Current Events > Fentanyl overdoses now the leading cause of death for Americans aged 18-45

(+) Yeah! (+)

TheGoldenEel posted...

Reminder that meth is medicinally legal but marijuana isnt

We get it dude. You love weed.

TheGoldenEel posted...

Reminder that meth is medicinally legal but marijuana isnt

Marijuana is medicinally legal though? Where do you live?

Alteres posted...

Far worse, some powder on your finger could kill you getting something out of your teeth.

But that's the thing, unconstituted fentanyl (powder form) is never going to be in the hands of a layperson legitimately. Even cancer patients being prescribed it will get a formulation like a skin patch or something that's very specific dosing. And most hospital uses already have it diluted for IV use at appropriate dosages.

Only black market drugs and dipshit drug dealers are where this comes into play. So like someone earlier mentioned, there is cross contamination and the highly concentrated powder form gets mixed in with other things either intentionally for better profit margins (since fentanyl is cheap) or unintentionally (they are unaware how concentrated even residual amounts of it can be with cross contamination).

So for a question like this:

ColdOne666 posted...

How much would you actually need to overdose and die. Is this drug super duper powerful, it it worse then Meth?

It's hard to answer. First off, meth is a stimulant, not an opioid. The danger with fentanyl is when an unknown amount is in your illegal drugs and you're opioid-naive meaning you'll likely stop breathing even with smaller doses. But someone who is on chronic pain medications can be on absolutely insane doses and still be breathing. For people on bad pain regimens and chronic pain, I've had to give insane amounts of opioid in surgery to get someone's pain under control, but that's because they take a boatload to begin with at home regularly. An older opioid naive patient might go apneic from 50-100 mcg of fentanyl, whereas these chronic pain patients on irresponsible amounts of narcotics at home can tolerate 250 mcg or above and still be breathing and screaming in pain.

The other danger comes when drug addicts wean off for a while, lose the tolerance, and jump straight back to their old habits (and doses) and die that way.

But like...in the right hands like a medical professional, fentanyl is like not dangerous at all and has a lot of good properties as part of a balanced anesthetic or for procedural sedation.

Sheiky-Baby posted...

Marijuana is medicinally legal though? Where do you live?

In America, marijuana is federally illegal

states are breaking federal law by legalizing it. Its generally not enforced federally but it is a gray area (and it shouldnt be)

Perascamin posted...

Where are people getting fentanyl

my wife got it administered when she gave birth. she got all shakey for a bit, but then was like "oh, i feel goooooood. is this why people do drugs?????" lmao.

BlameAnesthesia posted...

The problem with fentanyl is because manufacturers overseas are less regulated, so cartels in Mexico and elsewhere are able to get it wholesale and they cut their street drugs with it.

In a clinical setting, I administer fentanyl on a daily basis for a lot of anesthesia cases. It's a great drug when used appropriately.

Making blanket statements of the evils of fentanyl are just misguided. No one doubts the street problem, but it's a tool and in inpatient medicine, it's a very good one at that.

So your to blame?

modena posted...

So your to blame?

Jokes aside, the brief use of opioids for surgery don't increase risk of getting hooked on opioids. It's more so the post-op pain plan where a surgeon or a primary care might continue something like oxycodone for far longer than should be expected for typical post-op pain. Since the nature of opioids is that tolerance builds rapidly, it's not uncommon for a one week prescription turn into another week refill, then another week, and the dose keeps going up. Soon, they start getting withdrawal symptoms if they try to wean and without proper care it kind of just gets out of hand.

Anesthesia doesn't prescribe post-op meds, that's all the surgeon.

And it's not to say these drugs shouldn't be used at all. Studies also show people who get inappropriate pain control post-op also are at risk of seeking elsewhere for relief. They serve an important, but temporary purpose and it's just as problematic to under treat pain. That being said, healthcare is also fucked in regards to the fact that patients can sometimes be aggressively demanding because their expectations are of zero pain 24/7, which is not at all reasonable. It's gonna hurt, and setting expectations does wonders. But demanding patients and hospital administrators who are more concerned with patient satisfaction scores above all else put docs in unfortunate positions because a person left to their own devices often would make bad health choices for themselves.

BlameAnesthesia posted...

Jokes aside, the brief use of opioids for surgery don't increase risk of getting hooked on opioids. It's more so the post-op pain plan where a surgeon or a primary care might continue something like oxycodone for far longer than should be expected for typical post-op pain. Since the nature of opioids is that tolerance builds rapidly, it's not uncommon for a one week prescription turn into another week refill, then another week, and the dose keeps going up. Soon, they start getting withdrawal symptoms if they try to wean and without proper care it kind of just gets out of hand.

Anesthesia doesn't prescribe post-op meds, that's all the surgeon.

Jokes aside, I agree 100%. My last surgery for a broken bone I opted out of my Hydrocodone 10s because I knew I would just abuse them.

I actually did a research paper on the opioid epidemic for my Psychology of Addiction course. It's super depressing stuff.
Basically, Purdue Pharma was the trailblazer, marketing its miracle drug Oxycontin, which time-released a massive opioid dose, directly to doctors, often with (paid) doctors and fluffed-up journal articles and medical studies, making the following basic arguments:
1) There was a massive, untreated epidemic of chronic pain
2) The addictiveness of opioids and opiates had been greatly exaggerated
3) Their patented time-release mechanism made their drug perfectly safe
When other pharmaceutical companies saw Purdue's success, they eagerly piggy-backed on it, and the use of opioid and opiate painkillers exploded. Of course, Purdue hadn't bothered to study any of their claims, and it turned out the last two were completely false, of course.

Oh, and OxyContin helpfully came with a warning not to grind or crush the pills to disable the time-release mechanism. The dosage was meant to be taken twice a day (which was a huge customer-facing marketing pitch: that you wouldn't wake up in pain in the middle of the night) but it was so high some patients went to their doctors literally suffering from opioid withdrawal while between dosages.

modena posted...

My last surgery for a broken bone I opted out of my Hydrocodone 10s because I knew I would just abuse them.

Smart. If you can get good enough relief with tylenol and ibuprofen, it's the way to go.

Sheiky-Baby posted...

Imagine if this was the thing in the 80's. Especially in Pro Wrestling. Holy shit.

Pro wrestling would have been WAY less entertaining with the wrestlers all strung out. Cocaine was the right choice there for sure.

Perascamin posted...

Where are people getting fentanyl

China

DontHaveACowMan posted...

Yep all thanks for Big Pharma and their lust for greed. We need to destroy Big Pharma and start over. People deserve better but profit over patients is the way.

Preach-- this, so much this.

Dont do fentanyl kids. Dont do anything higher than weed.

Monolith1676 posted...

Don't be so naive.

I'm asking. Not telling, as indicated by the question mark.

Use a dealer you can trust folks

Meanwhile I can't even get a prescription for some percs or oxy for my tremendous back pain.

Do opiates get you like really high or something