Overview: Fentanyl

Fentanyl is a very potent synthetic opiate known under brand names like Actiq, Duragesic, and Fentora. It has a very rapid onset and short duration. It is 50-100 times stronger than morphine. Fentanyl was synthesized by Pual Janssen in 1960 as an analog to pethidine (also known as meperidine, brand name Demerol.)

What are the effects of Fentanyl?

Fentanyl is a very potent agonist of the mu opioid receptors much like other opiates/opioids. This action leads it to be a very potent analgesic as well as a central nervous depressant. Its effects are similar to that of other synthetic opiates, and it has many analogues established as well. Effects generally include..

• Pain Relief
• Euphoria
• Respiratory Depression
• Relaxation
• Sedation
• Anxiolytic
• Itchiness (Less common than some other opioids due to Histamine release being less with Fentanyl)
• Constipation
• Pupil Constriction
• Cough Suppression

Fentanyl was first synthesized in 1960 by Paul Janssen following the structure of Pethidine (Demerol) being tweaked around.  It was marketed as Sublimaze in the 1960s for general analgesia and a plethora of indistinguishable analogues were to come (e.g. Sufentanil, Alfentanil, Carfentanil). 

In the mid-1990s Fentanyl’s use in medicine increased greatly with the introduction of Duragesic, a transdermal patch version of the drug still commonly used today. Due to its activity in mcg range, the later decade included not just transdermal patches, but Actiq brand lollipops and other buccal forms of fentanyl. As of 2012, Fentanyl was the most widely used synthetic opiate in medicine, likely due to its low side effect profile and potency for patients suffering from cancers, or elderly suffering from other severely painful conditions. 

Fentanyl’s potency and widespread use has led to thousands of deaths since the start of the 21st century. From recreational use and improper medical treatment advisory. It is nearly impossible for the naked eye to see a difference in an effective dose of fentanyl citrate powder and a lethal dose. For this reason, ths drugs potency has garnered it mainstream attention as deaths have occured from fentanyl being cut into a number of drugs, specifically opiates like heroin. Fentanyl has been declared a public health crisis in Canada and the UK as it has averaged 2 deaths a day in these areas. It remains a major concern with illicit drugs. Legendary Pop singer Prince died from an overdose of Fentanyl found in his system. Counterfeit pills were found in his home labeled Watson 385, which is prescription Vicodin (Hydrocodone/Acetaminophen) so his death was labeled accidental and was very tragic and eye-opening for the media and his fans. Illicit clandestine produced Fentanyl has appeared widespread in Canada, the US, and the EU. It has also been reported most commonly as a dilutant in heroin, but Fentanyl and its many even more potent analogues have appeared in Cocaine, MDMA, and pressed pills sold as Oxycodone or Oxycontin and even Xanax “Bars.” Its easy synthesis and relatively cheap manufacturing is likely the reason it has been diluted and even sold as a plethora of other drugs that seem counterintuitive to dilute with Fentanyl (e.g. Cocaine, MDMA)