The CDC recently released a report on Fentanyl related deaths, and there is your Opiate Crisis. Of the 33,000 opiate related deaths in 2016, 18,335 were caused by fentanyl. That means only 15,000 or so were related to heroin, oxycodone, morphine, hydrocodone, dilaudid, nubain, demerol, or smoking pure opium.
As a matter of fact, every year Fentanyl deaths have doubled since 2011. Which is obviously a driving factor in opiate related deaths. Now, as a matter of course, Fentanyl is a very strong pain medication considered an “end of life” drug. End of life opiates are drugs given to people with terminal cancer to help deal with their pain.
I’ve had it once and I now mark it as an allergy. It had some gnarly side effects and I was told by a doctor to mark it as an allergy, because the side effects I experienced (hallucinations, a feeling of being disconnected from reality, feeling awake but like I was dreaming), are indicative that I was in the thoroughs of an overdose, despite having a patch on that was a slow release. Any fentanyl is too much for me to handle apparently. Which is fine, if I never have it again, great.
However, it has become a favorite go-to drug of hospitals. When I woke up from gallbladder surgery, I was in desperate pain. My hip was killing me, my abdomen and chest had holes in it, and I have CRPS which heightens the level of pain I’m feeling anyway. The nurse ran over with a syringe and even though I had just barely opened my eyes enough to groan, she was ready to inject me with Fentanyl. Thankfully, I had the presence of mind to ask what it was. She told me and I held up my allergy band. “I’m allergic, I can’t have Fentanyl.” A few minutes later another nurse came over with a syringe of dilaudid. I’m not a fan of dilaudid, but it is less likely to kill me and it did stop my groaning. Now, I know I was a special case. When J awoke from gallbladder surgery, they gave him a hydrocodone tablet.
I remember the anesthesiologist saying they’d be pushing fentanyl during his surgery. And after some discussion with the doctor and anesthesiologist during my prep the morning of my surgery, the word fentanyl was mentioned and I quickly reminded them, I was allergic. Instead, I got demerol during my surgery. When I had nerve ablation in September 2018, before we realized my problem was CRPS, I was told they would give me fentanyl for that too. Then it had to be altered to demerol, because again, I can’t take fentanyl.
Aside from being very potent as a painkiller, fentanyl is highly addictive, more so than it’s sister drug nubain (which is the other end of life painkiller). I’ve heard stories of people who received fentanyl once and became addicted. Yet, there are large swatches of the population that cannot handle fentanyl. People like me where one dose is enough to cause an overdose. So, I’m not terribly surprised Fentanyl plays a huge role in opiate deaths. It is highly addictive, builds tolerance fast, and can have some really extreme side effects.
Before my gallbladder surgery, I did ask the anesthesiologist about the use of Fentanyl. I mean, I’d already learned some things about it. Why use it? Because it can be used in conjunction with other opiates and it has sedation properties. Less “true” anesthesia (like propofol) can be used when Fentanyl is present during a surgery, and when a patient wakes up, you don’t have to worry as much about what they can have for their post surgical pain. Demerol is known to have severe interactions with a number of medications.
And so, the war on chronic pain patients continues because of fentanyl, a drug most of us do not use or need. Now, I am biased and freely admit, I feel the Opiate Crisis is a bit like punishing your two youngest children because the oldest made a bad decision. We, as a society, need to understand that making things harder to get legally (such as pain medication) does not stop people from illicit use. The Opiate Crisis hasn’t hindered illicit drug use, it has only hurt those that actually use their medications as prescribed for real conditions. And now we get to add another layer of ridiculousness to it, by learning that over half of opiate deaths in the US are related to the use of Fentanyl.