While the media focuses attention on the prevalence of oxycodone addictions, another equally pernicious addiction related to pharmaceuticals has been catching on, mostly unnoticed and unknown. People have been smoking Fentanyl pain patches, many times with deadly consequences.
Fentanyl is the most potent opioid painkilling drug presently available. It produces effects similar to those of heroin, but it’s 30 to 50 times stronger and up to 100 times more potent than pure morphine.1 Why would someone need such a strong drug? It’s mostly used after surgery to reduce severe pain, but also is prescribed to cancer patients and to those who’ve developed tolerance to less powerful opioids. In other words, post-surgical patients who’ve gotten hooked on oxycodone may no longer get the same degree of relief from their prescription-level pills, and so they get a Fentanyl patch as a supplement. It happens all the time. In fact, a friend of ours was given oxycodone after back surgery and three years later was still taking oxycodone, plus, his VA doctor added a fentanyl patch and some other goodies to his arsenal of drugs.
The problem with all those fentanyl prescriptions out there is that they open the door to an enormous abuse problem. The prescription patches and pills end up in the hands of the wrong people, same as with oxycodone pills and the like, but again, fentanyl is a lot more potent and therefore a lot more dangerous. To complicate the issue, dealers have figured out how to manufacture fentanyl themselves, and now there’s fentanyl on the streets that isn’t pharmaceutical at all, but rather, is manufactured by illegal labs. Unfortunately, recreational abuse of both prescription fentanyl and the illegally manufactured stuff is fast becoming a desperate problem. Drug overdoses in 2016 numbered 64,000, most of them from fentanyl.2 This number represents a 540-percent increase over just a three-year period. Astoundingly, drugs kill more people under the age of 50 than any other cause.
The illegally manufactured “street” fentanyl comes in a wider array of forms than the prescription drug— gel tabs, nasal sprays, various types of pills and powders for snorting or mixed in with heroin. It’s street fentanyl that killed the musician Prince, drawing attention to the phenomenon. But deadly as street fentanyl may be, the prescription patches may be equally as dangerous.
The thing about the patches is that they’re designed to be time-release, which means that patches typically have a three-day supply of the narcotic in them. To exceed that dosage can lead to depressed respiration, dizziness, coma, confusion, seizures, and death—and given the extraordinary potency, it can do so quickly, without even allowing the user enough time to experience the hoped-for high.3 According to Rusty Paine of the Drug Enforcement Agency, “It is so potent and so deadly that even a microgram amount can kill someone.” The patches are designed to deliver anywhere from 25 to 100 micrograms per hour to users, but only to those who already have developed a tolerance to lesser-strength opiates. In other words, they deliver a potentially lethal dose to those who haven’t built up such tolerance.
Nevertheless, plenty of people are abusing the patches by either stripping off the narcotic gel or just lighting up the patch and smoking it. In fact, there’s a shocking amount of discourse on the internet about how to smoke fentanyl, offering advice and hot tips to hopeful users. Here are instructions from a Reddit contributor: 4
“When you have the fentanyl patch cut in into strips the size of your finger nail …. After u do that now it's time to get your smoke on with ur Bic hollowed pen and the lighter flame under the foil it will start smoking and ENJOY THE HIGH.”
I “elipsised” out some of the key details so this article can’t serve as an instruction sheet for smoking fentanyl. And it’s worth keeping in mind that “tutorial” may well land readers in the hospital, because the concentration of fentanyl varies by location on the patch. The peak concentration is designed to be released between 24 and 72 hours after treatment begins, and so smoking the part of the patch with the strongest concentration of fentanyl easily can lead to an overdose.5 Of course, smoking any part of the patch can lead to overdose given that the patch was not designed for use in a single session, nor for people who have not already developed a tolerance.
Those who don’t like to smoke have found other potentially deadly methods of abusing the patches, including boiling them and then cutting them open to extract the liquid inside for injection, drinking the water they were boiled in, or just chewing the patches, making for a potentially fatal snack. Again, the amount extracted far exceeds the amount many people are able to tolerate without losing the ability to breathe.
People have been looking for ways to get high and to zone out from the pressures of life since ancient times, and so the quest to find a little something to take the sting out of existence is likely to continue ad infinitum. For many, an occasional glass of wine will do, but for so many people these days the pressures are too many and the needs too great, and as long as numbing drugs are available, there will likely be a hungry audience for them. But let’s get real here. The primary reasons for the current opioid epidemic are not “getting high” but grossly unethical misrepresentations from pharmaceutical companies and unconscionable over-prescription from the medical community. This is what created the nationwide addiction crisis that is now overwhelming the country. The good news is that drug companies say they’re hot on the trail of developing opioids that will numb pain and create that feel-good effect without suppressing breathing or leading to other fatal side-effects, though it may take a few years for these drugs to make it to market.6 But before you get too excited, it should be noted, that any “new” opioid medication is likely to be just as addictive as all the versions that have come before.
- 1. Zalkind, Susan. “What is Fentanyl? The little-known but deadly drug that killed Prince.” 3 June 2016. The Guardian. 11 January 2018. https://www.theguardian.com/us-news/2016/jun/03/what-is-fentanyl-prince-deadly-overdose
- 2. Katz, Josh. “The First Count of Fentanyl Deaths in 2016: Up 540% in Three Years.” 2 September 2017. New York Times. 15 January 2018. https://www.nytimes.com/interactive/2017/09/02/upshot/fentanyl-drug-overdose-deaths.html
- 3. “The Dangers of Abusing Fentanyl Patches.” American Addiction Centers. 15 January 2018. https://americanaddictioncenters.org/fentanyl-treatment/dangers-of-abuse/
- 4. https://www.reddit.com/r/opiates/comments/1swzjs/the_tutorial_smoking_fentanyl/
- 5. https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=49245
- 6. “Safer opioid drugs could relieve pain and save lives.” 5 December 2017. Science Daily. 15 January 2018. https://www.sciencedaily.com/releases/2017/12/171205091537.htm