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A tremendous amount of attention has been paid to the opioid epidemic in recent years. The drug fentanyl is regarded as one of the biggest killers in the opioid epidemic, according to in-depth research and analysis undertaken by National Public Radio (NPR). The abuse of and addiction to fentanyl has resulted in a major health crisis in the United States and in many other places around the world. As part of understanding the nature of this calamity, considering the history of fentanyl can prove helpful.
Creation of Fentanyl
A synthetic opioid, fentanyl was the creation of Dr. Paul Janssen. He created the drug in 1959 and obtained a patent for it under the name of his company Janssen Pharmaceuticals. (Janssen Pharmaceuticals is owned by Johnson & Johnson today.)
Fentanyl was deemed to be 100-times stronger than morphine. The drug was used for two primary purposes, as a painkiller and an anesthetic during surgical procedures. Initially, fentanyl was primarily used as an anesthetic but not often as a painkiller. Fentanyl as an intravenous anesthetic was sold under the brand name Sublimaze.
Sublimaze was widely used and led to the development of similar products using fentanyl:
- Sufentanil
- Alfentanil
- Lofentanil
- Remifentanil.
Expanded Use of Fentanyl
In addition to being widely used as an anesthetic, by the middle part of the 1990s the drug was becoming more regularly used as a painkiller. It was at this time that a fentanyl patch was developed. The patch allowed for the delivery of fentanyl as a painkiller to patients transdermally. Fentanyl was used in situations in which patients experienced extreme pain. For example, patients diagnosed with stage four cancer were prescribed the fentanyl patch to assist in addressing their pain issues.
The patch allowed for a controlled, longer-term release of the medication into a person’s body. The fentanyl contained in the skin patch released into a patient’s body fat. From that point, the powerful drug slowly moves into a patient’s bloodstream over the course of about three days.
Other delivery systems were developed to permit fentanyl to be used as a painkiller. These include buccal tablets. A buccal tablet is one that is held between a patient’s gum and cheek. The tablet dissolves, allowing for the release of the painkiller into a patient’s system.
In addition, fentanyl lozenges were developed a well as different oral preparations and an oral spray. With these different fentanyl delivery systems, the skin patch remains the most commonplace way in which the drug is made available for legal, medical uses.
New Developments Regarding Fentanyl Treatment
Recognizing the serious nature of the opioid epidemic, efforts continue to be made to ensure that the medical use of fentanyl limits the risk of abuse. A special focus has been on the way in which patients are delivered the drug.
One of the latest developments in regard to fentanyl delivery is a product known as Onsolis. With this product, fentanyl is incorporated into a small, disc-shaped film. The disc is placed in a patient’s mouth and dissolves. This product makes it impossible for fentanyl to be crushed and inhaled.
Rise of Illegal Fentanyl
As mentioned previously, fentanyl has been a major driver of the opioid epidemic. There are a number of reasons why fentanyl has become a pervasive problem in this day and age.
Fentanyl is “popular” among drug users because it is relatively inexpensive and easy to obtain. Fentanyl is considered to be fairly simple to manufacture. There are illegal fentanyl labs in operation in the United States that produce the drug.
In addition to the domestic manufacturing of fentanyl, the drug is also brought into the United States illegally from different countries. China is a primary foreign source of fentanyl today. A good deal of the fentanyl illegally coming into the United States from China was produced by pharmaceutical companies in that country. China has significantly more lax standards when it comes to drug manufacturing than does the United States.
Fentanyl and Other Drugs
A tangential problem associated with the opioid epidemic and the widespread use of fentanyl itself is found in the fact that the drug is mixed with other illegal mind-altering substances. For example, with increasing frequency, fentanyl is mixed with cocaine and heroin.
In some instances, drug users are aware that the cocaine or heroin they purchase is laced with fentanyl. In other cases, they are not aware that this has occurred. As a consequence, there are overdoses that can be attributed to the fact that a user unknowingly ingests dangerous amounts of cocaine or heroin laced with fentanyl.
As was discussed earlier, fentanyl is a very powerful substance. In too great a dose (which isn’t a large quantity of the drug), a person’s respiratory system is constricted. An overdose can result in oxygen being cut off to the body, including the brain. Death can occur in a very short period of time.
