MEDICAL ANIMATION TRANSCRIPT: Opioids are drugs that are prescribed to treat moderately severe or severe pain. Fentanyl is a strong synthetic opioid. It may be prescribed to treat severe pain from cancer or after surgery. Its potency, or strength, is up to fifty times that of heroin, an illegal opioid, and one hundred times that of morphine, another opioid used to treat severe pain. In order to understand how opioids like fentanyl work, it’s important to know how your body feels pain. The process begins when something harmful happens to your body. Information about this harm is converted to a nerve signal. The signal passes along nerves to your spinal cord and brain. In your brain, the signal is perceived as pain. Fentanyl affects how you feel pain. It attaches to structures, called opioid receptors. These receptors are found in cells in your brain, spinal cord, and other areas of your body. Fentanyl acts on these receptors to make you feel less pain. Fentanyl can also have other effects on your body. For example, it may give you an intense, short-term “high” and feelings of extreme happiness. Fentanyl also activates the reward pathway in your brain. This causes certain parts of the reward pathway to release a chemical, called dopamine. Scientists think dopamine helps you remember how good you felt while taking fentanyl, and makes you want to keep taking it. This link between remembering things that make you feel good with the desire to do them again is an important part of developing addiction. Fentanyl may also slow your breathing and make you feel nauseated. And, it may cause reduced motion of your intestines, resulting in constipation. There are two types of fentanyl: the pharmaceutical form, and the illicit, or illegal, form. While the pharmaceutical form of fentanyl may be prescribed to treat severe pain, it can be taken in ways that weren’t prescribed, such as taking too many, taking them to feel “high,” or giving them to someone else. The illicit form is made and sold illegally on the drug market. People take it because it produces a strong “high” and intense feelings of well-being. Fentanyl is a dangerous and addictive opioid because of its potency. As with any opioid, fentanyl addiction is a brain disease where you have an overwhelming craving for the drug. You can’t stop taking the drug despite the harm it may cause you. If you do stop taking the drug, you feel sick. This sickness is called withdrawal. Fentanyl withdrawal symptoms can be severe, which is why many people don’t stop taking it. Symptoms may include: anxiety, bone and muscle pain, increased heart rate, high blood pressure, vomiting and diarrhea, sweating and chills, and sleep problems. A fentanyl overdose means you’ve taken too much of the drug, which can cause life-threatening symptoms, or even death. Depending on your body size and how long you’ve been taking the drug, as little as two milligrams can kill you. Most cases of overdose and death from fentanyl in the United States are related to taking the illicit form. And, because fentanyl is strong and cheap to make illicitly, it’s often mixed with other illegal drugs, such as heroin, cocaine, and methamphetamines. This is dangerous because a person may take it without meaning to, which may result in accidental overdose or death. The symptoms of fentanyl overdose include: confusion; constricted, or “pinpoint” pupils; feeling sleepy or losing consciousness; weak, slowed, or stopped breathing; inability to talk; limp body; cold, clammy skin with discolored skin, lips, and nails; slowed or stopped heartbeat; and death. According to the Centers for Disease Control and Prevention, over one hundred and fifty Americans die each day from opioid overdoses, including fentanyl. If you have questions about fentanyl, or if you or someone close to you needs help for an opioid use disorder, talk to your healthcare practitioner.
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