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Article Summary

What Are The Different Forms Of Fentanyl?

Fentanyl is one of the most commonly abused substances in the United States. As a potent drug, it is in the same class as methadone, oxycodone, codeine, and morphine. This means that it is an opioid.

Doctors often prescribe it in the form of a slow-release patch. This is because it is effective in the relief of severe pain that has been ongoing for a long time. If you use this medication exactly as your doctor advised, it can be safe and effective.

However, you also need to realize that fentanyl is stronger than other opioids - about 100 times as strong as morphine. As such, it can be quite dangerous if you start misusing or abusing it. In fact, even a small dose of this drug could cause you to suffer an overdose that could potentially turn out to be fatal.

Understanding Fentanyl

As we mentioned above, fentanyl is classified as an opioid drug. This means that it will interact with the opioid receptors in your brain, where it will elicit various responses in your body. These responses include but are not limited to feelings of contentment, pleasure, euphoria, relaxation, and intense pain relief.

Doctors often prescribe it for the treatment of severe and chronic pain - such as due to surgery, major trauma, nerve damage, cancer, or back injury. This is because the drug is quite effective.

It is available in different forms. The pharmaceutical version of fentanyl is prescribed for the management of acute and chronic pain. However, there are also illicit batches of fentanyl that are illegally manufactured and sold on the drug market.

On the streets, people refer to fentanyl to avoid detection by law enforcement officials and other authorities. Examples of these street names for the drug include but are not limited to:

  • Apache
  • Cash
  • China girl
  • China town
  • China white
  • Jackpot
  • Murder 8
  • Poison
  • Tango
  • TNT

Medical Fentanyl

As we mentioned above, fentanyl is used for various medical uses. This medicinal version of the drug is available in different forms, which have varying degrees of strength based on the volume of the drug. They include:

  • Intravenous injection (Sublimaze)
  • Lollipops and lozenges (Actiq)
  • Transdermal patches (generic versions and Duragesic)

These versions of fentanyl are available for use in the treatment of breath through pain. This refers to sudden painful episodes that occur in spite of the use of other pain medications around the clock.

It is quite commonly used for cancer patients who are 18 years or older. However, you might be able to receive a prescription for Actiq lozenges if you are above the age of 16 and you have been taking another narcotic or opioid pain relief medication on a regular basis for some time. In such a situation, you would get these lozenges after your regular medication stops working due to the development of tolerance.

In many cases, your doctor is going to recommended that you start on a low dose of this drug before increasing your dose gradually until you find the right dose to relieve the breakthrough pain that you have been struggling with.

However, if you are still feeling pain half a hour after taking films of fentanyl, you might be switched to another form of the drug. Alternatively, your doctor could increase your dose of the films to deal with any new episodes of pain that arise.

You need to talk to the doctor and discuss the working mechanism of the drug. It is also advised that you inform your doctor in case you experience any adverse side effects. This way, they will be able to adjust your dose as needed.

In the same way, you should never take this drug more than 4 times on any given day. It is also recommended that you inform your doctor in case you experience 4 episodes of pain or more in one day. If this happens, they will adjust your dose so that the pain can be better controlled.

If you have a prescription for buccal tablets, you need to swallow them whole. Despite the temptation, you should never crush, chew, or split them. You should also ensure that you do not bite or chew the lozenges of fentanyl - but only suck on them as your doctor indicated.

You should not stop taking fentanyl unless your doctor has asked you to. There are certain instances where they might decrease the dose - but on a gradual basis. Suddenly stopping your use of this medication could lead to the development of withdrawal symptoms, some of which might be unpleasant or downright fatal.

Using Fentanyl

As mentioned earlier, there are different forms of fentanyl. As such, you should follow some express instructions while using these drugs. Consider the following advice about using this drug:

a) Actiq (Fentanyl Lozenges)

  • Check the handle and blister package to ensure that the lozenge has the right dose of fentanyl that your doctor prescribed
  • Open the package using a pair of scissors, but only when you are ready to take the medication
  • After placing the lozenge between your gum and cheek, suck on it actively
  • Do not bite, crush, or chew the lozenge
  • Move the fentanyl lozenge around your mouth using the handle
  • Twirl the lozenge handle often
  • Do not drink or eat anything until you have finished the lozenge, which should take around 15 minutes

You should, however, stop taking the lozenge in case it makes you feel nauseated, sleepy, or dizzy. Get rid of it or place it in a storage bottle that you can dispose of at a later time.

After finishing your lozenge, toss the handle in the trash can - but away from the reach of other people, especially small children. If you were not able to finish the lozenge, place it under running water until all the medication has dissolved before throwing it away.

b) Fentora (Fentanyl Buccal Tablets)

  • Take one blister unit from the card but be careful to ensure that you tear all along the marked perforations
  • Peel the foil back to open up the blister unit
  • Ensure that you do not push the buccal tablets through the foil or open a blister unit unless you wish to take a tablet
  • Place the tablet inside the mouth right above one upper back tooth and between your gum and cheek
  • Let the tablet dissolve completely
  • When the buccal tablet is dissolving, it might cause a bubbling feeling that could last anywhere between 14 and 25 minutes
  • Do not suck, bite, chew, or split the tablet
  • In case there are traces of the tablet left inside your mouth 30 minutes after you put it, swallow them with plenty of water
  • If you feel nauseated, sleepy, or dizzy before the tablet is fully dissolved, use water to rinse your mouth before spitting all remaining traces of it into the toilet or a sink

c) Abstral (Fentanyl Sublingual Tablets)

  • If your mouth feels dry, take a good sip of water until it is fully moist
  • Swallow or spit out the water and ensure that your hands are completely dry before you handle the tablet
  • Tear along the perforations to separate one blister from the card
  • Peel back the blister card without pushing the tablet all the way through the foil
  • Only open a blister unit when you are going to take a tablet
  • Place the sublingual tablet in your mouth right under the tongue - and as far back as possible
  • If you need to take more than one tablet, you should spread them all around the base or floor of the mouth but under your tongue
  • Allow the tablet to dissolve completely
  • Do not swallow, chew, or suck on the tablet
  • Do not drink or eat anything until after the tablet has dissolved completely and there are no traces of it in the mouth
  • d) Onsolis (Fentanyl Films)
  • Cut along the arrow markings on your foil package using a pair of scissors
  • Separate the layers before removing one film
  • Only open the foil package when you are planning to use a film
  • Ensure that you do not tear or cut the film
  • Wet the inside of one cheek using your tongue, or rinse your mouth using water so that the area where the film is going to go is wet
  • Holding the film on a dry and clean finger, ensure that the pink side is facing up
  • Place the film inside the mouth with the pink side right against the moistened cheek
  • Press the film firmly against the cheek for about 5 seconds
  • Remove your finger from your mouth once the film is stuck to the cheek
  • If you need to take more than one film, do not place the films right on top of each other; rather, place them on opposite sides in your mouth
  • Allow the film to dissolve completely
  • As it dissolves, you will get a minty flavor in your mouth - and this will take anywhere between quarter of a hour to half a hour
  • Do not swallow or chew the film, or move or touch it until it has dissolved completely
  • You might be able to drink some liquids 5 minutes after the film is in place; however, you should not eat anything until after the film has dissolved

Illicit Fentanyl Use

Like any other prescription controlled substances, there are some people who abuse fentanyl. If you are among these people, you might find yourself extracting the drug from its patch or injecting it. All these forms of substance abuse are dangerous especially because of the strength of the medication and the difficulty that comes with judging each individual dose.

Alternatively, you might divert this drug when you take it without a valid prescription, if you use your prescribed drugs recreationally or without following your doctor's instructions, or using medication that was not prescribed for you.

Dangers of Fentanyl

If you abuse fentanyl, it could lead to a wide variety of effects - and most of them are not half as pleasurable as you might have assumed. Once you get high on this drug, you may display the symptoms of drowsiness, physical relaxation, and instant euphoria. These effects could last for around 12 hours.

In case you are not tolerant to opioids, taking fentanyl could turn out to be fatal. This is because the drug could lead to the development of respiratory depression - where you will not be able to breathe normally.

Additionally, abusing this drug could cause extensive dental issues, such as tooth decay, tooth loss, cavities, and oral infections.

Fentanyl Withdrawal

The addictive nature and potency of fentanyl means that you might suffer withdrawal symptoms when you stop taking it. This is true even if you were using the drug exactly as your doctor recommended.

If you significantly reduce your normal dose of the drug or suddenly stop using it, you may experience adverse effects. For instance, there is a high risk that you could suffer an overdose if you start using fentanyl again after your tolerance has reduced.

Some of the symptoms of withdrawal linked with the various forms of this drug include but are not limited to:

  • Abdominal pain
  • Anxiety
  • Chills
  • Depression
  • Diarrhea
  • Elevated heart rate
  • Fatigue
  • Insomnia
  • Joint pain
  • Nausea
  • Restlessness
  • Runny nose
  • Sweating

Fentanyl Overdose

On the other hand, if you suffer a fentanyl overdose, you could experience some negative effects, some of which might lead to death. For this reason, it is recommended that you call 911 or your local poisons control center as soon as you start displaying the following symptoms of overdose involving this drug:

  • Bluish complexion and lips
  • Chest pain
  • Coma
  • Death
  • Passing out
  • Seizure
  • Slowed breathing

If you are addicted to fentanyl, the only way you can overcome your growing opioid use disorder is by checking into a professional addiction treatment and rehabilitation center so that you can get the help you need to stop abusing this drug - irrespective of the forms of fentanyl that you were taking.

CITATIONS

https://www.ems1.com/fentanyl/articles/233969048-8-deadly-forms-of-fentanyl/

https://www.healthline.com/health/fentanyl/transdermal-patch#warnings

https://medlineplus.gov/druginfo/meds/a605043.html

https://www.drugabuse.gov/publications/drugfacts/fentanyl

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/street-fentanyl

https://www.mayoclinic.org/drugs-supplements/fentanyl-buccal-mucosa-route-oromucosal-route-sublingual-route/description/drg-20063888

https://www.drugs.com/cdi/fentanyl-sublingual-tablet.html

https://www.ems1.com/medical-clinical/articles/233969048-8-deadly-forms-of-fentanyl/

https://medlineplus.gov/druginfo/meds/a601202.html

https://www.drugabuse.gov/publications/drugfacts/fentanyl

https://www.drugabuse.gov/emerging-trends/fake-prescription-drugs-laced-fentanyl

https://www.nps.org.au/search?q=fentanyl&scope=nps&age=any&category=all&sort=most-recent

https://medlineplus.gov/druginfo/meds/a601202.html#side-effects

https://www.nps.org.au/news/accidental-fentanyl-exposure-in-children-can-be-fatal

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