Fentanyl info

On April 20, 2006, the Maryland Poison Center (MPC) was contacted about a cluster of opioid overdoses in Wicomico County, Maryland. Subsequent investigation and analysis determined that fentanyl was the drug involved, and that it was illicitly manufactured. Since then, the MPC has been notified of additional fentanyl overdoses in other areas of Maryland. Fentanyl overdoses were also recently reported in the Camden, New Jersey area, Delaware and Illinois.

What is fentanyl? Fentanyl is a short-acting, synthetic opioid that is 50-100 times more potent than morphine. It is legally manufactured as a transdermal patch, an oral transmucosal lozenge and as an injection. Abuse of fentanyl patches is frequently reported. Fentanyl is also illicitly manufactured as a powder and tablets. “Designer” fentanyl analogs (3-methylfentanyl and alpha-methylfentanyl) are of a higher potency, and have been implicated in outbreaks of overdoses in several other states in past years.

What are some slang names for fentanyl? Infamous, flat line, TNT, snow man, THA truth, tsunami and lethal death are some of the slang names that have been identified for fentanyl. China white often refers to alpha-methylfentanyl. As always, slang names vary and cannot be relied upon to refer to a particular drug.

What are the toxic effects of fentanyl? The toxicity of fentanyl is similar to that of other opioids. Lethargy, coma, respiratory depression, respiratory arrest, hypotension, bradycardia, pulmonary edema and death can occur. Constricted pupils may or may not be present. Other signs and symptoms may occur due to the presence of other drugs as adulterants.

Are fentanyl overdoses treated any differently than overdoses with other opioids? The treatment of a fentanyl overdose is the same as that for other opioids; however, larger then usual doses of naloxone (2 – 10 mg) might be required for reversal of the opioid effects.

DID YOU KNOW THAT…a toxscreen will be negative for opiates when fentanyl has been used? Fentanyl is not detected by standard urine opiate immunoassays; therefore, opioid exposures should not be ruled out based on toxscreen results. To date, the only means of detecting fentanyl in blood or urine is by gas chromatography.

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This story reprinted from the Maryland Poison Center ToxiTidbits Newsletter.

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I reported on the overdose alert a few weeks ago.

Jamie
The Podmedic