It can often be difficult to understand what the purpose is for each of the different opioid drugs out there. With prescription medications like Oxycontin, Percocet, and Vicodin, it seems as if it’s all just the same drug disguised under a unique name. In reality, there are vast differences in how each of these opioid drugs interact with the brain. Some take effect relatively quickly, while others may be a bit slower to kick in. The intensity of each type will also vary, so which medication your doctor may be prescribing will likely depend on your specific illness and level of pain.

The most powerful—and dangerous—opioid drug prescribed by doctors is fentanyl. With a potency level 100 times greater than morphine, the risks of abuse, overdose and death are amplified greatly. In fact, fentanyl is already a commonly abused street drug, and will sometimes be mixed in with heroin to increase the drug’s intensity. So with the heightened risks and dangers compared to your run-of-the-mill opioid, why is such a powerful drug still available for use?

First, fentanyl does still serve a practical purpose within the operating room. Not only is it an extremely powerful pain suppressor, but it’s quick to kick in and has a relatively short duration of about 30-90 minutes. This makes fentanyl a great option for sedating patients and suppressing pain for certain surgeries.

In addition, fentanyl is used frequently for pain management during labor and delivery. If you’ve ever experienced the miracle of childbirth by any degree, you may be familiar with the epidural. This is a rather large needle that is inserted directly into the base of the spine, which then administers a combination of medications to manage labor pains, which usually include some type of opioid, such as fentanyl.

Outside of the O.R. and labor and delivery, however, fentanyl prescriptions are reserved for those who suffer from specific medical conditions which cause severe, chronic pain. But most of these patients aren’t typically prescribed fentanyl as their first opioid medication. It’s not until they’ve developed a tolerance to opioids of a lower intensity that they need something a bit stronger. This tolerance occurs as a result of long-term opioid use, when the brain adapts to the medication and the patient requires higher doses to experience the same pain relief.

Depending on a patient’s individual circumstances, fentanyl can be administered in several different forms, including lozenges, nasal spray, injections and patches. One key benefit of the transdermal patch versus other methods of administration is that fentanyl can be released through the skin and into the bloodstream gradually over time. This allows fentanyl to be administered safely and consistently to alleviate pain for continuous periods of time, up to 72 hours. Even after the patch is removed, fentanyl can remain effective for an additional 24 hours.

While fentanyl does have its place in the medical world, much of society is still unaware of the risks and dangers associated with fentanyl use. Because of its potency and highly addictive properties, it’s not uncommon for fentanyl abuse to occur in some form. What truly differentiates fentanyl from other opioid-based drugs is the potentially deadly narrow margin of dosing error that may occur. If prescribed or taken incorrectly, the slightest misuse of the drug can result in an overdose. For this reason, fentanyl is a highly controlled Schedule 2 prescription narcotic, and should only be used precisely as prescribed.

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