It’s no secret that America is in the midst of an opioid crisis, and there have been highly publicized cases of first responders and law enforcement experiencing startling and troubling symptoms after being exposed to fentanyl in the field. As this chapter of the crisis unfolds, it’s more important than ever that the responder community take great caution when encountering this substance and its derivatives. The key component in keeping them safe will be the use of appropriate and effective personal protective equipment (PPE). Depending on the wearer’s role and the particulars of the situation, different PPE may be called for, but here at Enviro we believe in preparing for every contingency.
Fentanyl is a synthetic opioid that is 80-100 times stronger than morphine. Pharmaceutical fentanyl was developed for pain management treatment of cancer patients, applied in a patch on the skin. Because of its powerful opioid properties, Fentanyl is also diverted for abuse. Fentanyl is added to heroin to increase its potency, or be disguised as highly potent heroin. Many users believe that they are purchasing heroin and actually don’t know that they are purchasing fentanyl – which often results in overdose deaths. Clandestinely-produced fentanyl is primarily manufactured in Mexico.
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What does it look like?
Fentanyl pharmaceutical products are currently available in the following dosage forms: oral transmucosal lozenges commonly referred to as fentanyl “lollipops” (Actiq), effervescent buccal tablets (Fentora), sublingual tablets (Abstral), sublingual sprays (Subsys), nasal sprays (Lazanda), transdermal patches (Duragesic), and injectable formulations. Clandestinely produced fentanyl is encountered either as a powder or in counterfeit tablets and is sold alone or in combination with other drugs such as heroin or cocaine.
How is it abused?
Fentanyl can be injected, snorted/sniffed, smoked, taken orally by pill or tablet, and spiked onto blotter paper. Fentanyl patches are abused by removing its gel contents and then injecting or ingesting these contents. Patches have also been frozen, cut into pieces, and placed under the tongue or in the cheek cavity. Illicitly produced fentanyl is sold alone or in combination with heroin and other substances and has been identified in counterfeit pills, mimicking pharmaceutical drugs such as oxycodone. According to the National Forensic Laboratory Information System, reports on fentanyl (both pharmaceutical and clandestinely produced) increased from nearly 5,400 in 2014 to over 14,600 in 2015, as reported by federal, state, and local forensic laboratories in the United States.
What is the effect on the body?
Fentanyl, similar to other commonly used opioid analgesics(e.g., morphine), produces effects such as relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.
How does it affect the body?
Intense, short-term high
Temporary feelings of euphoria
Slowed respiration and reduced blood pressure
What are the overdose effects?
Overdose may result in stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of triad of symptoms such as coma, pinpoint pupils, and respiratory depression are strongly suggestive of opioid poisoning. Which drugs cause similar effects? Drugs that cause similar effects include other opioids such as morphine, hydrocodone, oxycodone, hydromorphone, methadone, and heroin.
Federal Control Substances Act?
Fentanyl is a Schedule II narcotic under the United States Controlled Substances Act of 1970
“ Fentanyl. ” DEA, www.dea.gov/factsheets/fentanyl.