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    Why Fentanyl Is So Deadly?

    Fentanyl is a synthetic opioid that offers pain relief to those who suffer from severe or chronic pain conditions. But the drug is also capable of causing considerable harm or death to individuals who abuse or are accidentally exposed to the life-threatening drug. The world is struggling with an opioid overdose epidemic for the past decades. The fentanyl crisis we face in the United States has been one of the worst public health issues.

    Fentanyl, the synthetic narcotic painkiller, has been named a chief culprit in the nation’s opioid crisis.

    Fentanyl is also produced and sold illegally. Fentanyl, especially illicit fentanyl and its analogs, have caused an alarming number of opioid overdose deaths in the past decade. In 2018, the U.S. saw more than 30,000 overdose deaths involving synthetic opioids other than methadone, including fentanyl. The side effects of fentanyl are similar to that of heroin.

    In 2018, the U.S. saw more than 30,000 overdose deaths involving synthetic opioids other than methadone, including fentanyl.

    What is fentanyl, and what does it do?  Why is Fentanyl so deadly?

    Fentanyl is a powerful synthetic opioid that is like morphine but is 50 to 100 times more potent.  This explains why fentanyl is so deadly.  It is a prescription drug that is also made and used illegally.  Like morphine, it is a medicine that is typically used to treat patients with severe pain, especially after surgery.  It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids.  Tolerance occurs when you need a higher and/or more frequent amount of a drug to get the desired effects.

    Fentanyl is a powerful synthetic opioid approved by the FDA for use as a painkiller and anesthetic. It works by binding to opioid receptors in the brain, but it does so faster -- and in smaller doses -- than morphine or heroin. Like other opioids, it boosts levels of the chemical dopamine, which controls feelings of reward, pleasure, euphoria, and relaxation.

    Fentanyl used to be a relatively unknown medication, but it has recently gained notoriety as a central figure in the opioid epidemic.  This powerful synthetic opioid medication is prescribed legally in various forms under various brand names, including:

    • Duragesic (transdermal film).
    • Sublimaze (injection).
    • Subsys (sublingual spray).
    • Actiq (lozenge).
    • Fentora (tablet).

    Fentanyl Potency

    Fentanyl is deadly when compared to heroin

    Fentanyl is a potent opioid painkiller. It is 50-100 times more potent than morphine, and even just a small amount can cause a fatal overdose.  This helps to understand why fentanyl is so deadly.  Because it is so potent, this medication is primarily used for very severe pain, such as post-surgical pain. It is also used to treat chronic pain in people who have become tolerant to other opioids.  The picture below illustrates just how little Fentanyl it takes to be deadly, as compared to heroin.

    How much fentanyl is lethal may vary from person to person; however, it takes a tiny amount of fentanyl to cause a deadly overdose as a general rule. Fentanyl is deadly

    The United States Drug Enforcement Administration (DEA) produced the following image to demonstrate just what a small amount (2 milligrams, the size of 2 grains of salt) of fentanyl is so deadly in most people:

    Where Does Street Fentanyl Come From?

    Fentanyl purchased on the street may come from prescription fentanyl that has been stolen, obtained by forged prescriptions, or diverted illegally by patients or doctors.  However, fentanyl is now very often produced illegally. This product is referred to as illicitly manufactured fentanyl.

    According to the Centers for Disease Control and Prevention (CDC), it is illicitly manufactured fentanyl that is responsible for most of the fentanyl-related harm (overdose deaths, for example) in the United States.

    Illicitly manufactured fentanyl is often added to other drugs such as heroin, cocaine, or methamphetamine, often without the buyer’s knowledge.  Fentanyl-adulterated street drugs have been responsible for many unintentional overdoses.

    How Has Fentanyl Impacted Overdoses in Ohio

    Fentanyl is a powerful painkiller that the U.S. Drug Enforcement Administration says is 25 to 50 times more powerful than heroin and packs 50 to 100 times more punch than morphine.  Fentanyl reached record levels in Ohio’s drug supply last year during the covid-19 pandemic.  Fentanyl is 9x more likely to cause an overdose death than heroin or cocaine, and fentanyl is often cut into other drugs, this study of Ohio found.  More Ohio residents died of opioid overdoses during a three-month period of 2020 than at any other point in the last decade, according to a new analysis released by the Scientific Committee on Opioid Prevention and Education (SCOPE) initiated by Ohio Attorney General Dave Yost.  The graph below, from the Ohio Department of Health, illustrates the impact that fentanyl has had in Ohio.

    Fentanyl impact on Ohio Overdoses

    Symptoms and Signs of a Fentanyl Overdose

    A fentanyl overdose can happen quickly. An overdose on fentanyl or other opioids can usually be identified with 3 characteristic symptoms, known as the opioid overdose triad:

    1. Very small (pinpoint) pupils.
    2. Extreme sleepiness or unconsciousness/inability to wake.
    3. Problems breathing or stopped breathing.

    Other signs of opioid overdose include:

    • Limp body.
    • Choking sounds or gurgling.
    • Very slow or no heartbeat.
    • Cold, blue, or clammy skin.

    In the case of a fentanyl overdose, immediate action may save the person’s life. If you notice the signs of an opioid overdose in another person, call for emergency help right away. If you have naloxone (Narcan) and know how to use it, administer it immediately. Lay the person on their side to prevent choking and stay with them until help arrives.

    The Fentanyl Crisis in Ohio

    The horrors of the rising fentanyl crisis can be seen in action throughout Ohio, where heroin abuse has been eclipsed by the abuse of fentanyl or one of its analogs.  In the Franklin County area, where Columbus, Ohio is located here—drug overdose fatalities have skyrocketed.   In 2020, Franklin county suffered 614 drug fatalities which put Columbus and Franklin County at the top of Ohio's deadliest counties.

    These deaths are almost entirely related to fentanyl or equivalent drugs, and the problem is statewide in Ohio.  In Montgomery County, where Dayton is, three out of 100 drug overdose deaths tested positive for heroin, and 99 of the 100 tested positive for fentanyl or an analog. The deadliest fentanyl analog is carfentanil. This literal elephant tranquilizer is 5,000 times more potent than heroin, and a lethal dose can be as tiny as a couple of grains of salt.

    On the day that carfentanil showed up in Akron in 2016, 17 individuals overdosed, and one individual died over a nine-hour span. Through the next six months, 140 overdose fatalities tested positive for carfentanil—fifty percent more deaths than Akron had for all of 2015.

    What happens when someone stops using fentanyl?

    Withdrawal symptoms can be extremely uncomfortable and painful and may include muscle pain, diarrhea, vomiting, nausea, sweating, abdominal pain and cramping, rapid heart rate, insomnia, tremors, and anxiety.

    What is the treatment for addiction to fentanyl?

    Treatment for fentanyl addiction, like any opioid use disorder, includes the use of FDA-approved medications -- methadone, Suboxone, buprenorphine, or naltrexone -- prescribed and managed by a health care professional.  It also includes professional therapy and recovery support systems, such as group counseling and individual counseling.

    If you are struggling with fentanyl addiction, contact PUSH for Recovery today.  Our proven medically assisted treatments, like Suboxone, combined with evidence-based therapies delivered as part of our Ohio outpatient drug rehab program, can help you overcome fentanyl addiction.  Call today.  Immediate openings and same-day assessments are available in Columbus, Ohio.


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