Transcript shorter version - Addictions Foundation Manitoba

Fentanyl Abuse:
A fatal attraction
Sheri L. Fandrey, BSP, PhD
Knowledge Exchange Lead
Manitoba Addictions Knowledge Exchange
What is fentanyl?
• Fentanyl is an opioid pain killer in the same
class as codeine, morphine & oxycodone
• It can be used safely when prescribed by a
health professional and taken as directed.
• Fentanyl is also produced and sold illegally.
Illegal forms of street fentanyl
• Street fentanyl can be taken orally,
smoked, snorted, or injected
• Street fentanyl has been sold as:
– Pills
– Blotters
– Patches – cut up and sold as
“chicklets”
– Powder
– Other forms may resemble
‘popcorn’ or ‘nerds’ candy
• All have the potential to be
lethal!
Mixing with other street drugs
• Fentanyl is often added to other drugs without the
user’s knowledge.
– Traces have been found in other drugs including
cocaine, Xanax, MDMA, methamphetamine & possibly
marijuana.
• Fentanyl is sometimes sold as heroin, often leading
to overdoses.
• Organized crime groups press the powder form into
fake OxyContin tablets (“greenies”).
Real Xanax
Fake Xanax
Fake Ecstasy
One million doses of
fentanyl would fit in
a shoebox.
How dangerous is the fentanyl family?
• The risk of overdose and death are the greatest
concerns about fentanyl/related drugs.
• Fentanyl is a very potent drug – a very tiny amount
about equal to 2 grains of salt can be lethal.
• The effects of fentanyl occur very quickly after use
– Intoxication and overdose can occur before the user is
aware something is wrong.
– Respiratory depression following fentanyl outlasts its
analgesic effects 2x (60 vs. 20-30 min).
• The difference between an effective dose and a
lethal dose is very small – fentanyl is not a very
forgiving drug in overdose situations.
What does an overdose look like?
• There are different severities of opioid overdose
– Ranges from drowsiness/slurred speech to coma & possible death
• Early signs of an overdose include:
– Severe sleepiness – can’t stay awake
– Slow heartbeat
– Trouble breathing /Slow, shallow breathing (<12 breaths/minute)
or snoring/gurgling
– Cold, clammy skin – may look pale or blue
– Trouble walking (i.e., stumbling)
– Slurring words
– Pinpoint pupils
– Possible seizures
• If any of these signs are present, call 911 immediately.
• Naloxone may be administered while waiting for an
ambulance (once kits are widely available)
References
Arbuck, DM (2012) “New Views on Opioid Equivalency,” Pain Topics News/Research
Updates, available at:
http://webcache.googleusercontent.com/search?q=cache:1wN8fuMXuCUJ:updates.paintopics.org/2012/02/new-views-on-opioid-equivalency.html+&cd=9&hl=en&ct=clnk&gl=ca
Fischer B, Russell C, Murphy Y & Kurdyak P (2015) “Prescription opioids, abuse and public
health in Canada: is fentanyl the new centre of the opioid crisis?” Pharmacoepidemiology
& Drug Safety, 24: 1334-1336.
Mounteney J, Giraudon I, Denissov G, Griffiths P (2015) “Fentanyls: Are we missing the
signs? Highly potent and on the rise in Europe,” International Journalof Drug Policy, 26:
626–631.
National Drug Early Warning System (NDEWS) (2015) “Fentanyl & Fentanyl Analogs,”
NDEWS Special Report.
Pander V (2014) “Understanding Fentanyl Abuse: A Health Professional's Guide,” Pharmacy
Elective Project with AFM.
Tamburro LP, Al-Hadidi JH, Dragovic LJ (2016) “Resurgence of Fentanyl as a Drug of Abuse,”
Journal of Forensic Science and Medicine, 2(2): 111-114.
Image credits
All images in this presentation have been used under license
with Getty Images except as indicated in the notes section.