The patches should never be used on someone who’s not already opioid-tolerant from sustained use of an oral opioid medication such as oxycodone, morphine, or similar. Slapping it on someone whose body is not accustomed to potent opioids is a good recipe for respiratory arrest or death. Which is what makes the patches so deadly when abused intermittently.
The IV form of fentanyl is real good for surgical anesthesia. Also real good for a ticket to the morgue when diverted into someone else’s veins.
I don’t prescribe the oral fentanyl popsicles (actiq) and break out into a sweat over the thought of handing those out to anyone.
Fentanyl is very strong medicine, with a very, very high abuse potential. It’s often got a very narrow therapeutic window (the effective dose is just a tiny bit more than an ineffective dose, and a tiny bit less than a fatal one.) So it results in a lot of fatalities when abused. As is the horribly tragically sad case for our OP’s loved one.
These sorts of bad, unintended outcomes are common with opioid abuse.
When opioid addicts fail to get and stay clean, they tend to end up in prisons, institutions, or graveyards.
Qadgop the Mercotan, is this drug a controlled substance?
Also, news this week regarding Off Label Drug Marketing is ‘Free Speech’, will this decision have any impact on the availability of these types of drugs for “recreational” use?:
“A decision by a federal appeals court this week could have a dramatic impact on the marketing of prescription drugs in America, potentially affecting patient care and everything from TV advertising to future government prosecutions which, in the past, had yielded billions of dollars in settlements,…”
Any drug company pushing the recreational use of a scheduled drug will find it difficult to do business in this country, as the DEA would take strong exception.
Qadgop, only narcotic in my medical history is the 2.5 mg valium I take once every other year before I reluctantly submit to an MRI. (claustrophobic) Sounds like my doc is either incompetent or dirty. Maybe both. Noted. Thanks for your input.
There are probably street dealers selling diverted medical fentanyl to addicts out there, but the majority is manufactured illicitly to begin with like amphetamine, and not the result of over-prescribing by doctors or patients selling their medicines on the street.
Big shipments of homemade fentanyl have been confiscated inbound from Mexico, at least one illegal US lab was discovered in California, and there are varieties and derivatives known as China White that are made illegally in China. In these cases there are not only the dangers inherent to the drug itself to worry about, but also those of poor manufacturing, impure ingredients and uncertain doses, making them even more dangerous.
I’m so sorry, Soylent. Praying for the family & for you… I’m Auntie to my friends’ kids, too. & thank you for the information as well. It could save a life.
My husband is on this stuff in the patch form. He’s got back problems and always will. He used to just take norco, but doc was starting to worry about setting him on a path to liver damage, so we got him on this stuff. He tolerates it incredibly well and even though he’s had to have his dosage adjusted up recently, he’s not at all noticeably impaired.
What I can tell you about its availability is this: What a pain in the asshole!
It’s not like the other opiates at all. Every month I have to go to the doctor’s office to pick up an actual prescription that I then have to take to the pharmacy. This isn’t one they can call in. Somebody has to do the transactions in person. Now, I guess I’m lucky in that I am able to do it, but still, there’s one small line of defense against making it street easy. Also, if something goes wrong, you’re screwed. You get just enough patches to get you through exactly 30 days. If you mess one up, lose one, whatever, forget replacing it. That WILL NOT BE DONE under any circumstances. That part really is kinda harrowing. Once you’re on this drug, you WILL have withdrawals if you go without, and those are at the very least, super uncomfortable, and at the worst, fatal.
I’m so sorry for your loss, Soylent. I’m all at once sad for you, and unrepentantly angry at stupid kids for becoming junkies on anything, but doubly so for doing it on something that’s already difficult to get for people who actually need it.
I missed this before - is methadone really more deadly? I did some work that involved converting opiates to their morphine equivalent basis to standardize them (somewhat), and fentanyl was close to or at the top. Of course, morphine equivalency might be <> toxicity.
Methadone’s long half-life and weird pharmacokinetics can make it much easier to overdose on than a lot of other opioids. And for a time it enjoyed a renewed popularity as a cheap, long-acting painkiller back in the days when pain was pushed as the “5th vital sign” which always necessitated treatment until it went away. So more methadone was out there to be diverted.
In brief, methadone is superstrong and very, very long-acting and that combination makes it dangerous. Meanwhile fentanyl is superduperduper strong and incredibly fast-acting, a combination which makes it dangerous in somewhat different ways.
When I was 15 (so, almost 30 years ago), there were some classmates of mine who would steal their mothers’ pills. These girls had the collective intelligence of a frozen snail, so often what they stole was The Pill, or HRT, or ibuprofen… but other times it was Xanax, corticosteroids or heavy-duty painkillers. So long as one of them had access to any of those, all of them did. And, being that smart, they’d just pop anything by the combined handful, without having the slightest idea what the effects could be (some of us would re-steal the pots of pills when we saw they’d managed to hit something “serious”, after realizing that talking them out of it was not going to work; we weren’t interested in having to call more ambulances than the town had).
The “anger” stage of grief hit me last night. I was casually thinking about the interview that Tina did back in June where she answered the question of “where do you get the drugs” with “There are nasty people. These people are older and sell it to teenagers.”
…WTF. “Older people.” I had fantasies of getting her boyfriend to take me to these “older people” and shoving a picture of Tina in their faces and screaming “YOU KILLED THIS GIRL.” Of course because these people are sociopaths they’d be all like “She made the decision to take it - she did it to herself” to which I’d reply “YOU’RE THE FUCKING ADULT. You could have said “You’re a beautiful 19 year old with your whole life ahead of you - I’m not selling you these drugs.”” It’s freakin’ 100x more powerful than fucking heroin and these low-life bottom-feeders sell it to unsuspecting teenagers? THEY should be in the ground, not my beautiful teenaged niece who just graduated from high school.
I honestly don’t know if Tina’s boyfriend who was with her when she died is the same boyfriend who got her hooked - she said in the interview that her “boyfriend” was doing Oxycontin and she was curious so he gave her some and that’s what got her addicted - and I really don’t want to know until after the funeral. I want to look at the guy with sympathy towards a dude who just lost his girlfriend.
I hope I can manage to put aside this anger over the next two days. I don’t need seething rage on top of all the sorrow I’m feeling for the family that means so much to me. I need to be strong and stoic, especially for Tina’s little sister. Wish me luck today & tomorrow.
Of course. I feel for your grief. I’ve lost friends/family to drugs.
Just know that the supplier of the opioids isn’t always a greedy psychopath. All too often it’s a fellow opioid addict/abuser who is strung out and addled on the euphoric high and just wants to share…
They still need to face the consequences of their actions, though.
I’m sorry for your loss Soylent. If you live near Barrie, I am just across the lake from you. My ex-husband died from a Fentanyl overdose in May 2009. It was not prescribed for him, rather he had a life long addiction to pain killers and opioids. He got it from a fellow addict - and I can only imagine how she got it in the first place.
Our teenaged son found him. His death has impacted our two children in ways that can’t be measured. All death by addiction is an absolute tragedy and waste.
As QtM notes:
. . . that is indeed the mindset. Addicts often have a network of other addicts that may have something when they run out. They aren’t operating on the notion of moral responsibility to protect younger people. They work on the premise that I’ll share with you now and you’ll be a resource to me later. They often don’t affix a huge markup to the cost, which is of itself a problem. It makes the acquisition affordable for younger people or those who can’t hold a job.
From movies we’re inclined to imagine dark underworld figures who get people hooked only to increase the cost and promote the slide of a single being into depravity. More often it is a tale of absolute tragedy but couched in camaraderie.
As mentioned upthread, shows like Intervention do a wonderful service in educating people who have no RL context for addiction. I am so glad we’re starting to talk about it as it pertains to our friends, neighbours and families.
Well, one thing is that if other legal alternatives were available, few people would bother sucking the goo out of Fentanyl patches. But that’s probably a discussion for another thread.
Some kids get fentyl. from certain trash sites,when it’s thru(comes usally as Durigesic,a 3 day transdermyl patch.They "find"the old patches and open them to get the gel.It,s a pretty deadly and completly stupid fucking practice.Sadly it’s mostly youngsters,or “paperback junkees” who learn from old timers,then have no idea how to do it and just fucking die with the needle in they’re arm.
