Fentanyl, drug or medicine, abuse and side effects

David Holt
Fentanyl, drug or medicine, abuse and side effects

Fentanyl is a powerful synthetic opioid that has intense analgesic effects and its action is similar to that of other opioids such as morphine or heroin, the difference is that fentanyl is approximately 100 times more powerful than morphine and 50 times stronger than heroin. In fact, it is the most potent opioid analgesic available on the market for clinical use in pain management..

Although fentanyl is considered safe and effective when used and controlled in a medical setting, it carries a high risk of potential for abuse.


  • What is fentanyl
  • Clinical uses of fentanyl
    • Fentanyl patch
  • Fentanyl abuse
  • Side effects
    • Physical effects of fentanyl
    • Cognitive effects of fentanyl
    • Adverse effects of fentanyl
    • Side effects of addictive use of fentanyl
  • Risks
  • Overdose
    • Conclusions
    • References

What is fentanyl

Fentanyl is a very effective synthetic opioid for relieving moderate to severe chronic pain. This substance binds to opioid receptors in the body, increasing dopamine levels in the central nervous system. The increase in dopamine produces a state of relaxation, relieves pain, reduces the perception of suffering and promotes a feeling of well-being (euphoria).

It is used in medicine to control pain during surgery; it is also used to treat chronic pain symptoms in various conditions such as cancer.

Fentanyl depresses the respiratory centers, the cough reflex, and constricts the pupils. It works in a few minutes, relieving pain and producing sedation. But its effect is short-lived, between 30 to 90 minutes.

This substance affects each person differently. Its effects depend on weight, height, general health, dosage, etc. On the other hand, if fentanyl is taken in combination with other drugs, the effects can be considerably enhanced..

The difference between a therapeutic dose and a lethal dose of fentanyl, unfortunately, is very small. Additionally, there are many illegal fentanyl analogs and derivatives that are much stronger than the prescription version..

Some users often take fentanyl as a substitute for heroin.

Clinical uses of fentanyl

Fentanyl was first synthesized by Paul Janssen in 1960 after studying elements analogous to pethidine, a substance with opioid activity. It was from then on that the use of fentanyl in medicine, in the form of fentanyl citrate, as a general anesthetic became widespread. Following this, many other fentanyl analogues were developed and introduced into medical practice, including sufentanil, alfentanil, remifentanil, and carfentanil..

In the mid-1990s, fentanyl was first marketed as a palliative pain treatment in the form of a patch, the brand name of which is Duragesic. Then, in the decade that followed, the first fast-acting prescription forms of fentanyl were introduced for personal use. Since 2012, fentanyl has been the most widely used synthetic opioid in clinical practice with several new methods of administration now available as pills, oral injections, or sublingual spray..

Clinically it can also be taken intravenously, intramuscularly, spinally or epidurally (in a space in the lower part of the spinal cord).

Fentanyl patch

For continuous administration, fentanyl is usually given through a transdermal patch that is adhered to the skin. The patch works by slowly releasing this substance through the skin into the bloodstream over 48-72 hours..

Because it has already been absorbed through the skin, fentanyl can continue to be effective for 13-24 hours after the patch is removed..

Fentanyl abuse

Fentanyl analogs, designer drugs almost identical to the original, can be manufactured and mixed with or substituted for heroin. Because fentanyl and its analogues are incredibly potent even than heroin, there is a vastly increased risk of overdose and death.

Medicines outside of clinical practice are often obtained through diversion or theft of medical supplies, or it can be manufactured in illegal laboratories.

Discarded fentanyl patches may still contain significant amounts of the drug. It is for this reason that consumers can take advantage of to remove the content of the gel from discarded patches and eat it, place it under the tongue, smoke it or even inject it..

Fentanyl analogs produced in illicit laboratories can be hundreds of times more potent than street heroin and tend to produce significantly more respiratory depression, making them even more dangerous to users than heroin.

People who use heroin or cocaine may not know that the potency of these two drugs can be significantly increased by adding fentanyl, the potential danger of overdose and death being much greater.

Side effects

Older patients are more likely than younger ones to experience adverse effects, especially respiratory depressant effects. Extreme caution should be exercised with this age group.

Physical effects of fentanyl

  • Pain Relief: Compared to other opioids, fentanyl is a strong pain reliever that provides relief even in low doses.
  • Physical euphoria: its effects are less intense when compared to that of morphine or diacetylmorphine (heroin). The sensation itself can be described as feelings of intense physical comfort, warmth, and bliss that spread throughout the body..
  • Respiratory depression: Compared to other opioids, fentanyl exhibits this effect at low doses, producing the sensation of mild to moderate slowing of breathing. In high doses and overdose, respiratory depression can cause shortness of breath, abnormal breathing patterns, semi-consciousness, or loss of consciousness. Severe overdoses can lead to coma or death.
  • Sedation: Fentanyl is much more sedating than other opiates. Even at moderate doses, this compound can cause overwhelming feelings of sedation and fatigue considerably stronger than heroin and oxycodone.
  • Pupillary contraction
  • Double vision: at high doses, the eyes go out of focus and refocus uncontrollably. This creates a blurring effect and a double vision that is present no matter where one focuses their gaze..
  • Cough suppression
  • Decreased libido

Cognitive effects of fentanyl

  • Cognitive euphoria: the euphoria it produces is less intense than that of morphine or heroin. It is still, however, capable of causing overwhelming happiness in high doses. The symptoms can be described as a powerful and overwhelming feeling of emotional bliss, satisfaction, and happiness..
  • Suppression of anxiety symptoms
  • Tolerance and addiction

Adverse effects of fentanyl

  • Drowsiness and unconsciousness
  • Confusion
  • Constipation
  • Weakness
  • Dry mouth
  • Itch
  • Difficulty urinating
  • Slow breathing
  • Decreased heart rate
  • Decreased blood pressure
  • Sickness
  • Perspiration
  • Redness
  • Muscular stiffness
  • Difficult to focus
  • Appetite suppression
  • Anorgasmia

Adverse effects associated with fentanyl transdermal patches include redness, rash, itching, and swelling at the application site..

Side effects of addictive use of fentanyl

  • Depression
  • Crying episodes
  • Suicidal thoughts
  • Behavior changes
  • Anxiety and irritability
  • Hallucinations


As with any opioid, there is a high risk of dependence, tolerance, abuse, and addiction with the use of fentanyl. Physical dependence produces withdrawal symptoms when people abruptly stop taking the drug.

Withdrawal symptoms usually begin within 12 hours after the last dose of fentanyl and can last 1 week or more. An individual with withdrawal may experience:

  • Dilated pupils
  • Vomiting and diarrhea
  • Goose bumps
  • Runny nose
  • Hot and cold flashes
  • Anxiety
  • Agitation
  • Insomnia
  • Severe general pain

Fentanyl users quickly develop a tolerance to high doses, which means that more medication is needed for them to achieve the desired effect..

Repeated opioid use often ends in addiction, a chronic disease that goes beyond physical dependence and is characterized by uncontrollable drug-seeking behavior despite harmful and negative consequences. Being able to consume the drug becomes the main objective in the life of an addict, regardless of the consequences.

Treatment for fentanyl addiction is the same as for any opioid use disorder and depends on the severity of the addiction. May include detoxification treatments by entering specialized or outpatient centers, with medications to control cravings and relapses, and residential and outpatient behavioral treatment programs.


Consuming fentanyl can lead to accidental death even with a single dose, especially if it is taken incorrectly or in high doses. Celebrities like Prince or Demi Lobato have been consumers of this dangerous drug, with terrible outcomes.

The signs and symptoms of a fentanyl overdose are:

  • Slow or shallow breathing
  • Bradycardia (slow heart beat)
  • Severe drowsiness
  • Clammy skin
  • Trouble walking or talking
  • Feeling weak, dizzy, or confused
  • Lack of response


Fentanyl is an extremely potent opioid that offers significant pain relief to those with severe or chronic severe pain conditions, but is also capable of causing considerable harm or death to people who misuse or are accidentally exposed.



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