Fentanyl Abuse: A Literature Review
Abstract
Sachidanand R Peteru, Shivendra Shekhar, Neha Bandekar
Background and Objectives: Fentanyl is an opioid agonist with abuse potential. The overdose can begin suddenly, progress to death rapidly, and may have an atypical presentation with body and chest wall rigidity. This article aims to review the consequences of fentanyl abuse alone or in combination with other substances along with available treatment modalities.
Methods: A literature search using the keywords “opioid addiction” or “fentanyl abuse” and “fentanyl overdose” and “fentanyl treatment” was conducted on PubMed. Additional data was gathered from the Centers for Disease Control and Prevention and other websites. Finally, 32 out of 310 articles were selected for the review. Our case report highlights the consequences of fentanyl abuse in combination with other substances.
Case report: A 32 years old Caucasian female with a history of polysubstance use was admitted for community-acquired pneumonia after overdosing with fentanyl, heroin, and cocaine. Results: Fentanyl is often mixed with other substances and sold as heroin to unsuspecting users. Its abuse may cause life-threatening respiratory failure from an overdose.
Discussion and Conclusions: In 2016, approximately 50% who died from an opioid overdose in the US were taking fentanyl, and 57% of those who tested positive for fentanyl or its analogs were positive for other drugs such as heroin. Naloxone kits distribution has reported significant overdose reversals.
Scientific Significance: Opioid crisis, declared as an emergency by the federal government, is affecting public health. Prescribers have a major role in reducing overdose deaths by prescribing the lowest, effective dose with the shortest treatment duration.