Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. In its prescription form it is prescribed for pain, but fentanyl is also made illegally. Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths. Learn about fentanyl, health effects and treatment for addiction.
Lethal dose of Fentanyl on a tip of a no 2 pencil
Image by Drug Enforcement Administration (DEA)
What Is Fentanyl?
Heroin Carfentanil Fentanyl Lethal Dose Close Up
Image by United States Drug Enforcement Administration/Wikimedia
Heroin Carfentanil Fentanyl Lethal Dose Close Up
Comparasion of lethal heroin, carfentanil and fentanyl doses acording to the United States Drug Enforcement Administration.
Image by United States Drug Enforcement Administration/Wikimedia
What Is Fentanyl?
Fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent.
It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine that is typically used to treat patients with severe pain, especially after surgery. It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. Tolerance occurs when you need a higher and/or more frequent amount of a drug to get the desired effects.
In its prescription form, fentanyl is known by such names as Actiq, Duragesic, and Sublimaze.
Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States. In 2017, 59. percent of opioid-related deaths involved fentanyl compared to 14.3 percent in 2010.
What are Opioids?
Opioids are a class of drugs naturally found in the opium poppy plant. Some opioids are made from the plant directly, and others, like fentanyl, are made by scientists in labs using the same chemical structure (semi-synthetic or synthetic).
Source: National Institute on Drug Abuse (NIDA)
Additional Materials (22)
Lethal dose of Fentanyl on a tip of a no 2 pencil
An authentic lethal dose of fentanyl is displayed on the point of a number 2 pencil for size reference.
These images of actual legitimate and counterfeit pills are examples and do not represent the many variations of counterfeit pills. Never trust your own eyes to determine if a pill is legitimate. The only way to be sure is if it was dispensed by a licensed medical professional.
Image by Drug Enforcement Administration (DEA)
Drugs - fentanyl is the devil
Image by alarsenault/Pixabay
One Pill Can Kill (Opioid Overdose)
Image by wonderwoman627/Pixabay
Prescription Pain Medications (Opioids)
Fentanyl patch packages from several german generic drug manufacturers (from left to right: 1A Pharma, Winthrop, TAD Pharma, ratiopharm, Hexal).
Image by Alcibiades
Protect yourself from the dangers of fentanyl (:60)
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Hidden In Plain Sight: An Interactive Drug Education Program for Parents (2021)
Video by Drug Enforcement Administration/YouTube
Your Brain On Fentanyl (FIXED)
Video by AsapSCIENCE/YouTube
Fentanyl: What You Need To Know
Video by The Drug Classroom/YouTube
Fentanyl: America's Grim New Opioid Addiction
Video by Wall Street Journal/YouTube
Fentanyl is More Than One Drug
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
FENTANYL: A Hidden Danger
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
Opioid dependence & opioid use disorder
Video by Osmosis/YouTube
A city in crisis: How fentanyl devastated San Francisco - BBC Newsnight
Video by BBC News/YouTube
How fentanyl kills: A CBC News explainer
Video by CBC News/YouTube
'They were poisoned': Fentanyl-laced drug kills five friends
Video by Washington Post/YouTube
Fentanyl Addict interview-Dylan
Video by Soft White Underbelly/YouTube
Schools stockpile medication to combat rise in fentanyl overdoses
Video by PBS NewsHour/YouTube
Dr. Compton Discusses Half of Opioid-Related Overdose Deaths Involve Fentanyl
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
Why Fentanyl Is So Incredibly Dangerous
Video by Institute of Human Anatomy/YouTube
How Fentanyl Is Made | Trafficked | National Geographic UK
Video by National Geographic UK/YouTube
How Naloxone Saves Lives in Opioid Overdose
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
Mind Matters: What are Opioids?
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
Lethal dose of Fentanyl on a tip of a no 2 pencil
Drug Enforcement Administration (DEA)
Drugs - fentanyl is the devil
alarsenault/Pixabay
One Pill Can Kill (Opioid Overdose)
wonderwoman627/Pixabay
Prescription Pain Medications (Opioids)
Alcibiades
1:01
Protect yourself from the dangers of fentanyl (:60)
Centers for Disease Control and Prevention (CDC)/YouTube
18:17
Hidden In Plain Sight: An Interactive Drug Education Program for Parents (2021)
Drug Enforcement Administration/YouTube
3:45
Your Brain On Fentanyl (FIXED)
AsapSCIENCE/YouTube
8:17
Fentanyl: What You Need To Know
The Drug Classroom/YouTube
12:40
Fentanyl: America's Grim New Opioid Addiction
Wall Street Journal/YouTube
1:09
Fentanyl is More Than One Drug
National Institute on Drug Abuse (NIDA/NIH)/YouTube
1:03
FENTANYL: A Hidden Danger
National Institute on Drug Abuse (NIDA/NIH)/YouTube
14:00
Opioid dependence & opioid use disorder
Osmosis/YouTube
7:38
A city in crisis: How fentanyl devastated San Francisco - BBC Newsnight
BBC News/YouTube
1:47
How fentanyl kills: A CBC News explainer
CBC News/YouTube
7:07
'They were poisoned': Fentanyl-laced drug kills five friends
Washington Post/YouTube
22:06
Fentanyl Addict interview-Dylan
Soft White Underbelly/YouTube
8:17
Schools stockpile medication to combat rise in fentanyl overdoses
PBS NewsHour/YouTube
1:44
Dr. Compton Discusses Half of Opioid-Related Overdose Deaths Involve Fentanyl
National Institute on Drug Abuse (NIDA/NIH)/YouTube
19:46
Why Fentanyl Is So Incredibly Dangerous
Institute of Human Anatomy/YouTube
1:59
How Fentanyl Is Made | Trafficked | National Geographic UK
National Geographic UK/YouTube
5:40
How Naloxone Saves Lives in Opioid Overdose
National Institute on Drug Abuse (NIDA/NIH)/YouTube
1:13
Mind Matters: What are Opioids?
National Institute on Drug Abuse (NIDA/NIH)/YouTube
What You Need to Know
A generic fentanyl transdermal patch, with a release rate of 12mcg per hour, applied to the skin
Image by DanielTahar
A generic fentanyl transdermal patch, with a release rate of 12mcg per hour, applied to the skin
A generic fentanyl transdermal patch, with a release rate of 12mcg per hour, applied to the skin
Image by DanielTahar
Fentanyl Facts
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and nonfatal overdoses in the U.S.
There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl. Both are considered synthetic opioids. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain, especially after surgery and for advanced-stage cancer.
However, most recent cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl, which is distributed through illegal drug markets for its heroin-like effect. It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous.
Illicitly manufactured fentanyl
Illicitly manufactured fentanyl (IMF) is available on the drug market in different forms, including liquid and powder.
Powdered fentanyl looks just like many other drugs. It is commonly mixed with drugs like heroin, cocaine, and methamphetamine and made into pills that are made to resemble other prescription opioids. Fentanyl-laced drugs are extremely dangerous, and many people may be unaware that their drugs are laced with fentanyl.
In its liquid form, IMF can be found in nasal sprays, eye drops, and dropped onto paper or small candies.
Street names for IMF include:
Apache
Dance Fever
Friend
Goodfellas
Jackpot
Murder 8
Tango & Cash
Fentanyl and Overdose
Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths.Even in small doses, it can be deadly. Over 150people die every day from overdoses related to synthetic opioids like fentanyl.
Drugs may contain deadly levels of fentanyl, and you wouldn’t be able to see it, taste it, or smell it. It is nearly impossible to tell if drugs have been laced with fentanyl unless you test your drugs with fentanyl test strips.
Test strips are inexpensive and typically give results within 5 minutes, which can be the difference between life or death. Even if the test is negative, take caution as test strips might not detect more potent fentanyl-like drugs, like carfentanil.
Signs of overdose
Recognizing the signs of opioid overdose can save a life. Here are some things to look for:
Small, constricted “pinpoint pupils”
Falling asleep or losing consciousness
Slow, weak, or no breathing
Choking or gurgling sounds
Limp body
Cold and/or clammy skin
Discolored skin (especially in lips and nails)
Protect yourself from the dangers of fentanyl (:60)Protect yourself from the dangers of fentanyl (:30)Protect friends and family with lifesaving naloxone (:60)Protect friends and family with lifesaving naloxone (:30)Understanding the risks of mixing drugs (:60)What to do if you think someone is overdosing
It may be hard to tell whether a person is high or experiencing an overdose. If you aren’t sure, treat it like an overdose—you could save a life.
Call 911 Immediately.*
Administer naloxone, if available.**
Try to keep the person awake and breathing.
Lay the person on their side to prevent choking.
Stay with the person until emergency assistance arrives.
*Most states have laws that may protect a person who is overdosing or the person who called for help from legal trouble.
** Naloxone is a life-saving medication that can reverse the effects of opioid overdose and save lives. It is available in all 50 states and can be purchased from a local pharmacy without a prescription in most states.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (4)
What Every Parent and Caregiver Needs to Know About Fake Pills
Fentanyl is a deadly synthetic opioid that is being pressed into fake pills or cut into heroin, cocaine, and other street drugs to drive addiction.
Document by DEA
How Fentanyl Is Made | Trafficked | National Geographic UK
Video by National Geographic UK/YouTube
FENTANYL: A Hidden Danger
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
Dr. Compton Discusses Half of Opioid-Related Overdose Deaths Involve Fentanyl
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
What Every Parent and Caregiver Needs to Know About Fake Pills
DEA
1:59
How Fentanyl Is Made | Trafficked | National Geographic UK
National Geographic UK/YouTube
1:03
FENTANYL: A Hidden Danger
National Institute on Drug Abuse (NIDA/NIH)/YouTube
1:44
Dr. Compton Discusses Half of Opioid-Related Overdose Deaths Involve Fentanyl
National Institute on Drug Abuse (NIDA/NIH)/YouTube
Fentanyl
Fentanyl
Also called: Abstral®, Actiq®, Fentora®, Onsolis®, Fentanyl Citrate
Fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine that is typically used to treat patients with severe pain, especially after surgery.
Fentanyl
Also called: Abstral®, Actiq®, Fentora®, Onsolis®, Fentanyl Citrate
Fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine that is typically used to treat patients with severe pain, especially after surgery.
Get emergency help right away if you take too much fentanyl buccal tablets (overdose). When you first start taking fentanyl buccal tablets, when your dose is changed, or if you take too much (overdose), serious life-threatening breathing problems that can lead to death may occur.
Taking fentanyl buccal tablets with other medicines that may make you sleepy, such as other pain medicines, anti-depressants, sleeping pills, anti-anxiety medicines, antihistamines, or tranquilizers, or with alcohol or street drugs can cause severe drowsiness, confusion, breathing problems, coma, and death.
Never give anyone else your fentanyl buccal tablets. They could die from taking it. Store fentanyl buccal tablets away from children and in a safe place to prevent stealing or abuse. Selling or giving away fentanyl buccal tablets is against the law.
If you stop taking your around-the-clock opioid pain medicine for your cancer pain, you must stop using fentanyl buccal tablets. You may no longer be opioid tolerant. Talk to your healthcare provider about how to treat your pain.
Fentanyl buccal tablets are available only through a program called the Transmucosal Immediate Release Fentanyl (TIRF) Risk Evaluation and Mitigation Strategy (REMS) Access program. To receive fentanyl buccal tablets, you must:
talk to your healthcare provider
understand the benefits and risks of fentanyl buccal tablets
agree to all of the instructions
sign the Patient-Prescriber Agreement form
Fentanyl buccal tablets are only available at pharmacies that are part of the TIRF REMS Access program. Your healthcare provider will let you know the pharmacy closest to your home where you can have your fentanyl buccal tablets prescription filled.
Be very careful about taking other medicines that may make you sleepy, such as other pain medicines, anti-depressant medicines, sleeping pills, anti-anxiety medicines, antihistamines, or tranquilizers.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
A strong prescription pain medicine that contain an opioid (narcotic) that is used to manage breakthrough pain in adults with cancer who are already routinely taking other opioid pain medicines around-the-clock for cancer pain. Fentanyl buccal tablets are started only after you have been taking other opioid pain medicines and your body has become used to them (you are opioid tolerant). Do not use fentanyl buccal tablets if you are not opioid tolerant.
An opioid pain medicine that can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.
Do not take fentanyl buccal tablets if:
You are not opioid tolerant. Opioid tolerant means that you are already taking other opioid pain medicines around-the-clock for at least one week or longer for your cancer pain, and your body is used to these medicines.
You have severe asthma, trouble breathing, or other lung problems.
You have a bowel blockage or have narrowing of the stomach or intestines.
You are allergic to any of the ingredients in fentanyl buccal tablets. See the end of this Medication Guide for a complete list of ingredients in fentanyl buccal tablets.
You have short-term pain that you would expect to go away in a few days, such as:
pain after surgery
headache or migraine
dental pain
Before taking fentanyl buccal tablets, tell your healthcare provider if you have a history of:
Troubled breathing or lung problems such as asthma, wheezing, or shortness of breath
head injury, seizures
slow heart rate or other heart problems
low blood pressure
abuse of street or prescription drugs, alcohol addiction, or mental health problems
mental problems [including major depression, schizophrenia or hallucinations (seeing or hearing things that are not there)]
problems urinating
liver, kidney, thyroid problems
pancreas or gallbladder problems
Tell your healthcare provider if you are:
pregnant or planning to become pregnant. Prolonged use of fentanyl buccal tablets during pregnancy can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated.
breastfeeding. Fentanyl buccal tablets pass into breast milk and may harm your baby.
taking prescription over-the-counter medicines, vitamins, or herbal supplements. Taking fentanyl buccal tablets with certain other medicines can cause serious side effects that could lead to death.
When taking fentanyl buccal tablets:
Do not change your dose. Take fentanyl buccal tablets exactly as prescribed by your healthcare provider.
Your healthcare provider will change the dose until you and your healthcare provider find the right dose for you.
See the detailed Instructions for Use at the end of this Medication Guide for information about how to use fentanyl buccal tablets.
Use fentanyl buccal tablets whole.
Do not crush, split, suck, or chew fentanyl buccal tablets, or swallow the tablets whole. You will get less relief for your breakthrough cancer pain.
Wait 30 minutes after using fentanyl buccal tablets. If there is any of the fentanyl buccal tablet left in your mouth, you may drink a glass of water to help you swallow the left over medicine.
You must not use more than 2 doses of fentanyl buccal tablets for each episode of breakthrough cancer pain.
Use 1 dose of fentanyl buccal tablets for an episode of breakthrough cancer pain.
If your breakthrough cancer pain does not get better 30 minutes after taking the first dose of fentanyl buccal tablets, you can use only 1 more dose of fentanyl buccal tablets as instructed by your healthcare provider.
If your breakthrough pain does not get better after the second dose of fentanyl buccal tablets, call your healthcare provider for instructions. Do not use another dose of fentanyl buccal tablets at this time.
Wait at least 4 hours before treating a new episode of breakthrough cancer pain with fentanyl buccal tablets.
If you only need to take 1 dose of fentanyl buccal tablets for an episode of breakthrough pain, you must wait 4 hours from the time of that dose to take a dose of fentanyl buccal tablets for a new episode of breakthrough pain.
If you need to use 2 doses of fentanyl buccal tablets for an episode of breakthrough pain, you must wait 4 hours after the second dose to take a dose of fentanyl buccal tablets for a new episode of breakthrough pain.
It is important for you to keep taking your around-the-clock opioid pain medicine while using fentanyl buccal tablets.
Talk to your healthcare provider if your dose of fentanyl buccal tablets does not relieve your breakthrough cancer pain. Your healthcare provider will decide if your dose of fentanyl buccal tablets needs to be changed.
Talk to your healthcare provider if you have more than 4 episodes of breakthrough cancer pain per day. The dose of your around-the-clock opioid pain medicine may need to be adjusted.
If you begin to feel dizzy, sick to your stomach, or very sleepy before the tablet is completely dissolved, rinse your mouth with water and spit the remaining pieces of the tablet into a sink or toilet right away. Rinse the sink or flush the toilet to dispose of any remaining tablet pieces.
Do not stop taking fentanyl buccal tablets without talking to your healthcare provider. You could become sick with uncomfortable withdrawal symptoms because your body has become used to these medicines. Physical dependency is not the same as drug addiction.
After you stop taking, or when fentanyl buccal tablets is no longer needed, see “ How should I dispose of unused fentanyl buccal tablets when they are no longer needed?” for proper disposal of fentanyl buccal tablets.
DO NOT Drive or operate heavy machinery, until you know how fentanyl buccal tablets affect you. Fentanyl buccal tablets can make you sleepy, dizzy, or lightheaded.
DO NOT Drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using products containing alcohol during treatment with fentanyl buccal tablets may cause you to overdose and die.
DO NOT Switch from fentanyl buccal tablets to other medicines that contain fentanyl without talking with your healthcare provider. The amount of fentanyl in a dose of fentanyl buccal tablets is not the same as the amount of fentanyl in other medicines that contain fentanyl. Your healthcare provider will prescribe a starting dose of fentanyl buccal tablets that may be different than other fentanyl containing medicines you may have been taking.
The possible side effects of fentanyl buccal tablets:
constipation, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain, low red blood cell count, swelling of the arms, hands, legs and feet Call your healthcare provider if you have any of these symptoms and they are severe.
Decreased blood pressure. This can make you feel dizzy or lightheaded if you get up too fast from sitting or lying down.
Pain, irritation, or sores at the application site (on your gum, on the inside of your cheek, or under your tongue). Tell your healthcare provider if this is a problem for you.
Get emergency medical help if you have:
trouble breathing, shortness of breath, fast heartbeat, chest pain, swelling of your face, tongue, or throat, extreme drowsiness, light-headedness when changing positions, feeling faint, agitation, high body temperature, trouble walking, stiff muscles, or mental changes such as confusion.
These symptoms can be a sign that you have taken too much fentanyl buccal tablets or the dose is too high for you. These symptoms may lead to serious problems or death if not treated right away. If you have any of these symptoms, do not take any more fentanyl buccal tablets until you have talked to your healthcare provider.
These are not all the possible side effects of fentanyl buccal tablets. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. For more information go to dailymed.nlm.nih.gov
Always keep fentanyl buccal tablets in a safe place away from children and from anyone for whom it has not been prescribed. Protect fentanyl buccal tablets from theft.
Store fentanyl buccal tablets at room temperature, 59°F to 86°F (15° C to 30°C) until ready to use. Do not freeze fentanyl buccal tablets.
Keep fentanyl buccal tablets in the original blister unit. Do not remove fentanyl buccal tablets from its blister packaging for storage in a temporary container, such as a pill box.
Keep fentanyl buccal tablets dry.
Dispose of any unused fentanyl buccal tablets remaining from a prescription as soon as they are no longer needed.
Remove the tablets from blister packages and flush them down the toilet.
Do not flush the fentanyl buccal tablets packaging (card, blister units or cartons) down the toilet.
If you need help with disposal of fentanyl buccal tablets, call Teva Pharmaceuticals at 1-888-483-8279 or call your local Drug Enforcement Agency (DEA) office.
FENTANYL- fentanyl tablet Teva Pharmaceuticals USA, Inc.. Medication Guide. [accessed on Oct 24, 2018]
ACTIQ- fentanyl citrate lozenge Cephalon, Inc.. Medication Guide. [accessed on Oct 24, 2018]
FENTANYL BUCCAL- fentanyl citrate tablet Actavis Pharma, Inc.. Medication Guide. [accessed on Oct 24, 2018]
FENTANYL CITRATE - fentanyl citrate lozenge Physicians Total Care, Inc.. Medication Guide. [accessed on Oct 24, 2018]
TRANSMUCOSAL FENTANYL CITRATE - fentanyl citrate lozenge H.J. Harkins Company, Inc.. Medication Guide. [accessed on Oct 25, 2018]
ABSTRAL  FENTANYL - fentanyl citrate tablet, orally disintegrating Sentynl Therapeutics, Inc.. Medication Guide. [accessed on Oct 25, 2018]
ABSTRAL- fentanyl citrate tablet Galena Biopharma, Inc.. Medication Guide. [accessed on Oct 25, 2018]
Fentanyl. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
https://www.drugabuse.gov/publications/drugfacts/fentanyl [accessed on Mar 28, 2019]
These FAQs provide a summary of the most important information about Fentanyl. The drug should not be used for a condition other than that for which it is prescribed. Do not give it to other people, even if they have the same symptoms that you have. It may harm them. If you would like more information or have any questions, talk to your healthcare provider.
Additional Materials (2)
Your Brain On Fentanyl (FIXED)
Video by AsapSCIENCE/YouTube
Fentanyl
Stick model of the fentanyl molecule in the crystal structure of fentanyl citrate-toluene solvate.
Image by Ben Mills
3:45
Your Brain On Fentanyl (FIXED)
AsapSCIENCE/YouTube
Fentanyl
Ben Mills
Fentanyl Transdermal Patch
Fentanyl Transdermal Patch
Also called: Duragesic®, Ionsys®
Fentanyl transdermal patch is a prescription medicine that contains an opioid and is used to manage severe daily around-the-clock pain. It must be used with caution due to the risks of opioid addiction, abuse, and misuse.
Fentanyl Transdermal Patch
Also called: Duragesic®, Ionsys®
Fentanyl transdermal patch is a prescription medicine that contains an opioid and is used to manage severe daily around-the-clock pain. It must be used with caution due to the risks of opioid addiction, abuse, and misuse.
Get emergency help right away if you use too much fentanyl transdermal patch(overdose). When you first start taking fentanyl transdermal patch, when your dose is changed, or if you take too much (overdose), serious or life-threatening breathing problems that can lead to death may occur.
Taking fentanyl transdermal patch with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) may cause severe drowsiness, decreased awareness, breathing difficulties, with slow or shallow breathing, coma, and death.
Never give anyone else your fentanyl transdermal patch. They could die from using it. Store fentanyl transdermal patch away from children and in a safe place to prevent stealing or abuse. Selling or giving away fentanyl transdermal patch is against the law.
If the patch accidentally sticks to a family member while in close contact, take the patch off, wash the area with water, and get emergency help right away because an accidental exposure to fentanyl transdermal patch can lead to death or other serious medical problems.
Proper disposal of fentanyl transdermal patch after use and for unused patches when no longer needed: Fold the sticky sides of the patch together and flush down the toilet. Do not put patches in a trash can.
A strong prescription pain medicine that contains an opioid (narcotic) that is used to manage pain severe enough to require daily around-the-clock, long-term treatment with an opioid, in people who are already regularly using opioid pain medicine, when other pain treatments such as non-opioid pain medicines or immediate-release opioid medicines do not treat your pain well enough or you cannot tolerate them.
A long-acting (extended-release) opioid pain medicine that can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.
Not for use to treat pain that is not around-the-clock.
Do not use fentanyl transdermal patch if you have:
severe asthma, trouble breathing, or other lung problems.
a bowel blockage or have narrowing of the stomach or intestines.
Before applying fentanyl transdermal patch, tell your healthcare provider if you have a history of:
head injury, seizures
problems urinating
abuse of street or prescription drugs, alcohol addiction, or mental health problems.
liver, kidney, thyroid problems
pancreas or gallbladder problems
Tell your healthcare provider if you:
have a fever
are pregnant or planning to become pregnant. Prolonged use of fentanyl transdermal patch during pregnancy can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated.
are breastfeeding. Not recommended during treatment with fentanyl transdermal patch. It may harm your baby.
are taking prescription or over-the-counter medicines, vitamins, or herbal supplements. Taking fentanyl transdermal patch with certain other medicines can cause serious side effects that could lead to death.
When using fentanyl transdermal patch:
Do not change your dose. Apply fentanyl transdermal patch exactly as prescribed by your healthcare provider. Use the lowest dose possible for the shortest time needed.
See the detailed Instructions for Use for information about how to apply and dispose of the fentanyl transdermal patch.
Do not apply more than 1 patch at the same time unless your healthcare provider tells you to.
You should wear the fentanyl transdermal patch continuously for 3 days unless advised otherwise by your healthcare provider.
Do not cut, break, chew, crush, dissolve, snort, or inject fentanyl transdermal patch because this may cause you to overdose and die.
Call your healthcare provider if the dose you are using does not control your pain.
Do not stop using fentanyl transdermal patch without talking to your healthcare provider.
While using fentanyl transdermal patch DO NOT:
Take hot baths or sunbathe, use hot tubs, saunas, heating pads, electric blankets, heated waterbeds, or tanning lamps, or engage in exercise that increases your body temperature. These can cause an overdose that can lead to death.
Drive or operate heavy machinery, until you know how fentanyl transdermal patch affects you. Fentanyl transdermal patch can make you sleepy, dizzy, or lightheaded.
Drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using products containing alcohol during treatment with fentanyl transdermal patch may cause you to overdose and die.
The possible side effects of fentanyl transdermal patch are:
constipation
nausea
sleepiness
vomiting
tiredness
headache
dizziness
abdominal pain
itching
redness
rash where the patch is applied
Call your healthcare provider if you have any of these symptoms and they are severe.
Get emergency medical help if you have:
trouble breathing
shortness of breath
fast heartbeat
chest pain
swelling of your face, tongue or throat
extreme drowsiness
light-headedness when changing positions
feeling faint
agitation
high body temperature
trouble walking
stiff muscles
mental changes such as confusion.
These are not all the possible side effects of fentanyl transdermal patch. Call your doctor for medical advice about side effects.
FENTANYL TRANSDERMAL SYSTEM- fentanyl transdermal system patch, extended release Bryant Ranch Prepack. Medication Guide. [accessed on Oct 23, 2018]
LABEL: FENTANYL - fentanyl patch, extended release [accessed on Nov 09, 2018]
FENTANYL - fentanyl patch, extended release Dispensing Solutions Inc.. Medication Guide. [accessed on Oct 25, 2018]
IONSYS- fentanyl iontophoretic transdermal system patch The Medicines Company. Medication Guide. [accessed on Oct 25, 2018]
DURAGESIC- fentanyl patch Janssen Pharmaceuticals, Inc.. Medication Guide. [accessed on Oct 25, 2018]
FENTANYL SYSTEM- fentanyl patch Lake Erie Medical DBA Quality Care Products LLC. Medication Guide. [accessed on Oct 25, 2018]
Fentanyl Transdermal Patch. MedlinePlus/AHFS® Drug Information. [accessed on Oct 28, 2018]
These FAQs provide a summary of the most important information about Fentanyl Transdermal Patch. If you would like more information or have any questions, talk to your healthcare provider.
How Is It Used?
Rainbow Fentanyl M30
Image by Drug Enforcement Administration
Rainbow Fentanyl M30
Image by Drug Enforcement Administration
How Do People Use Fentanyl?
When prescribed by a doctor, fentanyl can be given as a shot, a patch that is put on a person’s skin, or as lozenges that are sucked like cough drops.
The illegally used fentanyl most often associated with recent overdoses is made in labs. This synthetic fentanyl is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.
Some drug dealers are mixing fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl, making it a cheaper option. This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive. They might be taking stronger opioids than their bodies are used to and can be more likely to overdose. To learn more about the mixture of fentanyl into other drugs, visit the Drug Enforcement Administration’s Drug Facts on fentanyl.
Source: National Institute on Drug Abuse (NIDA)
Additional Materials (4)
Fentanyl_Oxy_M30_2
Image by Drug Enforcement Administration
How Fentanyl Is Made | Trafficked | National Geographic UK
Video by National Geographic UK/YouTube
'They were poisoned': Fentanyl-laced drug kills five friends
Video by Washington Post/YouTube
Fentanyl: What You Need To Know
Video by The Drug Classroom/YouTube
Fentanyl_Oxy_M30_2
Drug Enforcement Administration
1:59
How Fentanyl Is Made | Trafficked | National Geographic UK
National Geographic UK/YouTube
7:07
'They were poisoned': Fentanyl-laced drug kills five friends
Washington Post/YouTube
8:17
Fentanyl: What You Need To Know
The Drug Classroom/YouTube
How Does It Affect Brain?
Substance Use and Abuse
Image by CNX Openstax
Substance Use and Abuse
As one of their mechanisms of action, cocaine and amphetamines block the reuptake of dopamine from the synapse into the presynaptic cell.
Image by CNX Openstax
How Does Fentanyl Affect the Brain?
Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. After taking opioids many times, the brain adapts to the drug, diminishing its sensitivity, making it hard to feel pleasure from anything besides the drug. When people become addicted, drug seeking and drug use take over their lives.
Fentanyl's effects include
extreme happiness
drowsiness
nausea
confusion
constipation
sedation
problems breathing
unconsciousness
Source: National Institute on Drug Abuse (NIDA)
Additional Materials (4)
A fentanyl nasal spray with a strength of 100 ÎĽg per use
Image by DanielTahar/Wikimedia
How fentanyl kills: A CBC News explainer
Video by CBC News/YouTube
Your Brain On Fentanyl (FIXED)
Video by AsapSCIENCE/YouTube
A city in crisis: How fentanyl devastated San Francisco - BBC Newsnight
Video by BBC News/YouTube
A fentanyl nasal spray with a strength of 100 ÎĽg per use
DanielTahar/Wikimedia
1:47
How fentanyl kills: A CBC News explainer
CBC News/YouTube
3:45
Your Brain On Fentanyl (FIXED)
AsapSCIENCE/YouTube
7:38
A city in crisis: How fentanyl devastated San Francisco - BBC Newsnight
BBC News/YouTube
Does It Lead to Addiction?
Avoid Addictions
Image by TheVisualMD
Avoid Addictions
Every addiction starts with gratification of some kind. Drugs of abuse work on different neurotransmitter systems in the brain, but they all act directly or indirectly on the brain's reward (mesolimbic) system and on the amygdala, flooding the reward circuit with dopamine and other neurotransmitters. Dopamine, which is associated with emotion, cognition, and feeling of pleasure, rewards natural behaviors, but drugs release 2 to 10 times the amount of dopamine that natural rewards do. Overstimulation of this system produces the euphoric feelings sought by drug users. Repeatedly activating the brain's reward system with supranatural stimuli results in reinforcement and addiction.
Image by TheVisualMD
Can Fentanyl Use Lead to Addiction?
Yes. Fentanyl is addictive because of its potency. A person taking prescription fentanyl as instructed by a doctor can experience dependence, which is characterized by withdrawal symptoms when the drug is stopped. A person can be dependent on a substance without being addicted, but dependence can sometimes lead to addiction.
Addiction is the most severe form of a substance use disorder (SUD). SUDs are characterized by compulsive drug seeking and drug use that can be difficult to control, despite harmful consequences. When someone is addicted to drugs, they continue to use them even though they cause health problems or issues at work, school, or home. An SUD can range from mild to severe.
People addicted to fentanyl who stop using it can have severe withdrawal symptoms that begin as early as a few hours after the drug was last taken. These symptoms include:
muscle and bone pain
sleep problems
diarrhea and vomiting
cold flashes with goose bumps
uncontrollable leg movements
severe cravings
These symptoms can be extremely uncomfortable and are the reason many people find it so difficult to stop taking fentanyl. There are medicines being developed to help with the withdrawal process for fentanyl and other opioids. The FDA has approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms. Also, the NSS-2 Bridge device is a small electrical nerve stimulator placed behind the person’s ear, that can be used to try to ease symptoms for up to five days during the acute withdrawal phase. In December 2018, the FDA cleared a mobile medical application, reSET®, to help treat opioid use disorders. This application is a prescription cognitive behavioral therapy and should be used in conjunction with treatment that includes buprenorphine and contingency management.
Source: National Institute on Drug Abuse (NIDA)
Additional Materials (4)
Take Action to Prevent Addiction
Document by CDC
Fentanyl: America's Grim New Opioid Addiction
Video by Wall Street Journal/YouTube
Why Fentanyl Is So Incredibly Dangerous
Video by Institute of Human Anatomy/YouTube
What is Addiction?
Video by Addiction Policy Forum/YouTube
Take Action to Prevent Addiction
CDC
12:40
Fentanyl: America's Grim New Opioid Addiction
Wall Street Journal/YouTube
19:46
Why Fentanyl Is So Incredibly Dangerous
Institute of Human Anatomy/YouTube
4:00
What is Addiction?
Addiction Policy Forum/YouTube
How Is Addiction Treated?
Overdose
Image by clarkdonald413/Pixabay
Overdose
Image by clarkdonald413/Pixabay
How Is Fentanyl Addiction Treated?
Like other opioid addictions, medication with behavioral therapies has been shown to be effective in treating people with a fentanyl addiction.
Medications for opioid use disorders—including fentanyl use disorder—are safe, effective, and save lives. These medicines interact with the same opioid receptors in the brain on which fentanyl acts, but they do not produce the same effects.
Methadone, an opioid receptor full agonist, attaches to and activates opioid receptors to ease withdrawal symptoms and cravings.
Buprenorphine, an opioid receptor partial agonist, attaches to and partially activates opioid receptors to ease withdrawal symptoms and cravings.
Naltrexone, an opioid receptor antagonist, prevents fentanyl from attaching to opioid receptors, thus blocking its effects.
Learn more about medications for opioid overdose, withdrawal and addiction.
Counseling: Behavioral therapies for addiction to opioids like fentanyl can help people modify their attitudes and behaviors related to drug use, increase healthy life skills, and help them stick with their medication. Some examples include:
cognitive behavioral therapy, which helps modify the patient's drug use expectations and behaviors, and effectively manage triggers and stress
contingency management, which uses a voucher-based system giving patients “points” based on negative drug tests. They can use the points to earn items that encourage healthy living
Motivational interviewing, which is a patient-centered counseling style that addresses a patient’s mixed feelings to change
These behavioral treatment approaches have proven effective, especially when used along with medicines.
Source: National Institute on Drug Abuse (NIDA)
Additional Materials (4)
Opioid Use Disorder - Treatment and Recovery Fact Sheet
What You Need to Know About Treatment and Recovery There is hope. Recovery is possible.
Document by CDC
Schools stockpile medication to combat rise in fentanyl overdoses
Video by PBS NewsHour/YouTube
Overdose awareness: The drug overdose signs you need to know
Yes, a person can overdose on fentanyl. An overdose occurs when a drug produces serious adverse effects and life-threatening symptoms. When people overdose on fentanyl, their breathing can slow or stop. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can lead to a coma and permanent brain damage, and even death.
Source: National Institute on Drug Abuse (NIDA)
Additional Materials (4)
Preventing An Opioid Overdose
Know the Signs. Save a Life.
Document by www.cdc.gov
Fentanyl and Other Synthetic Opioids Drug Overdose Deaths
This infographic summarizes mortality data from 2010-2016. Please note, 15 to 25 percent of death certificates analyzed did not indicate the type of drug involved in the overdose. This was because drug tests were not conducted or there was a failure to record test results on death certificates.
Document by d14rmgtrwzf5a.cloudfront.net
DEA One Pill Can Kill Public Safety Alert and Awareness Campaign PSA Video (Dec. 2021)
Video by Drug Enforcement Administration/YouTube
Signs of an opioid overdose
Video by thebccdc/YouTube
Preventing An Opioid Overdose
www.cdc.gov
Fentanyl and Other Synthetic Opioids Drug Overdose Deaths
d14rmgtrwzf5a.cloudfront.net
0:31
DEA One Pill Can Kill Public Safety Alert and Awareness Campaign PSA Video (Dec. 2021)
Drug Enforcement Administration/YouTube
0:41
Signs of an opioid overdose
thebccdc/YouTube
Can An Overdose Be Treated?
Naloxone Saves Lives
Image by Food and Drug Administration (FDA)
Naloxone Saves Lives
Anyone can save a life during an opioid overdose with naloxone, a front-line defense in the nation's opioid crisis. Naloxone is a life-saving drug that, when sprayed into the nose or injected, quickly reverses the powerful effects of opioids during an overdose.
Image by Food and Drug Administration (FDA)
How Can a Fentanyl Overdose Be Treated?
Many drug dealers mix the cheaper fentanyl with other drugs like heroin, cocaine, MDMA and methamphetamine to increase their profits, making it often difficult to know which drug is causing the overdose. Naloxone is a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. But fentanyl is stronger than other opioid drugs like morphine and might require multiple doses of naloxone.
Because of this, if you suspect someone has overdosed, the most important step to take is to call 911 so they can receive immediate medical attention. Once medical personnel arrive, they will administer naloxone if they suspect an opioid drug is involved.
Naloxone is available as an injectable (needle) solution and nasal sprays (NARCAN and KLOXXADO).
People who are given naloxone should be monitored for another two hours after the last dose of naloxone is given to make sure breathing does not slow or stop.
Some states have passed laws that allow pharmacists to dispense naloxone without a personal prescription. Friends, family, and others in the community can use the nasal spray versions of naloxone to save someone who is overdosing.
Source: National Institute on Drug Abuse (NIDA)
Additional Materials (4)
Naloxone
Naloxone kits as distributed in British Columbia, Canada
Image by James Heilman, MD
Naloxone nasal spray
Prefilled devices that spray medication into the nose.
Image by CDC
Injectable Naloxone
Medication (solution) given by injection into a muscle or under the skin.
Image by CDC
Naloxone Training Video
Video by Michael Mouris/YouTube
Naloxone
James Heilman, MD
Naloxone nasal spray
CDC
Injectable Naloxone
CDC
5:57
Naloxone Training Video
Michael Mouris/YouTube
Fentanyl Testing
Fentanyl
Image by Nils Wommelsdorf
Fentanyl
Fentanyl
Image by Nils Wommelsdorf
Fentanyl Test Strips: A Harm Reduction Strategy
What are fentanyl test strips?
Fentanyl test strips (FTS) are a low-cost method of helping prevent drug overdoses and reducing harm. FTS are small strips of paper that can detect the presence of fentanyl in all different kinds of drugs (cocaine, methamphetamine, heroin, etc.) and drug forms (pills, powder, and injectables). FTS provide people who use drugs and communities with important information about fentanyl in the illicit drug supply so they can take steps to reduce risk of overdose. Look for organizations in your city or state that distribute FTS, keep them on you, and use them!
How to use fentanyl test strips
Below are steps to test your drugs for fentanyl using FTS. Depending on the types of drugs you’re testing, the steps may be slightly different:
Step 1: Put a small amount (at least 10mg) of your drugs aside in a clean, dry container.
Step 2: Add water to the container and mix together.
Please note: For most drugs, you need ½ teaspoon of water. If you are testing methamphetamines, use1 full teaspoon.
Step 3: Place the wavy end of the test strip down in the water and let it absorb for about 15 seconds.
Step 4: Take the strip out of the water and place it on a flat surface for 2 to 5 minutes.
Step 5: Read results.
Positive results: A single pink line on the left-hand side indicates that fentanyl or a fentanyl analog has been detected in your drugs. If you receive a positive result, it is much safer to discard the batch. Using it could kill you. Illicitly manufactured fentanyl is extremely potent and can be deadly.
Negative results: Two pink lines indicate that fentanyl or a fentanyl analog has not been detected in your drugs. Remember that no test is 100% accurate and your drugs may still contain fentanyl or fentanyl analogs even if you receive a negative result. You should still take caution as FTS might not detect more potent fentanyl-like drugs, like carfentanil, and fentanyl might not be everywhere in your drugs and your test might miss it.
Invalid results: A single pink line on the right-hand side or no lines at all, indicates an invalid test. If you get an invalid result, test your drugs again using a new strip.
Lower your risk of overdose
In addition to using fentanyl test strips to know if fentanyl is in your drugs, there are other ways to lower your risk of overdose. You can take steps to keep yourself and others safe:
Keep naloxone readily available on you and at home. Talk with your healthcare provider or pharmacist about being prescribed naloxone (e.g., Narcan) if you or someone you know is at risk for an overdose. You can also check with your local health department or community-based organization to see if they distribute naloxone at no cost.
Avoid mixing drugs. Mixing multiple stimulants like methamphetamine and cocaine, depressants like opioids and alcohol, or a combination of both can cause harm and potentially death.
Don’t rely on a previous source or experience. Knowing where your drugs come from doesn’t mean they’re safe. And even if you have used drugs before, your body could react differently every time.
Never use drugs alone. Make sure the people around you are aware when you have taken drugs in case they need to give you naloxone or call for emergency assistance.
Ask for help if you’re ready to get treatment for your addiction. Recovery from substance use disorders is possible—it’s okay to ask for help. You can find evidence-based treatment and service options near you by visiting findtreatment.gov or by calling the 24/7, National Helpline at 800-662-HELP (4357).
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (4)
How To Test Your Drugs Using Fentanyl Test Strips
Test strips can tell you if your drugs contain fentanyl but not how much fentanyl there is or how strong it is.
Document by NYC.gov
Fentanyl is More Than One Drug
Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube
Protect yourself from the dangers of fentanyl (:60)
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Fentanyl Addict interview-Dylan
Video by Soft White Underbelly/YouTube
How To Test Your Drugs Using Fentanyl Test Strips
NYC.gov
1:09
Fentanyl is More Than One Drug
National Institute on Drug Abuse (NIDA/NIH)/YouTube
1:01
Protect yourself from the dangers of fentanyl (:60)
Centers for Disease Control and Prevention (CDC)/YouTube
22:06
Fentanyl Addict interview-Dylan
Soft White Underbelly/YouTube
Fentanyl Test
Fentanyl Test
Also called: Actiq®, Duragesic®, Sublimaze®
Fentanyl is a fully synthetic opioid that is more potent that morphine and is commonly used for management of severe pain and as an adjunct to general anesthesia. Fentanyl has a rapid onset and short duration of action, making it particularly effective in anesthesia induction as well as maintenance.
Fentanyl Test
Also called: Actiq®, Duragesic®, Sublimaze®
Fentanyl is a fully synthetic opioid that is more potent that morphine and is commonly used for management of severe pain and as an adjunct to general anesthesia. Fentanyl has a rapid onset and short duration of action, making it particularly effective in anesthesia induction as well as maintenance.
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Use the slider below to see how your results affect your
health.
ÎĽg/mL
0.1
Your result is Normal.
Normal ranges indicate therapeutic levels of fentanyl in blood.
Related conditions
Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. It is a schedule II prescription drug, and it is typically used to treat patients with severe pain or to manage pain after surgery. It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. In its prescription form, fentanyl is known by such names as Actiq®, Duragesic®, and Sublimaze®. Street names for fentanyl or for fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash.
When prescribed by a physician, fentanyl is often administered via injection, transdermal patch, or in lozenges. However, the fentanyl and fentanyl analogs associated with recent overdoses are produced in clandestine laboratories. This non-pharmaceutical fentanyl is sold in the following forms: as a powder; spiked on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids.People can swallow, snort, or inject fentanyl, or they can put blotter paper in their mouths so that fentanyl is absorbed through the mucous membrane.
Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. When opioid drugs bind to these receptors, they can drive up dopamine levels in the brain's reward areas, producing a state of euphoria and relaxation. Fentanyl's effects resemble those of heroin and include euphoria, drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma, and death.
Opioid receptors are also found in the areas of the brain that control breathing rate. High doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely, which can lead to death. The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl. Fentanyl sold on the street can be mixed with heroin or cocaine, which markedly amplifies its potency and potential dangers.
The medication naloxone is an opioid receptor antagonist that reverses opioid overdose and restores normal respiration.Overdoses of fentanyl should be treated immediately with naloxone and may require higher doses to successfully reverse the overdose.
Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent.
Non-pharmaceutical fentanyl is sold in the following forms: as a powder; spiked on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids.
Fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. Its effects include euphoria, drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma, and death.
The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl.
FentanylAndAnalogues [accessed on Oct 03, 2018]
Fentanyl | National Institute on Drug Abuse (NIDA) [accessed on Oct 03, 2018]
Fentanyl | Drug Overdose | CDC Injury Center [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (33)
Fentanyl: What You Need To Know
Video by The Drug Classroom/YouTube
Fentanyl: America's Grim New Opioid Addiction
Video by Wall Street Journal/YouTube
Fentanyl
Stick model of the fentanyl molecule in the crystal structure of fentanyl citrate-toluene solvate.
Image by Ben Mills
Prescription Pain Medications (Opioids)
Fentanyl's 3D molecular structure in animated gif format.
Image by Fuse809
Prescription Pain Medications (Opioids)
Fentanyl patch packages from several german generic drug manufacturers (from left to right: 1A Pharma, Winthrop, TAD Pharma, ratiopharm, Hexal).
Image by Alcibiades
Opiates
Opium poppy Papaver somniferum Field in Turkey
Image by Marknesbitt assumed (based on copyright claims).Credit: Mark Nesbitt and Delwen Samuel
Drugs of Abuse (2020)
Drugs of Abuse delivers clear, scientific information about drugs in a factual, straightforward way. With the information in this guide, parents and caregivers can help their children make smart choices and avoid the consequences of drug abuse. This publication covers topics including the Controlled Substances Act and introduces drug classes including narcotics, stimulants, marijuana/cannabis, inhalants, steroids, and more.
Document by Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Synthetic Opioids
Synthetic opioids are substances that are synthesized in a laboratory and that act on the same targets in the brain as
natural opioids (e.g., morphine and codeine) to produce analgesic (pain relief) effects. In contrast, natural opioids
are naturally occurring substances extracted from the seed pod of certain varieties of poppy plants. Some synthetic
opioids, such as fentanyl and methadone, have been approved for medical use.
Document by Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Fentanyl
Fentanyl is a synthetic opioid that is 80-100 times stronger than morphine. Pharmaceutical fentanyl was developed for pain management treatment of cancer patients, applied in a patch on the skin.Â
Document by Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Preventing An Opioid Overdose
Know the Signs. Save a Life.
Document by www.cdc.gov
Support for People with Cancer: Cancer Pain Control
Cancer pain can be managed. Having cancer doesn’t mean that you’ll have pain. But if you do, you can manage most of your pain with medicine and other treatments.
Document by www.cancer.gov
Fentanyl
Fentanyl
Image by Nils Wommelsdorf
Oxycodone
Semi-synthetic opioid drug prescribed for pain as Tylox®, Percodan®, OxyContin®. Derived from the poppy plant, has high potential for abuse.
Document by Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Opium
Opium is a non-synthetic narcotic extracted from the poppy plant, made into a liquid, powder or solid. Opium poppy is a key source for many narcotics.
Document by Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Morphine
Morphine is a non-synthetic narcotic with a high potential for abuse and is derived from opium.
Document by Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Opioid use disorder
A kit made for injecting street drugs, notably opiates (note the promethazine and roxicodone tablets).Items listed clockwise starting from top: Hydrocodone/Homatropine syrup (intensifies opiate effects/remedy for "dope sickness"), Butane Lighter (used to heat up "cook" the concoction before filling syringe), Package of insulin syringes, bottle of Promethazine (opiate potentiator, alleviates "dope-sickness" (often cooked up with the drug being injected), Pocket knife (used to chop or "break up" drug into fine powder), oxycodone pills, individual 1 CC insulin syringes, individual roxicodone pill 15mg (left of quarter) and promethazine 50mg (right of quarter), Q-Tips (cotton used as a filter when filling syringe), Metal spoon (concoction is "cooked up" on spoon), latex glove (used as a tourniquet), Ethanol or isopropyl alcohol (Used to clean skin and any surfaces the drug is to come in contact with)Note it is quite common for a drug injector to use a single needle repeatedly or share a needle with other users. It's also quite uncommon for a sterilizing agent such as alcohol to be used.
Image by Anonymous
Opioid use disorder
Image by Erik Fenderson
Suboxone
Suboxone tablet - both sides.
Image by Supertheman
Opioid use disorder
The contents of a needle exchange kit.The items are (also annotated in the picture), from the top clockwise: a torniquet, cotton balls, a pot for cooking drugs, a condom, sterile water, alcohol swabs, and (from l-r) a thin needle, a thinner needle, and the thinnest needle.Multiple needles of different bore sizes are included. Reason: The viscosity of drugs can be radically different, i.e. methadone is more viscous than heroin which is more viscous than cocaine. Pushing methadone through a small needle is impossible.
Image by Todd Huffman from Phoenix, AZ
Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome
Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome Use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). A new study to determine the extent, context, and costs of NAS found that incidence of NAS is rising in the United States. There was a five-fold increase in the proportion of babies born with NAS from 2000 to 2012, when an estimated 21,732 infants were born with NAS -equivalent to one baby suffering from opiate withdrawal born every 25 minutes. Newborns with NAS were more likely than other babies to also have low birthweight and respiratory complications. The number of delivering mothers using or dependent on opiates rose nearly five-fold from 2000 to 2009, to an estimated 23,009. In 2012, newborns with NAS stayed in the hospital an average of 16.9 days (compared to 2.1. days for other newborns), costing hospitals an estimated $1.5 billion; the majority of these charges (81%) were paid by state Medicaid programs, reflecting the greater tendency of opiate-abusing mothers to be from lower-income communities. The rising frequency (and costs) of drug withdrawal in newborns points to the need for measures to reduce antenatal exposure to opiates.Top Graph: Every 25 minutes, 1 baby is born suffering from opiate withdrawal.Bottom Left Graph: Average length or cost of hospital stay graph. Newborns with NAS stayed in the hospital for an average of 16.9 days compared to 2.1 days for those without NAS. The hospital costs for newborns with NAS were $66,700 on average compared to $3,500 for those without NAS.Bottom Right Graph: NAS and maternal opiate use on the rise graph.The rate of babies born with NAS per 1,000 hospital births was 1.2 in 2000, 1.5 in 2003, 1.96 in 2006, 3.39 in 2009 and 5.8 in 2012. The rate of maternal opiate use per 1,000 hospital births was 1.19 in 2000, 1.26 in 2003, 2.52 in 2006, and 5.63 in 2009.References: Patrick et. Al., JAMA 2012, Patrick et. Al., Journal of Perinatology 2015
Image by National Institute on Drug Abuse (NIDA)
Injection Drug Use and HIV Risk
Sharing needles, syringes, or other drug injection equipment (for example,
cookers) puts people at risk for getting or transmitting HIV and other infections.
Document by Centers for Disease Control and Prevention (CDC)
Fentanyl and Other Synthetic Opioids Drug Overdose Deaths
This infographic summarizes mortality data from 2010-2016. Please note, 15 to 25 percent of death certificates analyzed did not indicate the type of drug involved in the overdose. This was because drug tests were not conducted or there was a failure to record test results on death certificates.
Document by d14rmgtrwzf5a.cloudfront.net
Urine Drug Testing
When
prescribing opioids for chronic pain, clinicians should use urine drug testing before starting opioid therapy
and consider urine drug testing at least annually to assess for prescribed medications as well as other
controlled prescription drugs and illicit drugs.
Document by Centers for Disease Control and Prevention (CDC)
Neonatal Abstinence Syndrome - Low Birthweight
Prematurity can accompany withdrawal
Image by Aneta Meszko, Marcin Meszko
Pregnant concerned about opioid use
Pregnant concerned about opioid use
Document by National Institute on Drug Abuse (NIDA)
High Blood Pressure - Medicines to Help You rev. May 2011b
Use this guide to help you talk to your doctor, pharmacist, or nurse about your
blood pressure medicines. The guide lists all of the FDA-approved products now
available to treat this condition. You will also find some general information to
help you use your medicines wisely.
Document by U.S. Food and Drug Administration (FDA)
Drug overdose deaths
Drug overdose deaths
Image by National Institute on Drug Abuse
Drug overdose deaths
Drug overdose deaths
Image by National Institute on Drug Abuse
Anesthesia medications
Syringes prepared with medications that are expected to be used during an operation under general anesthesia maintained by sevoflurane gas:
Propofol, a hypnotic
Ephedrine, in case of hypotension
Fentanyl, for analgesia
Atracurium, for neuromuscular block
Glycopyrronium bromide (here under trade name Robinul), reducing secretions
Image by Mikael Häggström
Drug overdose deaths
Drug overdose deaths
Image by National Institute on Drug Abuse
Poppy
Poppy
Image by bettischmidt
Prescribing Opioids for Chronic Pain: Guidelines At A Glance
Factsheet CDC Guideline for Prescribing Opioids for Chronic Pain.
Document by Centers for Disease Control and Prevention
A generic fentanyl transdermal patch, with a release rate of 12mcg per hour, applied to the skin
A generic fentanyl transdermal patch, with a release rate of 12mcg per hour, applied to the skin
Image by DanielTahar
8:17
Fentanyl: What You Need To Know
The Drug Classroom/YouTube
12:40
Fentanyl: America's Grim New Opioid Addiction
Wall Street Journal/YouTube
Fentanyl
Ben Mills
Prescription Pain Medications (Opioids)
Fuse809
Prescription Pain Medications (Opioids)
Alcibiades
Opiates
Marknesbitt assumed (based on copyright claims).Credit: Mark Nesbitt and Delwen Samuel
Drugs of Abuse (2020)
Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Synthetic Opioids
Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Fentanyl
Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Preventing An Opioid Overdose
www.cdc.gov
Support for People with Cancer: Cancer Pain Control
www.cancer.gov
Fentanyl
Nils Wommelsdorf
Oxycodone
Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Opium
Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Morphine
Get Smart About Drugs / U.S. Drug Enforcement Administration (DEA)
Opioid use disorder
Anonymous
Opioid use disorder
Erik Fenderson
Suboxone
Supertheman
Opioid use disorder
Todd Huffman from Phoenix, AZ
Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome
National Institute on Drug Abuse (NIDA)
Injection Drug Use and HIV Risk
Centers for Disease Control and Prevention (CDC)
Fentanyl and Other Synthetic Opioids Drug Overdose Deaths
d14rmgtrwzf5a.cloudfront.net
Urine Drug Testing
Centers for Disease Control and Prevention (CDC)
Neonatal Abstinence Syndrome - Low Birthweight
Aneta Meszko, Marcin Meszko
Pregnant concerned about opioid use
National Institute on Drug Abuse (NIDA)
High Blood Pressure - Medicines to Help You rev. May 2011b
U.S. Food and Drug Administration (FDA)
Drug overdose deaths
National Institute on Drug Abuse
Drug overdose deaths
National Institute on Drug Abuse
Anesthesia medications
Mikael Häggström
Drug overdose deaths
National Institute on Drug Abuse
Poppy
bettischmidt
Prescribing Opioids for Chronic Pain: Guidelines At A Glance
Centers for Disease Control and Prevention
A generic fentanyl transdermal patch, with a release rate of 12mcg per hour, applied to the skin
DanielTahar
Opioid Testing
Opioid Testing
Also called: Opioid Screening, Opiate Screening, Opiate Testing
Opioid testing looks for opioids, usually in a sample of urine. Testing helps people get treatment for misusing opioid pain medicine or using illegal opioids.
Opioid Testing
Also called: Opioid Screening, Opiate Screening, Opiate Testing
Opioid testing looks for opioids, usually in a sample of urine. Testing helps people get treatment for misusing opioid pain medicine or using illegal opioids.
{"label":"Opioid Testing Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Opioids were not found in your body sample, or its levels were too low to be considered as relevant.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"This indicates opioids intake. A first positive test result can be considered presumptive until a confirmatory test gives the same result.","conditions":["Opioids use"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
Opioids were not found in your body sample, or its levels were too low to be considered as relevant.
Related conditions
Opioid testing looks for opioids in a sample of your urine (pee), blood, saliva (spit), hair, or sweat.
Opioids include powerful medicines that health care providers may prescribe to relieve pain from serious injuries, illnesses, or surgery. Opioids also include illegal drugs, such as heroin.
The terms "opioids" and "opiates" are often used to mean the same thing, but they're slightly different. Opioids include:
Opiates, which are natural opioids made from the opium poppy plant. Opiates include the medicines codeine and morphine, and the illegal drug heroin.
Synthetic and semi-synthetic opioids, which are medicines made in labs, including:
Oxycodone
Hydrocodone
Hydromorphone
Oxymorphone
Methadone
Fentanyl
Prescription opioids are relatively safe for reducing pain if you take them for a short time according to your provider's instructions. But opioids can increase feelings of pleasure and well-being in some people. For these reasons, misuse of prescription opioids is common.
Prescription opioid misuse means taking the medicine in a different way or for a different purpose than your provider prescribed. It includes:
Taking more than your prescribed dose or taking it more often
Getting and using prescription pills from friends or family members, even if you're using the pills for a medical condition
Taking prescription drugs to get high
Mixing prescription opioids with alcohol or other drugs
Opioid misuse is dangerous because opioids are highly addictive. Misusing them can lead to opioid use disorder (OUD), which is sometimes called opioid addiction. OUD can cause difficulties with work, school, and homelife. It can even lead to overdose and death.
Opioid testing can't diagnose opioid misuse or OUD. But it can be used with questionnaires called drug use screening tests to help find out who may need help with a drug problem.
Other names: opioid screening, opiate screening, opiate testing
Opioid testing may be used for different purposes, including:
Monitoring misuse of prescription opioids. If your provider prescribed opioids for pain, opioid tests may be used to make sure you're taking the right amount of medicine.
As part of an overall drug testing program to check for a variety of drugs, including marijuana, cocaine, and opioids. Drug testing may be used for:
Employment. Employers may test you for drugs before hiring you and/or after hiring to check for on-the-job drug use.
Legal evidence. Testing may be part of a criminal or motor vehicle accident investigation. Drug testing may also be ordered as part of a court case.
Drug treatment. Drug testing may be used to monitor treatment in programs for drug or alcohol use disorder.
Sports. Professional and other athletes are often tested for drugs.
Drug testing may be scheduled ahead of time or done randomly without notice./p>
Your provider may order opioid testing if you're taking prescription opioids to treat chronic pain or another medical condition. Certain tests can tell if you are taking more medicine than prescribed, which can be a sign of misuse or addiction.
Your provider may also order opioid testing if you have other signs or symptoms of opioid misuse or addiction, which may include:
Calling early for refills or asking for higher doses
Complaining of increasing pain even though the condition isn't getting worse
Having withdrawal symptoms when not taking opioids, which may include:
Frequent yawning
Wide open pupils (the openings that let light into your eyes)
Uncontrollable leg movements
Increased heart rate and blood pressure
Nausea and vomiting
In a hospital emergency room, a provider may order opioid testing if you have signs of a possible drug overdose, such as slow shallow breathing and very low blood pressure.
You may also be asked to take a drug test, which includes testing for opioids, for a job, to participate in certain organized sports, or as part of a police investigation or court case.
Opioid testing may be done in a variety of locations, including labs, hospitals, drug treatment centers, and workplaces. Most opioid tests require a urine sample. Other opioid tests may use samples of your blood, saliva, sweat, or hair.
For a urine test, you will be given instructions for how to collect your urine sample. Follow them carefully. In certain cases, a health care professional or other person may need to be present while you provide your sample. This is to make sure the urine is yours and isn't contaminated with anything that might affect the test results.
For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a saliva test, a sample may be collected in one of two ways:
A swab or pad will be placed inside of your cheek for a few minutes until it is soaked with saliva.
You'll spit into a tube.
For a sweat test, you'll wear a patch on your skin for five to seven days. The patch will absorb your sweat.
For a hair test, scissors will be used to cut a small sample of hair from near your scalp. Hair may be cut from other parts of your body instead. Hair samples can show long-term opioid use.
Be sure to tell the testing professional or your provider if you are taking any prescription or over-the-counter medicines. Some of these medicines may show up as opioids on your test results. Poppy seeds can also show up as opioids. So, you should avoid foods with poppy seeds for at least three days before your test.
There are no known risks to having a urine, saliva, sweat or hair test. There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Your test results depend on the type of opioid testing you had.
Tests to screen for drugs in your system are often done first. These tests only show whether opioids are in your sample. They can't show what kind or how much:
Positive results mean that opioids were found. But positive test results may not be accurate (false positives), so follow-up testing is usually required to confirm the results.
Negative results mean that either:
No opioids were found in your sample. That may be because you haven't taken any, or you took them but they are no longer in your body.
A very small amount of opioids was found, but too little to be called a positive test result. In certain cases, follow-up tests may be done to get more information.
Confirmation tests may be done if there is a question about the results of a screening test. These tests can show more detail about the amount and/or type of opioids found in your sample.
Opioid test results can be complicated to understand. They may be affected by how fast your body uses opioids, other medicines you take, and the different ways labs do the tests. So, it's best to ask your provider to explain what your results mean.
You can buy home tests for many opioids and other prescription and illegal drugs. These tests only check whether opioids show up in your sample. There are two types:
At-home tests let you do the entire test at home and get rapid results. But if the test result finds opioids, you'll need to have a follow-up lab test to check the accuracy of the result. Some at-home tests include a kit for collecting a sample, usually urine or saliva, to send to a lab in case the home test result is positive.
A self-collection test has a kit for gathering urine, saliva, or another type of sample to send to a lab for testing. Some self-collection tests include the cost of a second lab test to check the accuracy of a first test that has a positive result.
It's best to talk with your provider about using home drug testing so you can decide if it's right for your situation.
OPATU - Clinical: Opiates Confirmation, Urine [accessed on Oct 29, 2018]
Opioid Testing | Lab Tests Online [accessed on Oct 29, 2018]
737831: Opiates, Screen and Confirmation, Urine | LabCorp [accessed on Oct 29, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
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Fentanyl
Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. In its prescription form it is prescribed for pain, but fentanyl is also made illegally. Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths. Learn about fentanyl, health effects and treatment for addiction.