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Fentanyl is a narcotic or opiate drug. The primary medical use for narcotic drugs is for the control of moderate to severe pain.
Fentanyl is an extremely potent narcotic drug that can be administered as a transdermal patch, injected, or taken in pill or liquid form. It is marketed under brand names like Duragesic or Actiq, and these medicinal products contain extremely small amounts or significantly diluted forms of the drug.
Fentanyl’s mechanism of action is believed to primarily involve its ability to act as an opioid agonist, which means that the drug readily attaches to neurons in the central nervous system that are specialized for neurotransmitters like enkephalins and endorphins. These substances are often referred to as endogenous opiates because they have a similar chemical structure to opiate drugs. Because the neurons in the brain that are specialized for these endogenous opiates substances are ready-made for synthetic drugs like fentanyl, these drugs are very efficient at controlling pain, reducing stress, increasing sedation, and lessening anxiety.
They are considered to be central nervous system depressant substances that slow down the actions of the neurons in the brain and spinal cord. Because the brain is the control center for nearly every important bodily function, slowing the functioning of the brain also results in slowing the actions of other organs, such as the heart, lungs, kidneys, etc., as well as reducing the ability to engage in voluntary actions, such as walking, talking, and even thinking.
The majority of drugs classified as opiate drugs or narcotic medications are classified as Schedule II controlled substances by the Drug Enforcement Administration (DEA), and fentanyl is a Schedule II controlled substance. Despite their medical uses, these drugs have a high probability for abuse and are likely to produce physical dependence in people who take them on a regular basis for more than a few weeks. The addictive properties of these drugs are due to their major mechanism of action as well as their ability to affect the actions of other neurotransmitters in the brain like dopamine.
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Before discussing the potentially lethal dose of fentanyl, it may be useful to establish some perspective for those not familiar with the metric system. There are approximately 28.35 grams to an ounce. One milligram (1 mg) is equal to 1/1000 of a gram. One microgram is equal to 1/1000 of one milligram.
The medicinal doses associated with some of the more well-known narcotic medications, such as morphine, hydrocodone (the opiate drug in medications like Vicodin), and oxycodone (the opiate substance in medications like OxyContin) are often given in milligrams. Medicinal doses associated with fentanyl are often given in micrograms.
This illustrates the potency of opiate drugs in general and the increased potency associated with fentanyl compared to these other very potent narcotic medications.
According to the book Opiate Receptors and Antagonists: From Bench to Clinic, the following amounts are generally considered to be lethal doses for these opiate drugs for an average person who has not developed tolerance:
Based on the above figures, one can calculate that the lethal dose for fentanyl is approximately 100 times less than the lethal dose for morphine. In addition, when individuals mix drugs, such as fentanyl dosing in conjunction with heroin, the potential amount of a lethal dose of fentanyl is drastically reduced to the point of being so small that normal individuals might not be able to measure it.
In most cases, lethal doses of any drug will vary depending on who is taking the drug. The lethal dose for a small child or a 100-pound woman will be significantly smaller than the lethal dose for a 300-pound man.
In addition, individuals who have established significant tolerance to a substance will require significantly higher amounts of the drug in order to experience an overdose or lethal effects compared to individuals who have not established a tolerance for the drug.
In many cases, the mode of administration may play a role in how much of the drug is actually delivered to the individual’s system. For instance, taking a drug orally typically results in less of the drug entering a person’s system than snorting or injecting it. Moreover, snorting or injecting opiate drugs results in their actions being experienced far more quickly than taking them orally.
The signs and symptoms that occur in individuals who have overdosed on fentanyl can consist of:
The lethal effects that occur as a result of fentanyl overdose are most often due to significant respiratory suppression or the complete halting of breathing as a result of the central nervous system depressant effects of the drug.
If one suspects that someone has overdosed on fentanyl, there are several actions that should be taken:
Fentanyl is an extremely potent opioid drug. Individuals can experience potentially fatal effects from extremely small amounts of the drug. If fentanyl is taken in conjunction with other opiates, its lethal dose is even smaller.