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Last updated : June 24, 2017

What is fentanyl?

Fentanyl is a depressant drug, which means it slows down the messages travelling between the brain and body. It belongs to a group of drugs known as opioids. It is prescribed for the for chronic, severe pain as a result of cancer, nerve damage, back injury, major trauma or other causes.1 In Australia, fentanyl is a schedule 8 drug.2 It is about 80 to 100 times stronger than morphine.3

Fentanyl comes in a number of different forms and strengths including:

  • Transdermal patches (Durogesic® and generic versions)
  • Lozenges/lollipops (Actiq®)
  • Intravenous injection (Sublimaze®)2

How is it used?

  • The transdermal patch is applied to the skin and provides strong and consistent pain relief at an even rate over a 72 hour period.1 The patch is the most commonly used form of fentanyl.
  • The lozenges are dissolved in the mouth and are used for breakthrough pain in patients already taking regular opiates for severe pain.1
  • The intravenous solution is injected for pain relief and sedation during minor surgery and its duration of action is short.1

Some people use fentanyl illegally to get high by extracting the fentanyl from the patch and injecting it. This is very risky as there is little difference between the amount needed to get high and the amount that causes overdose. It is also extremely hard to judge a dose size.

Effects of fentanyl

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Fentanyl affects everyone differently, based on:

  • Size, weight and health
  • Whether the person is used to taking it
  • Whether other drugs are taken around the same time
  • The amount taken
  • The strength of the drug (varies between patches)

You may experience:

  • Relief from pain
  • Nausea, vomiting
  • Constipation and/or diarrohea
  • Reduced appetite
  • Wind, indigestion, cramps
  • Drowsiness, confusion
  • Weakness or fatigue
  • Dizziness
  • Euphoria
  • Headache
  • Incoherent or slurred speech
  • Impaired balance
  • Slow pulse and lowered blood pressure
  • Rash (inflammation, itch, swelling at patch site)1

Overdose

If the dose is too high, you might overdose. If you have any of these symptoms, call an ambulance  straight away by dialling triple zero (000). Ambulance officers do not have to involve the police.

  • Chest pain
  • Slowed breathing
  • Bluish lips and complexion
  • Seizure
  • Passing out
  • Coma
  • Death1,4

Naloxone (also known as Narcan®) reverses the effects of opiates (including fentanyl), in the case of an overdose. Naloxone can be injected intravenously (into a vein) or intramuscularly (into a muscle) by medical professionals, such as paramedics. It can also be administered by family and friends of people who use opiates. Speak with your chemist or pharmacist for more information.

Naloxone information video

Injecting fentanyl and sharing needles may also cause:

  • Tetanus
  • Hepatitis B
  • Hepatitis C
  • HIV/AIDs

Long term effects

Regular use of fentanyl may cause:

  • Mood instability
  • Reduced libido
  • Constipation
  • Menstrual problems
  • Respiratory impairment3

Using fentanyl with other drugs

The effects of taking fentanyl with other drugs – including over-the-counter or prescribed medications – can be unpredictable and dangerous and could cause:

  • Fentanyl + alcohol: adds to adverse effects and may increase the risk of respiratory depression.
  • Fentanyl + MAOI anti-depressants: may result in severe unpredictable reactions.
  • Fentanyl + benzodiazepines: may add to the sedative effects and diminished breathing.1

Withdrawal

Giving up fentanyl after using it for a long time is challenging because the body has to get used to functioning without it. Withdrawal symptoms usually start within 12 hours after the last dose and can last for about a week – days 1 to 3 will be the worst. These symptoms can include:

  • Goose flesh/bumps
  • Bouts of chills alternating with bouts of flushing and excessive sweating
  • Irritability
  • Insomnia
  • Loss of appetite
  • Yawning and sneezing
  • Watery eyes and runny nose
  • Vomiting and nausea
  • Diarrohea
  • Increased heart rate and blood pressure
  • Pains in the bones and muscle
  • General weakness
  • Depression3
Fentanyl statistics

National

  • In Australia between 2000-2011, one hundred and thirty-six fentanyl-related deaths were recorded.
  • 54% had a history of injecting drug use and 95% had injected fentanyl at the time of death.
  • Deaths were primarily among Australians aged under 47 years.6
Further information

Safe storage and disposal

Fentanyl patches should be stored at room temperature, away from excess heat and moisture (not in the bathroom). To dispose of used fentanyl patches fold the patch inwards on itself so that the adhesive sides meet, and return to the dispensing pharmacy. Wash your hands well with soap and water after disposing of the fentanyl patches. Do not put leftover or used fentanyl patches in the rubbish.4,5

References
  1. Upfal, J. (2006). The Australian drug guide (7th ed.). Melbourne: Black Inc.
  2. NPS Medicinewise (n.d.). Fentanyl.
  3. Brands B; Sproule B; & Marshman J. (Eds.) (1998) Drugs & Drug Abuse (3rd Ed.) Ontario: Addiction Research Foundation.
  4. Medline Plus. (2014). Fentanyl Transdermal Patch.
  5. NPS Medicinewise. (2015). Accidental fentanyl exposure in children can be fatal.
  6. Roxburgh, A., Burns, L., Drummer, O., Pilgrim, J., Farrell, M. & Degenhardt, L. (2013). Trends in fentanyl prescriptions and fentanyl-related mortality in Australia. Drug and Alcohol Review, 32. 269-275.

Effects

constipation, cramps, diarrhoea, dizziness, euphoria, fatigue, headache, impaired balance, indigestion, low blood pressure, nausea, rash, reduced appetite, relief from pain, skin rashes, slurred speech, treat severe pain, vomiting, weakness, wind.