Fentanyl is a potent synthetic opioid that was introduced to medical practices in the 1960s. It was given to patients as an intravenous anesthetic: “Sublimaze”. Doctors don’t often use Fentanyl due to its potency and high addiction rates. However, when used, it proves to be effective in relieving moderate-to-severe chronic pain. Because it has less adverse cardiac effects than other opioid pain relievers, it’s a good candidate for cardiac surgery patients. 

The difference between a dose for comfort and a lethal dose is slim. However, that hasn’t stopped it from hitting the streets. Many illegal forms of fentanyl sold usually either mixed with or in place of heroin causes accidental and lethal overdoses.

Effects of fentanyl

Like heroin, this Schedule II opioid bonds to the body’s opioid receptors. These receptors increase dopamine levels in the central nervous system. This is what gives the calming, almost numb effects. Fentanyl also depresses the respiratory centers as well as the cough reflex and constricts the pupils. The duration of the drug usually lasts from about 30 to 90 minutes.

The effects depend on the user’s:

  • Size
  • Weight
  • State of health
  • The amount taken
  • Taken with any other drugs
  • If the user has a tolerance to opioids

Medical use

Fentanyl can be medically administered in various forms, depending on the person and reasoning for use:

  • Lozenges
  • Lollipops
  • Oral and nasal sprays
  • Injections
  • Transdermal patch for slow, continuous delivery. The patch is only for patients who already are tolerant to opioids. Absorbed through the skin, it can last for 13-24 hours after the patch has been removed.

When prescribing the drug, clinicians must thoroughly screen candidates for the potential for abuse. Serious adverse events including death can occur as a result of improper patient selection and drug storage or disposal.

It is extremely important to follow the directions for using skin patches. This is to prevent death or other serious side effects from accidental overdose. However, those with cancer using it for extreme pain management are unlikely to become recreational users.

Illicit use of fentanyl

Fentanyl (known as drop dead, China white, serial killer, and shine on the streets) abuse began in the 1970s and has recently increased rapidly. It can either be obtained through medical supplies or manufactured in illicit labs. Note that even used patches can contain high doses of fentanyl. Abusers who find these patches remove the gel to either eat, place under their tongue, smoke, or inject it.

Fentanyl produced in illegal labs is hundreds of times more potent than heroin. This leads to more cases of respiratory depression and overdoses. There is a significant increase in the use and confiscation of illegal fentanyl from 2012 – 2014.

Those who abuse heroin or cocaine may not be aware of the potency of street-sold drugs, if laced with fentanyl. The potency of such drugs is unknown. Those who sell on the street don’t disclose the inclusion of fentanyl. Any dose – even a reduced dose – can cause accidental overdose or death.


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