Effects of Fentanyl on the Brain and Breathing

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• A new study has found that fentanyl can stop someone’s breathing minutes before they lose consciousness.
• The findings could help doctors administer drugs in a safer way.
• But it also explains why it is a dangerous drug when abused.
• Experts say fentanyl is highly addictive and should only be used when absolutely necessary.
• Patients should always discuss the drug with their doctor to determine the risks and benefits.

Conducted by scientists at Massachusetts General Hospital, PNAS Nexus The drug fentanyl has been shown to stop breathing in surgical patients even before there are observable changes, including loss of consciousness.

Elizabeth J. Sherman, PharmD, DABAT, BCPS, FAACT, clinical and executive director of the West Virginia Addiction Center and professor of clinical pharmacy at the West Virginia University School of Pharmacy, explained they were not involved in the study. A prescription drug commonly used during or after surgery and in intensive care units (ICUs) on mechanical ventilation.

It is also used on an outpatient basis for people in hospice care or in severe cancer pain.

According to researchers, fentanyl produces a unique pattern of electrical activity in the brain in electroencephalograms (EEG), allowing us to see the effects of fentanyl.

They specifically found that the drug could interfere with people’s breathing about four minutes before noticeable changes in alertness occurred.

This occurred at a drug concentration 1,700 times lower than that required to sedate the patient.

senior author Patrick L. PurdonPhD, said Harvard Gazette These findings may enable safer and more precise dosing of fentanyl in hospitals, for example, for sedated COVID-19 patients or for those undergoing anesthesia during surgery.

There is currently no way to know if these drugs are working when the patient is unconscious. EEG may be used to monitor the effects of fentanyl.

These findings also have important implications regarding the increased health risks associated with recreational drug use.Pardon said Harvard Gazette They explain one reason why fentanyl is a dangerous drug. It’s about being able to stop people from breathing before they even realize what’s going on.

according to U.S. Drug Enforcement Administration According to the (DEA), fentanyl is manufactured in secret laboratories outside the United States, then smuggled and sold illegally there.

They describe it as being sold as a powder and a spray. Counterfeit pills are also often made to look like genuine prescription drugs.

Without government oversight to ensure potency and purity, these counterfeit tablets could contain drugs other than those claimed, or lethal doses of fentanyl.

According to the DEA, the tablets they tested contained 0.2 to 5.1 mg of drug. 2 mg is a potentially lethal dose.

Also, because fentanyl is a powerful opioid that drug dealers can obtain at a low cost, drug dealers often mix it with other drugs such as heroin, methamphetamine, and cocaine to increase potency. This means that people may not even be aware they are being exposed to fentanyl.

according to U.S. Centers for Disease Control and Prevention (CDC), opioid overdose is a serious problem in the United States. In 2020, there were 56,000 of her deaths involving synthetic opioids other than methadone. In fact, mortality increased by more than 56% from 2019 to 2020, and he accounts for more than 82% of all opioid-related deaths. Overdose mortality in this category was 18 times higher than in 2013.

They say this increase is most likely caused by illegal activity rather than prescription fentanyl. 3-19% 80% of people who take prescription pain relievers become addicted and may switch to more readily available options such as illicit drugs. For example, about 45% of people who use heroin originally developed an addiction to prescription opioids.

of National Institute on Drug Abuse Fentanyl is 50 to 100 times more potent than morphine and is therefore addictive.

They note that even people who take their medication exactly as prescribed by their doctor can become dependent on it, and stopping taking it can lead to withdrawal symptoms. can make a person addicted. People can also build a tolerance to it, requiring more and more drugs to achieve the same effect.

Scharman advised that patients should always ask what type of medication they are taking for pain and whether the medication is an opioid.

“If a drug is prescribed for use only for a few days, such as after surgery, it’s not an addiction concern,” she said. If so, don’t worry about addiction.”

But opioids shouldn’t be the first drug people try to manage chronic pain, a non-life-threatening condition, she warns.

“Because of the risk of addiction, a side effect that must be considered, the use of opioids for chronic pain should be restricted to selected patients after all other options have been exhausted. .”

Sudia Pottle, DO, FASAM, a triple-board certified anesthesiologist, interventional pain doctor, and addiction medicine expert at Atlanta VA Medical Center, agrees that there is a problem in vulnerable patients, especially those with a history of addiction or those with family members. added that could occur. 1 history.

“Patients always have the choice to take or not take what they are prescribed,” said Potru. of doing so.

“It’s also important to talk openly with the clinician who cares for you so they can understand what you’re comfortable with from a medication standpoint,” he said. added.

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