Fentanyl is a synthetic opioid drug that is prescribed as an analgesic (pain reliever) for severe acute or chronic pain.
Opioids depress the central nervous system by binding to opioid receptors in the brain [1]. This means messages between the brain and the body are slowed down. Dopamine is released, which triggers pleasurable feelings and pain relief. Opioids can be derived naturally from the opium poppy plant (such as morphine), or synthetically (such as fentanyl, which is 80 to 100 times stronger than morphine [2, 3]).
In Australia, fentanyl is a Schedule 8 drug [4]. These are substances labelled as a ‘Controlled drug,’ which means they are strictly regulated due to their addictive potential, and can only be legally supplied on a doctor’s prescription.
However, illicit fentanyl also exists on the illegal drug market, and can be known by other names such as: goodfella, jackpot, murder 8, TNT, china white, and Tango and Cash [2, 3].
What are the effects of fentanyl?
Although fentanyl can be an effective medication if used as prescribed, there are risks involved, especially considering the drug’s potency. It’s important to be aware of the risks involved when using any drug.
Effects of fentanyl vary according to the individual, but include [2]:
- Nausea, vomiting
- Constipation and/or diarrhea
- Reduced appetite
- Wind, indigestion, cramps
- Relief from pain (analgesia)
- Drowsiness, confusion
- Weakness or fatigue
- Dizziness
- Headache
- Euphoria
- Incoherent or slurred speech
- Impaired balance
- Slow pulse and lowered blood pressure
- Rash
Long-term effects of fentanyl may involve [2]:
- Mood instability
- Reduced libido
- Constipation
- Menstrual problems
- Respiratory impairment.
- Tolerance and dependence
Due to the high strength of fentanyl, there is a serious risk of overdose if it’s not used according to a prescription.
Signs of overdose [2, 3]:
- Chest pain
- Slowed breathing
- Bluish lips and complexion
- Seizure
- Passing out
- Coma
- Extreme drowsiness or unable to be woken up
- Unresponsive to verbal approach
- Small (‘pinned’) pupils.
If you or someone else is exhibiting these symptoms, call an ambulance on triple zero (000). If caught in time, naloxone can be administered to reverse the effects of opioid overdose.
Fentanyl overseas and in Australia:
The opioid epidemic in North America and Canada has raised serious international concern due to the magnitude of the issue and high incidence of overdose deaths [5]. Fentanyl has been of particular consideration because of its strength and lethality, and emerged as its own epidemic in North America around 2013. This followed the heroin epidemic, as fentanyl was able to be used as a more potent opioid in place of, or mixed in with, the heroin supply.
In Australia, there is little evidence of an equivalent issue [5]. Although harms from medical and non-medical use of opioids have increased, it has not done so at the same rate as in the US and Canada.
This prompted researchers from Flinders University in 2011 to remind us how, ‘Australia is well placed to intervene at this relatively early stage of the trajectory of problems before they reach the level being experienced in these countries’ [6].
Although it has been 13 years since then and the rate of fatalities related to opioid overdoses has risen in that time, it is still a relevant and crucial reminder for today, and highlights the need for harm-minimisation prevention approaches to be implemented in Australia to reduce drug-associated harms. This is what OurFutures aims to achieve.
If you’re concerned about yourself or a loved one, help is available.
Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential support about alcohol and other drugs.
References:
[1] Alcohol and Drug Foundation. (2019). Opioids – Alcohol and Drug Foundation. Adf.org.au. https://adf.org.au/drug-facts/opioids/ [2] Alcohol and Drug Foundation. (2021, November 10). ADF – Drug Facts – fentanyl. ADF – Alcohol & Drug Foundation. https://adf.org.au/drug-facts/fentanyl/ [3] National Drug and Alcohol Research Centre (NDARC). (2021). Fentanyl [Fact sheet]. UNSW Medicine and Health. https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/NDARC%20Fact%20Sheet_Fentanyl.pdf [4] NSW Health. (2021, November 16). Pharmaceutical Services – Frequently asked questions. www.health.nsw.gov.au. https://www.health.nsw.gov.au/pharmaceutical/pharmacists/Pages/faq-pharmacists.aspx [5] Brown, R., & Morgan, A. (2019). The opioid epidemic in North America: Implications for Australia. Trends & Issues in Crime and Criminal Justice, 578. Australian Institute of Criminology. https://www.aic.gov.au/sites/default/files/202005/ti578_the_opioid_epidemic_in_north_america-v2.pdf [6] Nicholas, R., Lee, N., & Roche, A. (2011). Pharmaceutical drug misuse problems in Australia : complex issues, balanced responses. National Centre For Education And Training On Addiction (NCETA), Flinders University.
Author: Francesca Wallis
