Understanding the Difference Between Prescription Fentanyl and Illicit Fentanyl

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Medical uses
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Anesthesia
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Intravenous fentanyl is often used for anesthesia and as an analgesic. To induce anesthesia, it is given with a sedative-hypnotic, like propofol or thiopental, and a muscle relaxant.

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Regional anesthesia

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Fentanyl is the most commonly used intrathecal opioid because its lipophilic profile allows a quick onset of action (5–10 min) and intermediate duration of action (60–120 min). Spinal administration of hyperbaric bupivacaine with fentanyl may be the optimal combination. 

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Obstetrics

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Fentanyl is sometimes given intrathecally as part of spinal anesthesia or epidurally for epidural anaesthesia and analgesia. 


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Pain management

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A fentanyl nasal spray with a strength of 100 μg per use
The bioavailability of intranasal fentanyl is about 70–90%, but with some imprecision due to clotted nostrils, pharyngeal swallow, and incorrect administration. For both emergency and palliative use, intranasal fentanyl is available in doses of 50, 100, 200, 400(Pecfent) µg. In emergency medicine, safe administration of intranasal fentanyl with a low rate of side effects and a promising pain-reducing effect was demonstrated in a prospective observational study in about 900 out-of-hospital patients.[

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Understanding the Difference Between Prescription Fentanyl and Illicit Fentanyl

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Some increases in fentanyl deaths do not involve prescription fentanyl but are related to illicitly made fentanyl that is being mixed with or sold as heroin.

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Fentanyl is often mixed, cut, or ingested alongside other drugs, including cocaine and heroin. Fentanyl has been reported in pill form, including pills mimicking pharmaceutical drugs such as oxycodone.

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https://www.cdc.gov/stopoverdose/fentanyl/pdf/fentanyl_fact_sheet_508c.pdf



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