|Common names||Fentanyl, fentanil, Sublimaze, Actiq, Durogesic, Duragesic, Fentora, Matrifen, Haldid, Onsolis, Instanyl, Abstral, Lazanda|
fentanyl (also known as fentanil and by the brand names sublimaze, actiq, durogesic, duragesic, fentora, matrifen, haldid, onsolis, instanyl, abstral, lazanda among others) is a potent synthetic opioid of the piperidine chemical class that is known to produce analgesia with a rapid onset and short duration of action relative to other opioids (e.g. morphine or heroin) when administered.
fentanyl is a strong agonist at the μ-opioid receptors and approximately 40 to 50 times more potent than pharmaceutical grade (i.e. 100% pure) heroin and roughly 80 to 100 times more potent than morphine.
the subjective effects of fentanyl are similar to those of heroin, with the exception that many users report a noticeably less euphoric “high” that is associated with substances in the opioid class along with stronger respiratory depression, sedation and pain relief.
a wide range of pharmaceutical fentanyl preparations are available, including transdermal skin patches, lollipops, buccal tablets or patches, nasal sprays, and inhalers. on the street, it is typically encountered in powder form, where it is often cut into or sold as heroin and other drugs, which has resulted in numerous accidental overdoses and fatalities.
fentanyl was first synthesized by paul janssen in 1960 following the medical inception of pethidine several years earlier. janssen developed fentanyl by assaying analogues of the structurally related substance pethidine for opioid activity. the widespread use of fentanyl triggered the production of fentanyl citrate which entered the clinical practice as a general anesthetic under the trade name sublimaze in the 1960s. following this, many other fentanyl analogues were developed and introduced into medical practice, including sufentanil, alfentanil, remifentanil, and carfentanil.
in the mid-1990s, fentanyl was first introduced for widespread palliative use with the clinical introduction of the duragesic patch. it was followed in the next decade by the introduction of the first quick-acting prescription formulations of fentanyl for personal use, the actiq lollipop and fentora buccal through the delivery method of estradiol mylan transdermal patches. as of 2012, fentanyl was the most widely used synthetic opioid in clinical practice with several new delivery methods now available, including a sublingual spray for cancer patients. in 2013, 1700 kilograms were used globally.
fentanyl is a member of the phenylpiperidine class of synthetic opioids. its structure features a piperidine ring bound at its nitrogen constituent rn to a phenyl ring through an ethyl chain. the opposite carbon of the piperidine ring is bonded to the nitrogen member of a propanamide group, a three carbon chain with a nitrogen constituent adjacent to a carbon bonded to a ketone oxygen. this propanamide group is also substituted with an additional phenyl ring at rn.
the recreational effects of this compound occur because opioids structurally mimic endogenous endorphins which are naturally found within the body and also work upon the μ-opioid receptor set. the way in which opioids structurally mimic these natural endorphins results in their euphoria, pain relief and anxiolytic effects. this is because endorphins are responsible for reducing pain, causing sleepiness, and feelings of pleasure. they can be released in response to pain, strenuous exercise, orgasm, or general excitement.
fentanyl’s strong potency compared to that of morphine is mainly due to its high lipophilicity (the ability of a chemical compound to dissolve in fats, oils, and lipids). because of this, it can more easily penetrate the central nervous system in comparison to other opioids.