Fentanyl: Usage trends

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

Scope and severity
Fentanyl abuse among non-medical personnel has come in waves as new derivatives are discovered. However, the problem is growing in the United States. The Substance Abuse and Mental Health Services Administration (SAMHSA) states that 576 people were treated in emergency rooms for fentanyl abuse in 2000. This is higher than the 337 recorded instances in 1999. Figures from 2001 are incomplete, but at least 512 people were treated in emergency rooms in the first six months of the year. Since fentanyl is difficult to detect, these figures are believed to be lower than actual cases.
It is known that the abuse of prescription fentanyl is on the rise, but the degree of increase is difficult to distinguish. Doctors are increasingly wary of turning down requests for pain medication for fear of lawsuits if the patient truly is in a lot of pain. Determining how much pain a patient feels is nearly impossible for the doctor, so they must rely on what the patient tells them. This has led to an increase of people illicitly getting pain relievers for personal use or distribution. Some patients lie to their doctors about their conditions in order to get painkillers; others have gone to several doctors to get several prescriptions.
There are also a growing number of doctors wanting to supplement their income and do so by writing prescriptions for people who do not need them. Doctors who do this are referred to as “script writers.” These script writers can generally double their salary by selling the prescriptions for large sums of money. Middle-class drug users are increasingly viewing this route of acquisition as preferable because there are fewer stigmas attached to buying from a doctor and there is less risk of a drug deal turning violent. As demand for the pharmaceutical versions of designer drugs increases, the business of dispensing bogus prescriptions becomes even more profitable.
Age, ethnic, and gender trends
According to the American Society of Anesthesiologists, it is rare for an anesthesiology department not to have someone, at some point, need treatment for a chemical dependency. Anesthesiology has the highest incidence of chemical dependency among medical specialists. It is hypothesized that this is because they daily administer these drugs to others and are lulled into believing that they are less dangerous than they are. These professionals also have a high amount of accessibility to addictive drugs and seem to have a greater curiosity of the effects of drugs than other doctors. Due to its ready accessibility and difficulty of detection, fentanyl has long been the drug of choice to abuse by anesthesiologists.
Other than anesthesiologists, many professionals within the medical community abuse fentanyl. However, the majority of these are considered to be less skilled healthcare workers, rather than the pharmacists or doctors who abuse other drugs. Namely, abusers who steal fentanyl from hospitals are usually nursing aides and uncertified healthcare providers.
On the street, users tend to fall into one of three categories. The first group are those that view fentanyl as safer than heroin. Users in this category tend to be white, upper-middle class, male, educated at or above the college level, and ignorant to drug use. This group generally involves novice drug users who often are the ones who die from overdoses. There is not the same stigma attached to designer drugs as there seems to be with heroin, so people in this group view them as social drugs. Fentanyl is also attractive to this group because it is soluble through the skin. When ingested by directly absorbing the drug through the skin, users do not require a needle which can leave “track marks.”
The second group of people consists of addicts of other opiates who use fentanyl predominately only when their personal drug of choice is unavailable. Those in this group will generally choose other opiates because they tend to “shoot” the drug and many have complained of a burning sensation after injecting fentanyl. In a survey among opiate users in a Contra Costa County, California, treatment clinic, users in this category do not like to use fentanyl as much as heroin. These users felt that heroin gave them a more euphoric feeling.
The third group of people includes those at raves who experiment with a wide variety of designer drugs. The fentanyl used by this group is manufactured in clandestine laboratories. Users in this group are generally white, middle class, and in their teens or twenties. For the most part, users in this group are female. However, males in this group frequently take whatever drug the females are using.

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