Fentanyl was brought to the market in the form of transdermal patches for the treatment of chronic pain. In the hospital, it is used for anaesthesia and pain. Fentanyl is 100 times more potent than morphine on a gram-to-milligram basis. Fentanyl quickly enters the bloodstream and reaches the brain and other organs with a short time to spare.
Fentanyl enters the illegal drug supply and becomes a major driver of opiate overdoses and deaths. It is usually supplied as tablets or a powder. Fentanyl is not required for a high compared with other drugs, so it may be combined with or sold as other drugs. It's not easy to detect even potentially fatal doses.
Fentanyl works by binding to the opioids in the body It reduces the amount of oxygen in the air. Slow breathing and the build up of carbon dioxide are caused by overdoses. A coma, brain damage, or death can be caused by insufficient oxygen to the brain.
There have been reports of law enforcement officers falling ill or dying from simply touching the drug. Toxicologists have questioned the stories and pointed out that skin contact isn't enough to cause an overdose. There is a story about a cop who touched Fentanyl that is nonsense. Fentanyl patches show that it can be absorbed by the skin, but they work slowly and are formulated to push the drug across the skin barrier. Skin is usually an effective barrier against a variety of toxins. Fentanyl patches must adhere to the skin and not be removed for some time in order for the drug to accumulate in the upper layers of the tissue and be available to the blood stream. It takes 20 minutes for fentanyl to penetrate the skin and be detected in the blood. It will take 1-2 days for the patch to be absorbed.
Ryan Feldman is a clever pharmacist who found a way to turn an accident into a paper. The person was fine.
The paper describes how he came to become a case study. He accidentally spilled a container of Fentanyl solution on his hand, wrist and forearm. The skin on his exposed hand was not in optimal condition after he had a cut and some scratches. He washed the area after this exposure. The medical exam was normal despite the exposure and skin contact. He resumed work after not showing any signs of exposure to the drug.
Exposure and absorption of a drug like Fentanyl will be determined by the area of the body exposed and the dose that one is exposed to. The case study should be reassuring to those who are concerned about accidental exposure.
Many first responders believe that even brief skin contact with the drug can lead to overdoses and death. This group is concerned about occupational exposure to drugs. It has been suggested by toxicologists that reported reactions may be psychogenic. The case study shows that there is no need to worry about ungloved contact with Fentanyl. No meaningful absorption is anticipated if there is skin exposure to the drug. The area should be washed with soap and water.
Scott is looking at the profession of pharmacy through the lens of science-based medicine. He wants to improve the cost-effective use of drugs. Scott has a Bachelor of Science in Pharmacy degree and a Master of Business Administration degree from the University of Toronto. He has worked in both community and hospital settings. He is a registered pharmacy in Canada. Scott doesn't have conflicts of interests. Scott does not represent the opinions of any current or former employers or organizations that he may be associated with. Information should not be used as a substitute for consultation with a licensed and accredited health professional.
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