I’m on a close cousin of Fentanyl - well into the HDO (High Dose Opioid) range - for chronic pain (CNCP specifically). I just passed the 10yr mark for living with chronic pain, and being on high dose Opiates and… it’s hell. It’s a fsking living hell. I know it’s different because I have a heck of a lot of pain underneath the drugs, and that without them the pain is so intense that it would blot out the sun leaving a lead sandwich as the only way out - but how people do this for “fun” is well beyond my realm of understanding. Well, all I can say for sure is I’m not enjoying myself.
That said, the one constant I’ve found is that people don’t become junkies because life is going well.
I hear bored housewives are the new blooming demographic for opiate abuse - I guess that the American Dream of failed nuclear families must be more painful than we give it credit for…
I don’t make the rules, nor you, but we as a society do. Enjoy your invisible hand jobs, I recent officially became too old to have long talks with libertarians about why giving sociopaths free reign in society is a poor idea.
I live in chronic pain and discomfort. I guess I am lucky it isn’t crippling pain, just life sapping. I am on tramadol right now, but I just got a new Dr and hopefully next month after my tests come back we can talk about trying something new and/or a muscle relaxer at night.
It isn’t about giving sociopaths fee reign. IMHO, it is a balancing act. Sociopaths and other “bad” people will do things no matter what laws are made. Does making something illegal actually end up making the problem worse? I think one can cite abortion and recreational drugs as two examples where making it illegal didn’t stop anything and made a lot of things worse in many ways.
Indeed, the needs of society need to be balanced against the desires of the individual.
Sometimes yes, sometimes no. The naive approach to drug prohibition’s been a disaster. Banning DDT hasn’t caused secret DDT abusers to make things worse for bald eagles and condors. We can sort things out as they come along and work for laws that are more in line with reality, but instant-fentanyl devices are something that I think we as a society could manage to prevent without greater harm than good. Probably. Whether and how we as a society sort it out if such a thing appears will involve much more than hot air on internet forums, though.
In the abstract fantasy of infinite chemical delivery machines in the universe of perfectly spherical rational actors, I’ll give it a maybe…
In the muddled present reality of specific cases and people who are a jury-rigged mess of nerves, chemical receptors, and unhappy thoughts, I really don’t think we need more fentanyl in circulation. It’s just as addictive as heroin and much much more dangerous to its users. With the active doses measured in micrograms, it only takes a tiny measurement error to kill you, or someone else you sold it to, or passed it on to. For another thing, there’s already a fuck of a lot of it out there, given that it’s in widespread medical use.
One of my old friends ODed on fentanyl, or at least his friends are fairly sure he had. He worked in a hospital, he had access, and his roommate found him with a webpage about fentanyl open on his computer in front of his dead self. Edit: and a syringe. Requiescat in pace, that’s all she wrote.
Russian spetsnaz security forces used a fentanyl-based gas to incapacitate people rapidly in the Moscow theater hostage crisis. The siege was ended, but about 130 of the 850 hostages died due to the use of the gas. The deaths were mostly due to lack of proper medical intervention and the unconscious hostages being left to choke (as opposed to being placed in a recovery position).
Incidentally, a commonly prescribed form is a lollipop.
It’s a great analgesic and very useful during anaesthesia. It’s nice and potent so reduces the amount of induction agent needed to get someone anaesthetised, but for Day Stay procedures can stick around for long enough as an analgesic to tide you over until post-op oral drugs start working; while still wearing off fast enough to reduce post-op nausea and vomiting later in the day compared to the longer acting drugs. It’s rare a day goes by that I don’t administer it at least once.
It’s also (unfortunately) one of the drugs that is relatively easy to abuse in a hospital environment. It’s simple to leave a little in the bottom of an ampoule and snort it. Trans nasal bioavailability is high …
One of the Shulgin books mentioned a bucket method for fentanyl production however only as an aside, not his area of interest. There are also the various analogues and isomers - methylfentanyl “china white” has previously had illicit synthesis. Remifentanyl and alfentanil are commercial variations, not simply isomers.
Trans nasal bioavailability is high …