Fentanyl has developed a dark reputation for the role it has played in the opioid overdose epidemic. But the original uses of fentanyl were actually intended for the healthcare setting. What exactly is fentanyl, and how do people misuse this substance?
What Is Fentanyl Used For?
Although fentanyl is better–known for its contributions to the opioid overdose crisis, healthcare professionals originally developed this drug because clinicians were looking for a more effective, faster-acting painkiller for their patients.
The Journal of Pain reports that a Belgium doctor named Paul Janssen and his team of researchers created the first iteration of fentanyl in 1960. In those early stages, it could only be used as an intravenous pain reliever because it was less effective in other forms. But even when it was first synthesized, fentanyl was still up to 200 times more powerful than morphine.
Throughout the 1960s and 1970s, clinicians started to mix fentanyl with other medications, such as sedatives, to use as an anesthetic because it was so much more powerful than other painkillers, so very little fentanyl was needed to ensure that a patient didn’t experience any discomfort during surgery.
Although fentanyl was gaining popularity in Europe, it didn’t make its way to the United States until the late 1960s and was met with some resistance from the Food and Drug Administration. Concerns regarding fentanyl’s potency and potential for abuse led to negotiations about how to safely bring fentanyl to America. Once a compromise was reached, the FDA approved fentanyl for use in the U.S. in 1968, but only if combined with droperidol, a medication commonly used as a sedative.
Fentanyl use began to expand in the 1980s, with healthcare professionals replacing high-dose morphine with high-dose fentanyl in heart and vascular surgeries and using fentanyl for spinal anesthesia and spinal epidurals. Researchers then began to recognize that fentanyl could also be used for severe pain after surgery or for patients who were struggling with chronic pain. Soon, researchers began to develop other types of fentanyl.
What Are the Types of Fentanyl?
The restrictions the FDA placed on fentanyl didn’t last long. By the early 1970s, fentanyl became available without other medications mixed with it. And as fentanyl use in the United States — and around the world — grew, other types of fentanyl began to emerge.
The National Institute on Drug Abuse says that, besides an injection, doctors can now prescribe a fentanyl patch that a person puts directly on their skin, or they can prescribe fentanyl as a lozenge that resembles a cough drop, although fentanyl lozenges also sometimes look like lollipops. The most common prescription names for fentanyl are Actiq®, Duragesic®, and Sublimaze®.
But the types of fentanyl are no longer limited to prescriptions. Because fentanyl is so easy and inexpensive to produce, people started to develop illegal types of fentanyl. Like prescription fentanyl, illicit fentanyl also comes in various forms, and some are manufactured to look like something you can get at a doctor’s office. Some common illegal forms include fentanyl powder, drops on blotter paper, eyedrops, nasal spray, or fentanyl pills that look like prescription opioids. Some street names for fentanyl include Goodfellas, Jackpot, and Dance Fever.
How Is Fentanyl Misused?
Like other opioids, fentanyl produces a euphoric and sedative effect that can be addictive. The difference is that fentanyl is far more potent than opioids such as morphine. If a person misuses fentanyl by taking more than prescribed for longer than recommended, they run the risk of developing a fentanyl addiction.
Clinicians were reportedly the first to start misusing fentanyl in the mid-1970s, says the National Institute on Drug Abuse, but patients also began misusing fentanyl prescribed by their doctors. However, when obtaining a prescription for fentanyl became more challenging, many people turned to illegal forms of fentanyl, which were becoming easier to get because it was simple and inexpensive to make.
But not everyone who takes illegal drugs knows that they’re taking fentanyl, and that can lead to deadly outcomes. Many drug dealers mix drugs such as heroin, cocaine, and MDMA with fentanyl because it produces greater euphoric effects but costs less to make. But when a person doesn’t know that they are taking fentanyl, they may take more than their body is used to or can handle, and this can cause dangerous side effects or lead to an overdose.
In fact, the rise in illegally produced fentanyl and drugs laced with fentanyl has played a major role in overdose deaths in the United States. The Centers for Disease Control and Prevention reports that more than 31,000 people died from fentanyl-related overdose deaths in 2018.
While fentanyl is primarily used for anesthesia and pain management, fentanyl misuse and the production of illegal fentanyl have contributed to a devastating number of overdose deaths in the United States. But it doesn’t have to be this way. If you or someone you love is struggling with fentanyl addiction, getting professional opioid addiction treatment can put you on the path to lasting recovery.