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Life Sciences => Physiology & Medicine => Topic started by: smart on 08/08/2018 15:21:30

Title: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: smart on 08/08/2018 15:21:30
Hello,

Could someone get dopesick because he or she received 100mcg of intravenous fentanyl in a clinical setting the day after the anesthetic procedure?

Please educate me and comment!!  :)

Thank you.

tk
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: Bored chemist on 08/08/2018 19:09:15
What do you mean by "dopesick "?
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: smart on 08/08/2018 19:14:27
What do you mean by "dopesick "?

It is a slang that people livng in the streets knows very well. For example, when someone is doing crack (heroin) or even cocaine and stop using it for some reasons, he might experience severe discomfort, pain, and other stuff... We call this syndrome "dopesick".

tk
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: Bored chemist on 08/08/2018 19:17:38
crack (heroin)
I was never on the streets, but I know crack isn't heroin.

It is possible for someone to suffer withdrawal symptoms following clinical use of opiates like fentanyl.
However I can't see it happening after a single exposure.
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: smart on 08/08/2018 19:22:42
It is possible for someone to suffer withdrawal symptoms following clinical use of opiates like fentanyl.
However I can't see it happening after a single exposure.

Do you agree that fentanyl is potentially among the most powerful anesthetic drug ever conceived and that it is typically reserved for large animals only?

By the way, crack is heroin laced with cocaine...

tk
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: guest39538 on 08/08/2018 19:28:04
Hello,

Could someone get dopesick because he or she received 100mcg of intravenous fentanyl in a clinical setting the day after the anesthetic procedure?

Please educate me and comment!!  :)

Thank you.

tk
https://www.theguardian.com/society/2018/aug/06/fentanyl-drug-deaths-rise-nearly-third-england-wales

No,  you would not expect anyone to get dopesik if he or she received 100mcg of intravenous fentanyl in a clinical setting the day after the anesthetic procedure.  Micrograms being a low amount but due to its potency, it has a high potential for addiction.   However , see the link provided, which may be a bit misguiding to the subject, I do not think it refers to long term use.

Also : https://www.drugabuse.gov/drugs-abuse/opioids

Quote
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl,


Which in essence is selling illegal drugs legally.


Added - here you go : https://www.bbc.co.uk/bbcthree/article/bf2caf17-55e1-4708-87b6-e9cd3bf4321d   ;)

Support  - http://www.researchpublications.qmul.ac.uk/publications/staff/21158.html


hrs before ≠ up to three days after

The Jammy dodgey was bad before it went down the hole, it is not the holes fault the jammy dodgey is bad to begin with .  Time frame was not met, so of course thats what the results say, because they didnt wait for the jammy dodger to dissipate from the system packet, the proof seems simple enough .


Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: chiralSPO on 08/08/2018 20:05:41
A few points:

• Fentanyl is a very powerful opiate, and comes with all of the same side effects and inherent* risks whether administered by a professional in a hospital setting, or a druggie on the street (*by inherent, I mean risks due to the compound itself, of course there are issues with drug purity, dose control, and having antidotes/extra care on hand if complications arise, all of which make administration in a hospital safer than on the street).
• I think it is unlikely that a single dose would elicit withdrawal symptoms in a drug-naive person. However, an addict or recovering (recovered) addict could certainly experience withdrawal symptoms after a single dose. Some of this could be psychological effects, and some is physiological.
• "Crack" is not heroin with cocaine in it... Crack is the street name for freebase cocaine (powder cocaine is the hydrochloride salt). Neither of these compounds is similar at all to heroin--not in terms of structure, effect, mechanism of action. I'm sure there is a term for a mixture containing heroin and cocaine, but it's not "crack."
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: chiralSPO on 08/08/2018 20:12:57
Do you agree that fentanyl is potentially among the most powerful anesthetic drug ever conceived and that it is typically reserved for large animals only?

Yes fentanyl is among the most potent opiates, but it isn't really reserved for large animals. Fentanyl is often used on humans when extreme pain is involved and immediate action is required (soldiers may carry a kit containing fentanyl into the battlefield because it is one of the few drugs that can dull the pain of losing a limb, and it acts very quickly). Also, I believe that there are cases in which a patient with organ damage (liver and/or kidneys) would not be able to handle (metabolically) a large dose of a not-so-potent drug, but would be able to a small dose of a very potent drug, like fentanyl.

There are even more potent compounds than fentanyl, like carfentanyl, which are reserved for use in large animals.
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: guest39538 on 08/08/2018 20:18:14
A few points:

• Fentanyl is a very powerful opiate, and comes with all of the same side effects and inherent* risks whether administered by a professional in a hospital setting, or a druggie on the street (*by inherent, I mean risks due to the compound itself, of course there are issues with drug purity, dose control, and having antidotes/extra care on hand if complications arise, all of which make administration in a hospital safer than on the street).
• I think it is unlikely that a single dose would elicit withdrawal symptoms in a drug-naive person. However, an addict or recovering (recovered) addict could certainly experience withdrawal symptoms after a single dose. Some of this could be psychological effects, and some is physiological.
• "Crack" is not heroin with cocaine in it... Crack is the street name for freebase cocaine (powder cocaine is the hydrochloride salt). Neither of these compounds is similar at all to heroin--not in terms of structure, effect, mechanism of action. I'm sure there is a term for a mixture containing heroin and cocaine, but it's not "crack."
I am glad I never did  hard drugs in my life, I have known a few people who died from doing hard drugs, there is a women I use to know from school, she lost her legs through smack , which is heroin.  Nasty , nasty stuff...
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: Bored chemist on 08/08/2018 21:10:13
By the way, crack is heroin laced with cocaine...
That's a speedball  (or a "Brompton cocktail" if you get it on prescription).

 Crack is crude freebase cocaine.
It's clear which of us studied pharmacology.
The point is that most slang terms are imprecise.

Do you agree that fentanyl is potentially among the most powerful anesthetic drug ever conceived and that it is typically reserved for large animals only?

Yes, and no.
"Do you agree that fentanyl is potentially among the most powerful anesthetic drug "
Yes (with reservations about calling an opiate "anesthetic")

"and that it is typically reserved for large animals only?"
No.
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: mrsmith2211 on 09/08/2018 00:25:10
I have been out of the field too long, but in the olden days crack was a 100% cocaine based product. During my research times morphine was considered the most effective pain reliever. We did studies eliminating the effects of morphine withdrawal with a combination of drugs that would block the addictive centers of the brain and thus target the pain relief centers. We were able to eliminate 4 of the symptoms of morphine withdrawal in rats by including drugs such as naloxone. The goal of our research was to eliminate the addictive properties of morphine and take advantage of the pain relief properties. Sorry not familiar with fentanyl.
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: chiralSPO on 09/08/2018 02:21:55
As far as I understand it, the mechanism of action for fentanyl is exactly the same as morphine. Same receptors, same agonism, just much higher binding constant.
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: smart on 09/08/2018 09:30:11
• I think it is unlikely that a single dose would elicit withdrawal symptoms in a drug-naive person. However, an addict or recovering (recovered) addict could certainly experience withdrawal symptoms after a single dose. Some of this could be psychological effects, and some is physiological.

I have observed in at least 2 different individuals (females) identical symptoms of someone being "dopesick" only after 1 anesthetic procedure with medicinal grade fentanyl... Both individuals received 100mcg of intravenous fentanyl as part of standard colonoscopy. Symptoms of probable dopesickness were: vomitting, diarrhea, extreme fatigue, physical discomfort and lost of appetite...

Thank you.

tk
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: chiralSPO on 09/08/2018 18:09:38
I have no first-hand experience with "dopesickness," but my theoretical understanding suggests that there might be two cases that should be distinguished, and I will use alcohol as an example because I am familiar with that first hand (and I expect many others are as well):
• There is the equivalent of a hangover, which can certainly occur after a single use, and despite being unpleasant is fairly short in duration.
• And then there are the DTs (which I have not experienced myself, but have observed their effects in others), which is an extreme case of withdrawal by an alcohol-dependent person--this can lead to hallucinations and seizures and is a long, painful and dangerous process.
Title: Re: Could someone get dopesick from fentanyl administration in a clinical setting?
Post by: wolfekeeper on 10/08/2018 20:34:10
I also have no first hand knowledge, but I know it's chemically similar in action to morphine; but the primary difference is that it's highly fat soluble. This enables it to kick in much more quickly, because it can penetrate the blood-brain barrier much more easily- but it also fades much more quickly because it can escape again. However, it also binds to other receptors throughout the body, which presumably has a number of side-effects and may well explain the 'dopesick'ness you describe.