What is fentanyl?

Fentanyl, N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylpropanamide, is a synthetic opioid type analgesic invented in 1959 but introduced only in the 1990s for palliative pain relief in terminally ill patients. It is 80 to 100 times more active than morphine and about 40 to 50 times stronger than heroin (diamorphine). It also goes by the anem of fentanil, Sublimaze, Actiq, Durogesic, Duragesic, Fentora, Matrifen, Haldid, Onsolis, Instanyl, Abstral, and Lazanda1. It works quickly and its effects last only a short time as it trips the mu-opioid receptors in the brain.

chemical-structure-of-fentanyl

It is widely used in medicine (often in skin patches) but, is also a drug of abuse and has been since the 1970s. Unfortunately, its strength means overdosing is a serious risk leading to respiratory collapse rather than liver failure. There have been several prominent cases in the last few months and pundits are talking of a fentanyl epidemic. Perhaps the most prominent recent case is the accidental death of popstar Prince (Prince Rogers Nelson) in April 2016. The Midwest Medical Examiner’s Office announced on 2nd June its findings regarding his death and concluded an accidental death from fentanyl toxicity. You can read the Office’s PDF press release here. Deaths from fentanyl overdose in the drug community are, in some US states, such as New Hampshire, far outstripping heroin overdoses, according to the New York Times. It is, worryingly, used increasingly by drug dealers to cut heroin.

Fentanyl was used by the Russian security forces in a spray to incapacitate people in the Moscow theatre hostage crisis in October 2002. Some 130 of the 850 hostages died through respiratory problems and choking having not received adequate medical attention once the seige was ended, essentially they were not put into the recovery position. BBC report.

As with most drugs of abuse, they are rapidly and widely adopted by popular culture. Fentanyl has many street names including Apache, China Girl, China White, Dance Fever, Goodfella, Jackpot, Murder 8, and TNT.