FENTANYL – The Good and The Bad!

Fentanyl is a synthetic opioid that is utilized in medical practice as a powerful pain reliever. It’s most commonly used in clinical settings either prior to surgery to induce sedation before administering longer-lasting sedation or in the recovery room following surgery for immediate pain relief. Fentanyl is very potent and effective to relieve pain, but it has a short duration of action—one to two hours at most, and often less than one hour.

The drug is also used to relieve extreme pain outside of the clinical setting via a drug patch applied to the skin. This transdermal patch slowly releases fentanyl over a 72-hour period. When I practiced pharmacy in an out-patient setting, a significant number of patients came to my homecare services sporting fentanyl patches as part of their overall pain relief plan while our nursing support administered intravenous medications for a variety of ailments that caused the extreme pain.

As commonly as fentanyl is in both the clinical and non-clinical settings, its reputation has taken on a more ominous one as a “filler” to “cut” heroin as well as other opioid and some non-opioid drugs. Over the last few years, fentanyl has been found as a filler in the party drug cocaine, and this is considered by drug law enforcement as a “game-changer.”

Courtesy of the New Hampshire State Police Forensics Lab

The reason for this enhanced apprehensiveness is somewhat complex, but a central concern is why people abuse heroin vs cocaine and the type of users who abuse these drugs. Heroin, an opioid from the poppy flower plant, is a depressant drug. Heroin is the type of drug that gives a sustained “buzz” and a heroin abuser often has a greater tolerance to opioid drugs. Although fentanyl-laced heroin is an extremely dangerous combination, drug overdoses have not been as extreme as in cases of fentanyl being added to cocaine.

Cocaine is a stimulant drug, a non-opiate from the coca plant, that gives a short-term euphoric effect—thus, its popularity as a party drug. When fentanyl is mixed into cocaine, that becomes the “game-changer,” as law enforcement agencies suggest. Cocaine users are more casual drug abusers, with a lesser chance of long-term addiction. The addition of fentanyl changes those dynamics, and that becomes a lethal combination.

Now it appears that drug-using party animals who use cocaine casually and occasionally have become unsuspecting victims with the progression of fentanyl into street drug mixes.

A 2016 study of overdose deaths in New York City revealed that 44% of the 1,300 overdose deaths involved fentanyl and 37% of those OVERALL overdose deaths involved a fentanyl-cocaine mix—that’s 84% of the lethal overdoses that involved fentanyl and that represents an increase of 11% over the previous year.

Synthetic opioids, such as fentanyl, are cheap to make, are easily available on the dark web and become extraordinarily profitable for illicit drug distributers. Heroin-fentanyl on the street costs a fraction of what prescription painkillers cost on the street. Although much focus has been given recently in news broadcasts regarding prescription opiate abuse and overdoses, most of the deaths are seen with illicit opiate abuse—as with the synthetic opioid fentanyl and fentanyl-laced street drugs.

Fentanyl is an extremely potent and dangerous drug when not used properly. Although heroin is about three times more potent than morphine (the so-called “standard” used for pain-relieving drug potency), fentanyl is up to 100 times more potent than morphine.

The initial symptoms of an overdose include pinpoint pupils, muscle weakness, dizziness and confusion. The symptoms progress to a profound decrease in heart rate and very low blood pressure, with eventual loss of consciousness. Extreme respiratory depression and a dangerously slow heart beat lead to lack of oxygen to the brain (and potentially lethal hypoxia) that can exhibit as permanent brain damage.

If your next storyline involves a drug overdose, a fentanyl-laced drug might be an interesting and timely addition to consider.

Thoughts? Comments? I’d love to hear them!

About James J. Murray, Fiction Writer

With experience in both pharmaceutical manufacturing and clinical patient management, medications and their impact on one’s quality of life have been my expertise. My secret passion of murder and mayhem, however, is a whole other matter. I’ve always loved reading murder mysteries and thrillers, and longed to weave such tales of my own. Drawing on my clinical expertise as a pharmacist and my infatuation with the lethal effects of drugs, my tales of murder, mayhem and medicine will have you looking over your shoulder and suspicious of anything in your medicine cabinet.
This entry was posted in A How To Blog on Murder Plot Ideas, A How To Blog on Murder Weapons, A New Drug Abuse Threat, A New Street Drug, About James J. Murray, About Medications/Pharmacy, About Murder, About Writing, All About Murder, Blog Writers, Blogging, Bloodless Death Scene Writing, Deadliest Drugs in America, Deadliest Drugs in US, Deadly Drugs in America, Death From Prescription Painkillers, Deciding How to Kill Off a Character in a Novel, Designer Street Drugs, Designing Murder Plots, Developing Storyline Ideas, Dramatic Murder Weapons, Drug Abuse, Drug Misadventures, Drugs For Murder Plots, Drugs Used For Murder, Euphoric Party Drugs, Fentanyl as a Street Drug, Fentanyl Street Drugs and Overdose Deaths, Fentanyl-Laced Cocaine, Fentanyl-Laced Heroin, Fentanyl-Laced Street Drugs, How to Choose a Murder Weapon for a Plot Idea, Ideas for Murder Scenes, Illegal Drug Trends, James J. Murray Blog, Killing Off Characters in Your Novel, Misuse of Drugs, Murder Mayhem and Medicine, Murder Weapons Discussed, Murder With Drugs, Murder With Party Drugs, New Blog, New Methods To Kill Characters in Your Novel, New Street Drug Trends, Party Drugs, Pharmacy/Pharmaceuticals, Plotting Interesting Murder Scenes, Prescription For Murder Blog, Street Drug Abuse Substances, Street Drug Overdosing, Street Drugs, Street Drugs and Murder, The Science of Murder, The Writings of James J. Murray, Thrill-Seeker Drugs, Unique Murder Plots, Writing Death Scenes, Writing Dramatic Murder Scenes and tagged , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.

3 Responses to FENTANYL – The Good and The Bad!

  1. Thanks very much for the insights, James. You have provided excellent context for all of the news reports we see and read about the abuse of these drugs. Can’t help wondering about how illicit drug gangs are gaining access to huge amounts of these powerful drugs. Surely they can’t be manufactured undetected in such enormous quantities by illegal backstreet labs.

  2. That’s a good question, Jim.
    Much of what is considered illegal distribution of legal drugs are 1) those manufactured in “kitchen labs” since much of the pure, active drug in legal medications could be duplicated by a clever, but unscrupulous, chemist; or 2) these drugs are counterfeits of the real drug (and often these have much of the active drug in them).
    See my latest novel “IMPERFECT MURDER” for more on this #2 point – Available on Amazon at https://www.amazon.com/Imperfect-Murder-Masters-Novel-Book ebook/dp/B072C18JF2/ref=asap_bc?ie=UTF8

    Thanks for your great comments. All the best!

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