Fentanyl: A Powerful Synthetic Opioid
Fentanyl is a synthetic opioid that is 50-100 times more potent than morphine and 25-50 times more potent than heroin. It was first developed in the 1960s as a powerful painkiller and anesthetic for medical use. In controlled settings, fentanyl is often used to treat severe pain in patients with chronic conditions, such as cancer, or those undergoing surgery.
However, its potency and ability to induce a powerful "high" have also made it attractive to illicit drug manufacturers and users. Illegally produced fentanyl and its analogs have become a major concern in the opioid crisis, as they are frequently mixed with other drugs, like heroin or cocaine, to increase their potency and generate greater profits.
The Impact of Fentanyl on the Opioid Crisis
Fentanyl has had a profound impact on the opioid crisis in the US. According to the Centers for Disease Control and Prevention (CDC), synthetic opioids, primarily fentanyl, accounted for nearly 60% of all opioid-related overdose deaths in 2017. As fentanyl continues to infiltrate the illicit drug market, the risk of accidental overdose has increased significantly.
The danger of fentanyl lies in its potency and the fact that users often do not know they are consuming it. A small amount of fentanyl can be lethal, and users who believe they are taking another drug, like heroin, may unknowingly ingest a lethal dose. This has led to a surge in overdose deaths, placing a strain on communities, healthcare systems, and law enforcement agencies.
How Fentanyl Has Infiltrated the Illicit Drug Market
Fentanyl's infiltration into the illicit drug market can be attributed to several factors. Its high potency allows for smaller quantities to be transported and sold, making it easier for drug traffickers to avoid detection. Additionally, the production of synthetic opioids like fentanyl does not rely on the cultivation of natural resources, such as the opium poppy plant, making it more accessible and cost-effective for illegal drug manufacturers.
Many fentanyl-related overdose deaths can be traced back to counterfeit prescription pills that contain fentanyl. These counterfeit pills are made to look like commonly prescribed painkillers, such as oxycodone or hydrocodone, but are laced with fentanyl. Unsuspecting users may take these pills, believing they are safe prescription medications, only to suffer the consequences of fentanyl's potency.
Furthermore, fentanyl is often mixed with other drugs, like heroin, cocaine, or methamphetamine. Drug dealers do this to increase the potency and appeal of their product, as fentanyl can induce a more powerful high. However, this practice also increases the risk of overdose, as users may not be aware of the presence of fentanyl or may not know the correct dose to take.
Fentanyl Tolerance and Its Impact on Treatment
As with other opioids, long-term fentanyl use can lead to the development of tolerance. Tolerance occurs when the body becomes accustomed to the presence of a drug and requires higher doses to achieve the same effect. This is particularly dangerous with fentanyl due to its high potency and the risk of overdose.
Fentanyl tolerance develops as the brain's opioid receptors become less sensitive to the drug's effects. This forces users to take larger doses to achieve the same euphoric high, further increasing the risk of overdose and other negative health effects. Additionally, long-term fentanyl use can result in physical dependence, where the body relies on the drug to function normally, leading to withdrawal symptoms when the drug is no longer present.
An important aspect of fentanyl tolerance is its impact on treatment options for individuals with opioid use disorder. One of the most common treatments for opioid use disorder is medication-assisted treatment (MAT), which involves the use of medications like buprenorphine to help manage withdrawal symptoms and reduce cravings. Buprenorphine is a partial opioid agonist, meaning it binds to the same opioid receptors in the brain but produces a weaker effect, helping individuals transition away from more potent opioids like fentanyl.
However, initiating buprenorphine treatment for individuals with a history of long-term fentanyl use can be challenging. Fentanyl is lipophilic, meaning it has a high affinity for fat cells in the body. As a result, fentanyl accumulates in these cells over time, and its presence can linger even after a person stops using the drug. This buildup can make it difficult for healthcare providers to determine the appropriate timing and dosage for buprenorphine induction, as the presence of residual fentanyl in the body can interfere with buprenorphine's effects and potentially trigger withdrawal symptoms.
To minimize the risk of complications during buprenorphine induction, healthcare providers must carefully assess each individual's history of fentanyl use, withdrawal symptoms, and any other factors that may influence treatment outcomes. In some cases, a supervised, gradual tapering of fentanyl use may be necessary before transitioning to buprenorphine. Additionally, close monitoring and regular communication between the patient and healthcare provider can help ensure a safe and effective transition to buprenorphine treatment.
Tolerance to fentanyl complicates the transition to medication-assisted treatment. Addressing the issue of fentanyl tolerance and its impact on treatment requires a comprehensive understanding of each individual's history of fentanyl use, as well as careful planning and monitoring during the initiation of buprenorphine therapy.
How We Can Help
MATClinics has staff dedicated to helping patients transition from fentanyl to buprenorphine. We know how difficult it can be to make the shift and we make sure that you get the support you need. When you start your treatment you will get a call and text message within 24 hours to follow up on your progress. But you don’t need to wait! Our patients are encouraged to reach out with questions and concerns any time, either by phone or text message.