What is fentanyl?

In 2002, during the Moscow theater hostage crisis,  gaseous fentanyl was used, garnering worldwide attention. Today, there is increasing talk about the epidemic of fentanyl addiction, especially in the United States. A growing number of young people are turning to the misuse of this drug, which can have tragic consequences.

What is fentanyl?

Fentanyl is a synthetic opioid first synthesized by Paul Janssen and has been in use in America since 1968. It is 50-100 times stronger than morphine. It is necessary to define the difference between opioids and opiates. Opiates are active components derived from opium, the sticky sap obtained from the seed pods of the poppy plant, containing various alkaloids, the most famous being morphine, papaverine, codeine, and similar substances. Opioids encompass all active substances that act on opioid receptors, which can be of natural, synthetic, or semisynthetic origin. Fentanyl was created by simplifying the structure of morphine. Due to its lipophilicity, it crosses the blood-brain barrier well and acts more strongly than morphine. In addition to fentanyl, there are numerous derivatives with varying properties, including alfentanil, remifentanil, and sufentanil, which is the strongest.

How does it work?

The common goal of opioids and opiates is pain suppression, or analgesia. There are three receptors responsible for reducing pain sensation: μ-receptors, δ-receptors, and κ-receptors. To better understand how fentanyl works, it is necessary to define what agonists and antagonists are. Agonists are substances that bind to a specific receptor and activate it, while antagonists bind to the receptor and block it, preventing the binding of substances that activate it. Fentanyl acts agonistically on μ-receptors. Its action on μ-receptors, besides pain suppression, is responsible for the euphoria that causes addiction and respiratory depression that can lead to death. Other common side effects of fentanyl are very similar to those of heroin, including depression, confusion, hallucinations, nausea, constipation, delirium (also known as “narcotic delirium”), hypotension, and coma.

Fentanyl in medicine

It is commonly used before surgical procedures and anesthesia. It is used to treat moderate to severe pain, most commonly in patients with cancer or in cases of resistance to other opiates.

More young lives are at risk

In the past decade, fentanyl has gained popularity, increasingly abused by young people, which increases the number of overdoses and, consequently, deaths. Euphoria caused by opioids is the most common cause of addiction. Fentanyl is often found in trace amounts in other drugs like heroin to increase potency, with individuals consuming these substances often unaware of what they are consuming.

The World Health Organization claims that in 2021, around 296 million people aged 16 to 64 consumed at least one type of drug, with 60 million specifically using opioids. In 2019, 125,000 deaths were caused by opioid overdoses. During the COVID-19 pandemic, there has been an increase in deaths due to synthetic opioids.

One of the potential ways to reduce opioid addiction is to decrease the irrational prescription of opioids, control patient consumption, and limit the sale of opioids without a prescription.