It has come to my attention that many patients in this clinic are using Fentanyl.  I am not entirely sure why this is a recent trend. Perhaps it is availability, or perhaps it is because it is harder to detect than other opiates.  There are a few things you need to know about Fentanyl in order to make an informed decision about whether or not to use it.

Fentanyl is a ‘transdermal’ opiate, meaning that it is taken by placing a patch on the skin, and the opiate is absorbed through the skin.  It was designed to provide a constant flow of opiate to cancer patients who are in significant pain.  Fentanyl is very potent, that is why the doses are in micrograms, not milligrams.  Some estimate that Fentanyl is 1000 times more potent than morphine.  The gel on the patch controls the release of small amounts of the drug.  The release is very well controlled if used as it was intended – as a patch.  If the patch is tampered with, by smoking, preparation for injecting, or even sucking on it, then the amount of drug that will be released is VERY variable.  That means that one time you may get a little, and another you may get a lot.  That is why the risk of overdosing by abusing Fentanyl is very high.  In fact, I have read or heard about someone dying (none of my patients, thankfully) from overdose of Fentanyl EVERY WEEK for the past few months.  Please keep this in mind, and don’t abuse Fentanyl.

I should make another note about Fentanyl and intravenous use specifically.  Once the gel is cooked, it is a liquid, and this can be injected.  This preparation can return to a gel once it is in your body, and that could result in clogging small arteries.  If those arteries supply blood to your heart, you get a heart attack.  If those arteries supply blood to your brain, you get a stroke.  Think about it.

Over the past few weeks, we have instituted a new policy of randomly testing every patient at the clinic for Fentanyl.  Unfortunately, many people have come up positive.  Soon, we will have new Urine Drug Testing panels that include Fentanyl in every test.

If you currently have carries, please note that those who are found positive for Fentanyl will lose carries, and they will then have to regain the lost carries by being clean of street drugs for 4 weeks, not the usual 1 week.  The reason for this is that the assumption will be that you earned those carries while using Fentanyl, and that you weren’t really clean of opiates while gaining carries.  Again, please think about this.  It makes sense.


So, if you don’t use Fentanyl, then there is no problem.  If you do use it, stop now.  Hopefully it will clear your system before your random, and later your regular, Urine Drug Test for Fentanyl comes up.

Remember, this is all for your benefit.  I am concerned about your health and recovery from opiate addiction.

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