As a nationwide opioid crisis continues to rage on, another drug has drastically shown up on the scene: fentanyl. Drug professionals at the University of Wyoming weighed in on the situation to give students and staff a word of warning.
“Fentanyl is 50 to 100 times more potent than morphine and 50 times more potent than heroin. It is so much more addictive because it hits the brain faster and it binds to the receptors more tightly. You get a bigger, faster high,” Melissa Hunter, UW Drug Information Director, said.
“Depending on the source, two to three milligrams is a lethal dose, and two milligrams can fit on the tip of the pencil.”
Fentanyl is often added to tablets of other opioids so as to make the compound more potent. Those using the drugs are often unable to detect any signs of fentanyl.
“Producers of illegal fentanyl do not know the potency; they’re not made with exact dosing. We don’t know what you’re getting. So that’s the big problem: that people die,” Dave Bruch, senior clinical lecturer at the UW school of pharmacy, said.
“They want to mix that fentanyl with heroin to get the user a bigger high. That’s the point of it, but they’re not dosing correctly; they’re killing people.”
When using any form of drug it is vital the user understands what and how much they’re taking. When using illegal drugs, this can be impossible.
“You can die by taking too much Tylenol, but it will tell you on the box, ‘do not take this many in a 24 hour period.’ That helps you, as a consumer, know where the safety lies and where that range is. You don’t get that opportunity with an illegal medication, period,” Bruch said.
Bruch added that the physiological consequences are almost always unknown to the user, and explained that fentanyl and other illegal drugs become increasingly dangerous as they’re mixed together.
“People don’t typically take one medication, they will take an upper, like a methamphetamine, and a downer. All of that changes the level of mortality and morbidity. They’re not scientists,” Bruch said.
“It is what we would call polypharmacy, or the use of many medications at once. That makes it hard to treat people.”
Under normal conditions, there are means to counteract the effects of a fentanyl overdose.
“Narcan is a brand name of a medication, its generic name is called Naloxone. It’s what’s called an antagonist, inhibitor or blocker, pretty much all meaning the same thing, of the opioid receptor. Fentanyl, heroin and morphine are agonists or they potentiate or cause the receptor to do what it’s supposed to do, which is pain relief, euphoria, et cetera,” Bruch said.
“[Narcan is like] the opposite [of Fentanyl] it pulls things away from that receptor, or blocks the receptor, so it’s a reversal agent.”
Having the proper equipment and medications can potentially save someone’s life.
“When someone stops breathing from an overdose, it’s an emergency and minutes matter. Your brain really likes oxygen and when it doesn’t get oxygen for prolonged time, you don’t survive that. And so the sooner that someone can have Narcan on board, the sooner and the more likely you are to save their life,” Hunter said.
“You never know what circumstance you’re going to be in, and minutes truly can save a life.”
Narcan is widely available, and if one were to use Narcan on an individual with no fentanyl in their system, there would be few effects.
“You can get Narcan from any pharmacy in town. Pharmacists have the ability to write the prescription for it and so you don’t even need to go to a provider. If you have a concern for yourself or one of your friends or being in a situation where someone might be in an overdose, you can get Naloxone.” Hunter said.
According to Bruch, signs of fentanyl use include irritability, eyes that do not dilate, and constipation. It can be difficult to identify an active fentanyl overdose, however.
“They will appear like they’re asleep. They will be lying there, unconscious, trying to get air. [There will be] respiratory failure, in the sense that they will look psychotic. [They will be] graying, blueing, as their body isn’t taking in oxygen because they’re not breathing. You’ll look for the purpley blue lips, passed out. Their chest will not rise and fall very fast or at all,” Bruch said.
“People that die, quite often they will find the syringe stuck in their arm. It’s that fast.”
According to the CDC, there were over 68,000 overdoses involving synthetic opioids, despite the fact the science behind them is well known. Bruch believes the solution lies in the hands of more than just medical professionals.
“Everybody that is a nurse, pharmacist or health care provider understands, because it’s in the same class as oxycontin, vicodin or any of these things that we use just painkillers forever, how to treat it. We all understand, ‘This one does this and it reverses with this.’ There’s not enough people to help give that stuff out or deter it,” Bruch said.
“It’s the same old adage: just don’t do it.”
