Fentanyl is a highly potent synthetic piperidine opioid primarily used as an analgesic. It is 20 to 40 times more potent than heroin and 100 times more potent than morphine;[9] its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries.[10][11] Fentanyl is also used as a sedative.[12] Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose.[13] Fentanyl works by activating μ-opioid receptors.[7] Fentanyl is sold under the brand names Actiq, Duragesic and Sublimaze, among others.[14]
Pharmaceutical fentanyl's adverse effects are identical to those of other opioids and narcotics,[15] including addiction, confusion, respiratory depression (which, if extensive and untreated, may lead to respiratory arrest), drowsiness, nausea, visual disturbances, dyskinesia, hallucinations, delirium, a subset of the latter known as "narcotic delirium", narcotic ileus, muscle rigidity, constipation, loss of consciousness, hypotension, coma, and death.[12] Alcohol and other drugs (e.g., cocaine and heroin) can synergistically exacerbate fentanyl's side effects. Naloxone (also known as Narcan) can reverse the effects of an opioid overdose, but because fentanyl is so potent, multiple doses might be necessary.[14]
