Fentanyl: Misuse and Toxicity

Course overview

Fentanyl was developed for use as a surgical anesthesia. Its accepted medical use was later expanded to include treatment for chronic pain and cancer pain; however, fentanyl and fentanyl analogues have a high potential for misuse. Fentanyl and fentanyl analogues have also emerged in illegal forms and consumption of these drugs is a primary contributor to the current U.S., opioid crisis. Illegally manufactured fentanyl is widely available on the streets. Fentanyl is a relatively common adulterant in heroin, and unfortunately, some of the beneficial pharmacologic properties of fentanyl, such as rapid onset of action and its high strength relative to other opioids also make it very dangerous when it is used inappropriately. Because of fentanyl's misuse and emergence as an illegal drug, health clinicians need to understand fentanyl's mechanisms of action, toxicology, and the options available to treat fentanyl overdose.