abuser intensive therapy as well • Anyone who sells or distributes fentanyl can face criminal offenses. • Possession of less than 40 grams of fentanyl is a schedule 2 offense

12. Works Cited • http://www.emcdda.europa.eu/publications/drug-profiles/fentanyl • http://www.redwoodtoxicology.com/resources/drug_info/fentanyl.html • http://www.soberliving.com/resources/addictions/fentanyl-popular-opiate-drug-and-substitute-for-heroin-and-oxycontin • http://ecstasy.com.ua/fentanyl/fentanyl-legal-consequences • http://www.enotes.com/fentanyl-reference/fentanyl