Fentanyl: Physiological effects

Last modified: Sunday, 31. May 2009 - 3:33 pm

The major Physiological effects of fentanyl are euphoria, drowsiness, respiratory depression, decreased gastrointestinal mobility, nausea, and muscular rigidity. People build up a tolerance to fentanyl the more they use it, causing them to need more to obtain the same effects they once received from a smaller dose. The “high” of fentanyl can last 10-72 hours, depending on the ingestion method, the fentanyl derivative used, and the amount taken.
Harmful side effects
Fentanyl acts on the heart rate, blood pressure, and respiratory system. It can decrease the heart rate by as much as 25% in a controlled setting and even more if too much is ingested too quickly. In a clinical setting, this is less dangerous due to monitors that can alert staff to these changes and machines that control breathing and heart rate. However, in the streets, these side effects can quickly cause death. Experienced drug users who use fentanyl often have a supply of cocaine or methamphetamine with them, thinking that if they experience the respiratory failure sometimes associated with fentanyl, they can then use the stimulant to keep from dying. It is possible for just one patch combined with other depressants to kill a user.
Designer heroin, or street-made fentanyl, adds many side effects due to the impurities added to the drug. Aside from allergic reactions from additives unknown to the user, street chemists are often unaware of the potency of the drug they are creating. Clandestine laboratories may not dilute the drug enough, causing too much of the drug to be ingested. This can cause immediate death. Reports have also shown that irreparable harm can be done to the receptors of a user’s brain from a single use of “designer heroin.”
The effects that the drug has on the gastrointestinal tract are quite severe. Fentanyl use, whether clinical or recreational, will cause constipation in the user. It is recommended that patients always take laxatives or stool softeners when using fentanyl. At least one bowel movement every two to three days is recommended. Longer periods of time between movements can result in damage to the colon, intestines, and stomach. If it has been longer than three days since the last bowel movement, patients are instructed to contact their physician, who may suggest an enema or suppository to encourage bowel release.
In regular users of fentanyl, dry mouth is common. It is suggested that patients chew sugarless gum, suck on hard candy, and most importantly, drink plenty of water. Dehydration can occur if fentanyl users fail to consume more water than they normally do. A regular user of fentanyl must make sure to tell their doctor if they are having surgery. The added fentanyl in their system from the anesthesia can cause death.
Some other rare side effects from fentanyl include breathing difficulties, wheezing, cold and clammy skin, seizures, slow or fast heartbeat, severe rash, and unusual weakness. A physician should be notified immediately if any of these symptoms occur. It is more common for patients to experience confusion, fainting spells, and nervousness or restlessness; any of these also need medical attention. Some side effects that do not require immediate medical attention but can be reported if bothersome include itching, blurred vision, clumsiness, difficulty urinating, headache, and nausea.
According to the American Association of Pediatrics, clinical use of fentanyl is considered safe for pregnant and nursing mothers. Other organizations have deemed the results of studies to be inconclusive. Some of the drug will pass into the baby from a nursing mother, so constipation, dry mouth, and drowsiness can be expected. Babies born to mothers who abused fentanyl during pregnancy can be expected to have an addiction to fentanyl at birth.
Long-term health effects
As with any narcotic, fentanyl is addictive. Because it interacts with the mu receptor, which has an effect on addiction, it is highly addictive. Fentanyl users also build a tolerance to the drug’s effects, thus needing more of the drug to reach the same euphoric experiences. Building up a tolerance to the drug can be harmful to the user. As the user continues to consume more and more of the drug to achieve the same effects, an overdose becomes likely.
Even though fentanyl is habit-forming, addiction can only be experienced by those using the drug for recreational or pleasure purposes. According to the SAMSHA, users who are being treated for extreme pain cannot be addicted to their medication because they have a physical, not psychological, need for the medication. They may become tolerant to the drug, though, and should not stop treatment without a doctor’s supervision.
The more of the drug that is used, the more dangerous the effects of the constipation can be. Long-term constipation left untreated can be very dangerous to the user, so doctors may suggest a change of diet. Patients are encouraged to include more fiber and bran in their diets to help offset the consequences of the constipation.
This is especially important in elderly patients, who often have problems with constipation that are unrelated to fentanyl use.

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