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What you don't know about fentanyl can kill you | Opinion

Regional slang for fentanyl includes China Girl, China White, Dance Fever, He-Man, Tango and Cash, Goodfellas, Poison, China Town and Great Bear.

Fentanyl, an opium-related painkiller, is synthetically manufactured legally by pharmaceutical companies and mass-produced illicitly by covert laboratories using chemical precursors. Fentanyl and fentanyl-related substances largely are made in China, Mexico and India. Chemical precursors are combined into finished fentanyl powder and bags of pressed tablets that are shipped via mail services and smuggled into the U.S. by human carriers and concealed forms of transportation.

FILE - A reporter holds up an example of the amount of fentanyl that can be deadly after a news conference about deaths from fentanyl exposure at DEA Headquarters in Arlington, Va., June 6, 2017. (AP Photo/Jacquelyn Martin, File)
FILE - A reporter holds up an example of the amount of fentanyl that can be deadly after a news conference about deaths from fentanyl exposure at DEA Headquarters in Arlington, Va., June 6, 2017. (AP Photo/Jacquelyn Martin, File)

Fentanyl has been around for 60-plus years. First formulated as an IV medication used as an anesthetic, fentanyl is now a Food and Drug Administration-approved anesthetic and analgesic with valid medical purposes. Fentanyl helps control pain after surgery and is used palliatively to manage cancer-related pain and discomfort in dying individuals.

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Gary Dodd
Gary Dodd

The potency of fentanyl is reported to be 100 times more than morphine and 50 times more than heroin. Various dosage formulations include transdermal patches, sublingual and buccal tablets, sublingual and nasal sprays, an injectable formulation and transmucosal lozenges.

Licit fentanyl is diverted by counterfeit prescriptions, by theft and at times by patients, licensed medical providers or pharmacists. Illicit fentanyl increasingly is being mixed with or used to replace heroin, combined with cocaine, methamphetamine and benzodiazepines and, according to some media reports, laced into marijuana. A person buying a pain pill on the street might acquire a counterfeit pill that has only fentanyl in it. People who are physically naïve to fentanyl are at a higher risk of overdose deaths.

People abuse fentanyl by using it orally, nasally and intravenously. Fentanyl patches are frozen and then cut into pieces that are used sublingually and buccally. Fentanyl transdermal patches that have been on another person’s body for three days are sometimes chewed to ingest any remaining Fentanyl. Fentanyl also is smoked.

The U.S. is experiencing an alarming increase in the use of synthetic drugs like fentanyl, which is highly addictive. Illicit suppliers can make a higher profit selling fentanyl. The Centers for Disease Control and Prevention and the National Center for Health Statistics collect and monitor data on overdose deaths. Their data suggest that from Dec. 1, 2020, to Nov. 30, 2021, approximately 106,854 people in the United States died from overdoses, a likely increase of more than 30% in one year. Over 150 people are dying daily due to synthetic opioid overdoses. The overdose deaths may be underreported.

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While more action needs to be taken to address immigration, U.S. government organizations are working to address the issues and dangers surrounding fentanyl. The High Intensity Drug Trafficking Areas program reports the seizure of pills containing fentanyl has increased from around 42,000 tablets during the first quarter of 2018 to over 2 million tablets during the last quarter of 2021. At President Joe Biden’s urging, the United Nations Commission on Narcotic Drugs passed a measure to control more broadly the access to and use of additional chemical precursors synthesized to manufacture fentanyl illicitly. Narcan, which potentially can reverse an opioid overdose with fentanyl, is available without a prescription in many states and should be obtained by anyone using licit or illicit opioid medication.

A person using illicit substances cannot see, smell or taste fentanyl. Highly sensitive fentanyl testing strips can potentially save your life by indicating the presence of fentanyl residue. Unfortunately, these test strips may not detect carfentanil, a substance that is 100 times more powerful than fentanyl and 1,000 times more potent than morphine.

What you do not know about fentanyl can not only hurt you; it also can kill you.

For help, call or text the Tennessee REDLINE at 1-800-889-9789.

Gary Dodd works as a nurse practitioner at Cedar Recovery, a medical practice seeking to solve the opioid crisis and repair communities by providing addiction treatment.

This article originally appeared on Nashville Tennessean: What you don't know about fentanyl can kill you