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Reasons to avoid fentanyl.

Mellar P Davis¹, Bertrand Behm²

¹Geisinger Medical Center, Danville, PA, USA. mdavis2@geisinger.edu.

Annals of Palliative Medicine

|March 12, 2020

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Fentanyl, an analgesic approved in 1968, has evolving clinical utility. Tamperable preparations and non-pharmacologic fentanyl are now major causes of opioid deaths in the U.S.

Area of Science:

Pharmacology
Toxicology
Public Health

Background:

Fentanyl, an FDA-approved analgesic since 1968, has seen numerous preparations developed.
Recent understanding of fentanyl's clinical utility, balancing risks and benefits, is limited.
Commercially available fentanyl preparations are susceptible to tampering, contributing to its abuse.

Purpose of the Study:

To provide a state-of-the-art review of fentanyl.
To discuss the pharmacology, clinical utility, safety, and abuse of fentanyl.
To highlight the public health impact of fentanyl abuse.

Main Methods:

Literature review of fentanyl pharmacology.
Analysis of clinical utility data, including risks and benefits.
Examination of safety profiles and abuse potential of fentanyl preparations.

Keywords:

Fentanyl respiratory depression substance abuse utility wooden chest syndrome

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Main Results:

Non-pharmacologic fentanyl has emerged as a primary driver of opioid-related fatalities in the United States.
Tampering with commercially available fentanyl products poses significant safety risks.
Understanding of fentanyl's risk-benefit profile is still developing.

Conclusions:

Fentanyl's long history contrasts with recent insights into its clinical utility and risks.
The abuse of tamperable fentanyl preparations is a critical public health crisis.
Comprehensive review of fentanyl's multifaceted aspects is essential for informed clinical practice and policy.