To maintain anesthesia, inhaled anesthetics and additional fentanyl may be used. To induce anesthesia, it is given with a sedative-hypnotic, like propofol or thiopental, and a muscle relaxant. Intravenous fentanyl is often used for anesthesia and to treat pain. It can be cut into, or even replace entirely, the supply of heroin and other opiates. Compared to heroin, it is more potent, has higher profit margins, and, because it is compact, has simpler logistics. There is concern that the growing demand may prove highly attractive to organized crime and aspiring criminals, especially those operating in areas around the Golden Triangle in Southeast Asia and Shan State in Myanmar where production of synthetic drugs has expanded dramatically over the last decade. Most of these overdose deaths were due to illegally made fentanyl. In 2016, fentanyl and fentanyl analogues were the most common cause of overdose deaths in the United States at more than 20,000, about half of all opioid-related deaths. In recent years, fentanyl has disrupted the North American market for illegal drugs, capitalizing on pre-existing demand for opiates such as heroin and prescription pharmaceuticals. It is on the World Health Organization's List of Essential Medicines. As of 2017, fentanyl was the most widely used synthetic opioid in medicine in 2019, it was the 278th most commonly prescribed medication in the United States, with more than 1 million prescriptions. In 2015, 1,600 kilograms (3,500 lb) were used in healthcare globally. įentanyl was first made by Paul Janssen in 1960 and approved for medical use in the United States in 1968. Some fentanyl analogues such as carfentanil are up to 10,000 times stronger than morphine. It is around 100 times stronger than morphine and about 50 times stronger than heroin.
Fentanyl works primarily by activating μ-opioid receptors. Serious side effects may include respiratory depression, hallucinations, serotonin syndrome, low blood pressure, or development of an opioid use disorder. Ĭommon side effects of fentanyl include nausea, vomiting, constipation, sedation, confusion, and injuries related to poor coordination.
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Medically, it is used by injection, nasal spray, or skin patch, or absorbed through the cheek as a lozenge or tablet. It has a rapid onset and its effects generally last under two hours. Fentanyl is commonly used to create counterfeit drugs marketed as Ox圜ontin, Xanax, Adderall, and other pills. It is also used as a recreational drug, sometimes mixed with heroin, cocaine, or methamphetamine, and its potentially deadly overdose effects can be neutralized by naloxone. Fentanyl, also spelled fentanil, is a powerful opioid used as a pain medication and, together with other medications, for anesthesia.