Fentanyl

The RCMP Detachment in Fox Creek, Alberta issued a warning to industry and public that they were investigating 3 deaths resulting from suspected Fentanyl overdoses. None of the suspected overdoses occurred at a worksite and or camp, however individuals involved worked in the “oil patch”. Over the past few weeks there has been lots of media attention focused on Fentanyl overdoses causing death in numerous locations in Canada.

In 2013 / 2014 on average in Canada almost two deaths involving Fentanyl occurred every three days. Typically these overdoses do not involve the workplace.

ECS Safety Services has received many calls asking for a variety of information on Fentanyl. This bulletin is designed to answer the most common questions or concerns that have been asked.

 

What is Fentanyl?

Fentanyl is a strong, synthetic (man-made) narcotic that is similar to morphine. A 0.1 mg dose of Fentanyl is approximately equal to 10 mg of morphine administered by intramuscular injection. Fentanyl stimulates receptors on nerves in the brain to increase the threshold to pain (the amount of stimulation it takes to feel pain) and reduce the perception of pain (the perceived importance of the pain). Fentanyl is available in transdermal (for application to the skin), transmucosal (for application to mucus membranes) and parenteral (injectable) forms.

In its prescription form, Fentanyl is known as Actiq, Duragesic, and Sublimaze.

Because it is inexpensive, drug dealers often add it to other powders and pills in order to boost their potency.

 

Street names for the Fentanyl include:

  • Apache
  • China girl, China White
  • Dance fever, friend
  • Goodfella, jackpot
  • Murder 8, TNT
  • Tango and Cash
  • Apples and greenies

 

How is Fentanyl abused?

Fentanyl has become a popular drug of abuse which is illicitly manufactured in clandestine laboratories appearing in the United States and Canada. It can be abused in a number of ways, varying from ingestion, smoking or injecting. Self administered injections are common with opiate addicts, while patches can be cut up and eaten or the gel can be extracted from the patches and smoked or injected. Pills can be taken orally, however the abuser will generally crush the pill for smoking, injecting or snorting. Because Fentanyl is quick-acting and 50 to 100 times more powerful than morphine, it can lead to an almost immediate overdose death.

 

Effects of Fentanyl

The ability of opioids to produce a feeling of well-being or euphoria (“high”) is the reason for their recreational use. When used under the supervision of a physician, opioids can effectively relieve pain and improve function. In addition to their analgesic (i.e., pain relieving) effects, opioids are associated with a wide variety of other effects. Opioids can cause drowsiness, sedation and droopy eyelids, creating a state that resembles sleep, often referred to as being “on the nod.” Other effects include lowered heart rate and respiration, inability to concentrate, reduced physical activity, fixed and constricted pupils, nausea, and flushing of the face and neck. With high doses, the depression of respiration can be sufficiently profound so as to cause a cessation of breathing, cardiac arrest and death. Repeated use of opioids can lead to physical dependence and addiction. These are serious health problems that often require specialized treatment services and supports.

Opioids cause sedation and drowsiness that can have a significant impact on the ability to operate a vehicle safely. Effects include slowed reaction time, sleepiness, poor psychomotor performance and coordination, reduced ability to divide attention, inattentiveness, increased errors and difficulty following instructions. These effects can last for up to four hours following a single administration of the drug.

 

How does Fentanyl work?

Like heroin, morphine, and other opioid drugs, Fentanyl works by binding to the body’s opiate receptors, highly concentrated in areas of the brain that control pain and emotions. When opiate drugs bind to these receptors, they can drive up dopamine levels in the brain’s reward areas, producing a state of euphoria and relaxation.

When prescribed by a physician, Fentanyl is often administered via injection, transdermal patch, or in lozenge form. Fentanyl is normally prescribed for cancer patient pain management with limited other use because of its potency.

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Can you drug test for Fentanyl?

Fentanyl is not tested for in the Opiate category when a laboratory conducts a drug screening test.

In order to test for Fentanyl, a specific request must be made to ECS Safety Services. Currently the laboratory can only provide a qualitative result (Positive or Negative). It is expected that in the near future the laboratory will be able to conduct confirmation testing with the use of GC/MS which would provide quantitative test results.

 

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What is drug abuse or misuse?

Drug abuse or misuse is use that is associated with increased risk for harm, such as:

  • Obtaining the drugs from illegitimate sources
  • Deviating from accepted medical practice or scientific knowledge
  • Taking the drugs for purposes that are not therapeutic.

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What is drug addiction?

Drug addiction is a chronic relapsing disorder with genetic and environmental factors influencing its development and manifestations. It is characterized by one or more of the following behaviors:

  • Impaired control over drug use
  • Compulsive drug-seeking behavior
  • Continued use despite harm
  • Craving

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What can I do as an employer?

There is nothing wrong with being concerned, asking questions and determining if you have to make any changes to your current substance abuse prevention strategy. Managers / supervisor/safety or security personnel trained in signs & symptoms of drug abuse with appropriate intervention strategies would go a long way in mitigating the dangers of Fentanyl abuse in the workplace. Make informed decisions. Discuss your concerns with ECS Safety Services.

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