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Fentanyl Patch Side Effects and Abuse

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Fentanyl is a powerful opioid drug that’s used to treat moderate to severe pain. It’s also a drug that’s driving a spike in opioid overdose deaths in the United States. Medicinal fentanyl is a useful drug that can be administered for quick relief of severe pain. It can even be administered via a convenient transdermal patch which is easy to use and non-invasive. However, illicit fentanyl is a powerful drug that can be fatal to people that abuse it. 

Is the fentanyl patch an advantageous medication or a drug that’s more dangerous than it’s worth? Learn more about this drug, and its means of administration. 

What is Fentanyl? 

Fentanyl is a synthetic opioid that’s among the most potent pain relievers that are used for medical purposes in humans. As an opioid, fentanyl works in a way that’s similar to morphine and oxycodone. Fentanyl is very similar to your own naturally-occurring opioid called endorphins. 

These endorphins in your nervous system are designed to regulate the pain response in your body by binding to opioid receptors and stopping pain signals that are being sent to your brain. In cases of moderate to severe pain, symptoms may be too strong for your natural endorphins to stop the pain completely. Medicinal opioids have a much more intense effect on pain receptors, effectively blocking neurons that are both sending and receiving pain signals. 

Fentanyl is a fast-acting and extremely strong opioid. In fact, it can be up to 100 times more powerful than morphine. This relative strength makes it an effective drug in the right hands. Small amounts of the drug can go along way, and it’s strong enough to be used through multiple routes of administration including, injections, lozenges, and a transdermal patch. However, in the wrong hands, fentanyl can be dangerous. The drug’s strength can cause it to lead to an overdose even in tiny doses. For the average adult, it only takes 3 milligrams of the drug to cause a fatal overdose. That means a fatal dose of pure fentanyl is about ten times lighter than a snowflake. 

Because fentanyl is so potent, it’s also cheap to produce and ship legally and illegally. Very small packages can contain a significant amount of fentanyl. In fact, considering fentanyl’s strength, a one-pound brick would contain more than 150,000 lethal doses. In illegal trade, fentanyl has been shipped in packages as small as iPhone boxes. That makes it cheap to ship and very difficult to detect. As a result, the United States has seen an increase in illicit fentanyl use. 

The drug is often mixed into heroin and other drugs in order to increase its overall potency. This causes people to overdose that don’t even realize their heroin has been mixed with fentanyl. Other opioid users seek out fentanyl because it is so strong and cheap. People with chronic opioid use disorders may have a high enough tolerance to handle fentanyl, and it affords them more bang for their buck. However, it’s difficult for drug dealers and users to measure out appropriate doses of the drug. Since it’s so potent, even small mistakes can be fatal.

Because fentanyl is so dangerous, medications that include it are heavily regulated. For instance, most institutions follow narcotics regulations when dealing with fentanyl patches. A nurse who is removing and changing a fentanyl patch needs another nurse to be there to witness them throwing out the old patch.

What are the Benefits of the Fentanyl Patch?

The fentanyl patch is a special formulation that delivers the medication over a specific period of time. This can help facilitate quick pain relief that lasts for a significant amount of time before wearing off. 

The patch works by delivering fentanyl into the bloodstream through the skin. This is a non-invasive way to administer the medication that doesn’t require an injection or an IV. This makes it ideal for people who need ongoing pain management in a clinical setting. 

Fentanyl patches are also used to manage the pain of cancer patients, especially people with severe late-stage cancer. In some cases, patients can’t swallow pills or keep them down, so an analgesic that can be administered through the skin is helpful. If the medication needs to be suddenly discontinued, the patch can simply be removed to stop the medication from entering the body. 

What are the Drawbacks of the Fentanyl Patch?

The most obvious drawback of a fentanyl patch is the potential for abuse, addiction, and overdose that comes with powerful opioids. As an opioid, fentanyl can slow down the nervous system. This can cause a feeling of sedation and relaxation that can aid in recovery, but it can also cause a feeling of euphoria. Fast-acting, euphoric psychoactive drugs tend to be the kind of drugs people abuse for recreation. Fentanyl abuse is inherently dangerous. A dose that’s slightly too high can cause a fatal overdose. If you don’t overdose, frequent use can cause dependence and addiction. 

Dependence occurs when your brain adapts your neurochemistry around the presence of the drug. If you stop using the drug after becoming dependent, the resulting chemical imbalance will cause extremely uncomfortable withdrawal symptoms. Addiction occurs when the drug starts to affect the reward center of the brain. Your reward center is designed to pick up on important, life-sustaining activities and encourage you to repeat them. The reward center works with certain chemicals like endorphins, dopamine, and serotonin. 

Fentanyl mimics endorphins in the brain, and research shows that opioids also affect the release of dopamine. High doses or repeated use can cause your reward center to mistake fentanyl use for life-sustaining activities like eating and drinking. Then, it will cause powerful compulsions to use the drug again. 

High doses of fentanyl can cause deadly overdose symptoms. Opioids can cause your nervous system to slow down to the point of affecting some of the automatic functions of your autonomic nervous system like your heart rate, breathing, or blood pressure. An overdose can cause hypotension and respiratory depression. In fatal overdoses, respiratory depression usually leads to oxygen deprivation, brain damage, and death.

Sources

Cafasso, J. (2017, July 11). Why Do We Need Endorphins? from https://www.healthline.com/health/endorphins

Centers for Disease Control and Prevention. (2019, May 31). Fentanyl | Drug Overdose | CDC Injury Center. from https://www.cdc.gov/drugoverdose/opioids/fentanyl.html

Drug Enforcement Administration. (n.d.). Fentanyl. from https://www.dea.gov/factsheets/fentanyl

National Institute on Drug Abuse. (2007, January). 4: Opiates binding to opiate receptors in the nucleus accumbens: increased dopamine release. from https://www.drugabuse.gov/publications/teaching-packets/neurobiology-drug-addiction/section-iii-action-heroin-morphine/4-opiates-binding-to-opiate-rece

National Institute on Drug Abuse. (2019, January 29). Overdose Death Rates. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

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