All of that is interesting about
the street use of Fentanyl. I personally had little knowledge of it's use as a street drug, but I have given gallons of it ( well, a whole lot any way) over the years as an anesthesia provider before recent retirement. I trained with it when it was the new super drug for anesthesia in the 70s.
I can see how it's street use could lead to frequent death. This drug provides rapid and spectacular pain reduction with very little effect on level of consciousness and little feeling of being high. (I am speaking of IV push, or possibly epidural or spinal injections, I know nothing of other forms of administration, like oral or skin patch.) But the thing is, you have to really monitor folks who you are giving it to, as they might not appear to go to sleep, or stop responding to you, but simply stop breathing. It is a powerful respiratory depressant. Many a time over the years I have had to repeatedly tell an awake patient to breath, and they always respond by breathing, until I had to tell them again after 30 seconds. None of this is an issue in surgery, where we are either already resuscitating folks, or ready to do so in the blink of an eye. But street or recreational use? Man, the danger!
OTOH, I lost one good friend to illegal fentanyl use, and another lost his career after going back to using after rehab. The friend I lost was the nicest, most clean cut young man, family man with small children. Left working with us here at the big anesthesia group in the big hospital to work by himself at a small hospital about
30 miles up the road. No one knew he was addicted and stealing the OR Fentanyl. One day they could not find him when he was on call, would not answer his beeper. They found his body in a closet, needle still in his arm.
Of course, that is NOT prescript
ion drug use. And the last hing I want to see is people with chronic pain unable to get the drugs they need to alleviate their suffering. Still, this needs paying attention to, it is not just street drugs. To repeat the quote from CDC: "We now know that overdoses from prescript
ion opioids are a driving factor in the 15-year increase in opioid overdose deaths. The amount of prescript
ion opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010,3,4 yet there had not been an overall change in the amount of pain that Americans reported.5,6 Deaths from prescript
ion opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999".
I'm suspecting the problem does not stem from long term chronic pain users, but more from the folks who go to their doctor and get that first prescript
ion for surgery or dental procedures, or maybe injuries, and people just don't realize how easy it is for some people to get addicted. I'm no expert in what the cause might be, but the fact that death from prescript
ion opioids have quadrupled since 1999, with over 1/2 million dead(what a staggering #!) surely requires some looking into.
Post Edited (BillyBob@388) : 9/4/2017 9:03:33 PM (GMT-6)