The Dangers and Detection of Fentanyl: An Overview of Potency, Risks, and Testing

This article gives an overview of the dangers and ways to find fentanyl, including how strong it is, what risks it poses, and how it is used in medicine. It talks about how worrying it is that fentanyl is being made illegally and mixed with other drugs, and how testing is needed to find it.

The Dangers and Detection of Fentanyl: An Overview of Potency, Risks, and Testing
Proposal to include fentanyl detection in toxicology tests. Photo by Dan Meyers on Unsplash

According to Carlos A. Galicia, advisor in mental health and substance use disorder of the Advisory Council of Nuevo Leon, the presence of fentanyl cannot be detected in drug or anti-doping tests in Mexico. The only system currently available is test strips used in the United States to identify contamination of products with the substance. Galicia spoke about "Fentanyl, from the molecular to the social" at the International Seminar on Neurosciences and Addictions, organized by the Cannabinoids Laboratory of the Faculty of Medicine of the National University.

Galicia recommends that fentanyl should be included in all drug toxicology tests as the current reagents used in anti-doping do not include it. He acknowledges that including fentanyl would increase the cost of the tests as the reagents needed are quite expensive.

Fentanyl analogues are not easy to identify as they require specialized toxicological tests. For example, carfentanil is 10,000 times stronger than morphine and is typically used in African elephants. The Center for Disease Control and Prevention in the United States has recorded an increase in deaths due to fentanyl overdose year after year. In 2021, there were 91,238 deaths due to overdose of this opiate.

Galicia highlights that in the US, underreporting of fentanyl-related deaths in Mexico is likely to have occurred. Officially, only five cases have been reported, but more than 91,000 people have been lost to this cause. He is also a consultant of the United Nations Office on Drugs and Crime (UNODC), which reports that in 2017, 53 million people in the world died from the use of opioids for non-medical purposes, representing 1.1 percent of the world's population aged 15 to 65 years.

Understanding Fentanyl: Potency, Risks, and Medical Uses

Fentanyl is a synthetic opioid used to alleviate severe pain. Its potency is immense, with a lethal dose equivalent to a fraction of a grain of rice. It is typically prescribed as a pill, aerosol pill, skin patch, or injection, and is 50 to 100 times more potent than morphine. Unlike other opioids, it is entirely human-made.

Illegally manufactured fentanyl is a growing concern as it is often mixed with other illicit drugs such as cocaine, methamphetamine, and heroin. Non-pharmaceutical fentanyl can cause euphoria, pain relief, and quick dependence. However, it also suppresses breathing, leading to brain damage, coma, or even death.

The drug is particularly prevalent among female users in northern Mexico, particularly in Ciudad Juárez, Chihuahua; San Luis Río Colorado, Sonora; and Tijuana, Baja California. It has been in use for over 50 years but gained FDA approval for severe pain relief in the early 1990s.

Despite its medical uses, non-medical fentanyl abuse has become increasingly common in the United States. Symptoms of fentanyl overdose include pinpoint pupils, choking or gurgling, cold and clammy skin, and loss of consciousness.

To treat patients who have overdosed on fentanyl, physicians may use precipitated withdrawal to control symptoms. Other side effects of fentanyl use include depression, irritability, dry mouth, short and long-term memory disorders, and renal and urinary infections.