opioid

Fentanyl, also spelled fentanil, is an opioid used as a pain medication and together with other medications for anesthesia. Fentanyl is also used as a recreational drug, often mixed with heroin or cocaine. It has a rapid onset and effects generally last less than two hours.Medically, fentanyl is used by injection, as a patch on the skin, as a nasal spray, or in the mouth.

Common side effects include vomiting, constipation, sedation, confusion, hallucinations, and injuries related to poor coordination. Serious side effects may include decreased breathing (respiratory depression), serotonin syndrome, low blood pressure, addiction, or coma. Fentanyl works primarily by activating μ-opioid receptors. It is around 100 times stronger than morphine, and some analogues such as carfentanil are around 10,000 times stronger.

Fentanyl was first made by Paul Janssen in 1960 and approved for medical use in the United States in 1968. In 2015, 1,600 kilograms (3,500 lb) were used in healthcare globally.As of 2017, fentanyl was the most widely used synthetic opioid in medicine. Fentanyl patches for cancer pain are on the WHO List of Essential Medicines, which lists the most effective and safe medicines needed in a health system. For a 100 microgram vial, the average wholesale cost in the developing world was US$0.66 in 2015. In 2017, the price in the United States was US$0.49 for that same amount. In 2016, it was the 218th most prescribed medication in the United States, with more than 2 million prescriptions. In 2016, fentanyl and analogues were the most common cause of overdose deaths in the United States at more than 20,000, about half of all opioid-related deaths. Most of these overdose deaths were due to illegally made fentanyl.

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