Fentanyl: Dangerous potential for abuse

Kimberly Kjome 2013_mg_0057Reports of possible fentanyl-related drug overdoses in Austin prompt a deeper look into this powerful opioid drug.

Fentanyl is a potent prescription drug used to treat people with chronic pain or long-lasting pain conditions including some forms of cancer. It also helps ease pain in cases of severe acute pain from surgery.

Its effects are similar to the pain relief of morphine. But unlike morphine and its fellow opioids such as hydrocodone and oxycodone, fentanyl is synthetic. It’s made entirely in the lab setting, which makes it much cheaper and easier to produce than its naturally-occurring cousins.

“Since it’s very easy to manufacture, places in China may make and sell it to Latin-American drug cartels who then mix the fentanyl with heroin or totally different drugs like cocaine,” Kimberly Kjome, MD, assistant professor at Dell Medical School at the University of Texas said.

“So people think they’re taking heroin or cocaine or some other drug they’re familiar with, and have no idea it has fentanyl in it,” said Kjome, medical director and inpatient psychiatrist at Seton Shoal Creek Hospital, which houses a chemical dependency unit where patients with mental health conditions and chemical dependency problems can seek treatment.

Why is fentanyl so dangerous when abused?

Fentanyl, a Schedule II narcotic, produces a state of euphoria and relaxation. It’s also a very short-acting opiate. The shorter a drug acts, the more intense the high it tends to give. Hence part of its appeal, said Kjome.

But because fentanyl is 30 to 50 times more powerful than heroin, and up to 100 times stronger than morphine, according to the U.S. Drug Enforcement Agency, it binds more strongly with the opiate receptors in parts of the brain that control pain and emotions. As a result, those who abuse it quickly become tolerant to its effects.

Extremely lethal, fentanyl can kill even in doses as small as 0.25 mg.

“It causes the heart and lungs to slow down until you stop breathing – that’s what kills people when they overdose on it,” Kjome said.

It can be taken in several different forms, including inhaling it, swallowing a pill, injecting it, getting it through an IV or absorbing it through the skin with a patch.

Recent rise in fentanyl abuse

As authorities crack down on the opiate abuse epidemic, physicians accordingly have begun to limit how much they prescribe this class of medications.

“People who used to abuse prescription opiates may be trying to get it illegally now, turning to the streets and looking for substitutes,” Kjome said.

Since 2014, certain U.S. regions including the east coast, Appalachia, and Los Angeles as recently as last month have seen rises of fentanyl-related overdoses.

“Substance abusers need to know that if someone sells you a drug, it doesn’t necessarily contain what they say it does. You’re putting yourself at risk of dying,” Kjome said.

Though fentanyl is extremely dangerous, an overdose may be treated if the user receives treatment soon enough. Naxalone is one possible antidote for fentanyl overdose.

People struggling with substance abuse problems can seek help from Seton Shoal Creek doctors, along with several other community resources for help.