I was thinking of dealers selling heroin in particular, since that feels like the appropriate thing to compare fentanyl-pushing MDs to, but in a broader sense, your point is if course correct.
Ironically, fentanyl is more dangerous than heroin and a large amount of heroin overdose have supposedly been because fentanyl was mixed in with the heroin unbeknownst to the user.
It's more dangerous in street drugs because it is potent at extremely low doses, so poorly mixed drugs can contain fatal doses very easily.
In a controlled setting, where the dose is precisely known, that is not an issue. I did some reading of fentanyl vs. morphine a while ago, and found that fentanyl is often preferred for acute pain due to faster onset, shorter duration (which may make controlling adverse reactions/overdoses easier), fewer side-effects and less histamine release. Specifically:
> When adverse event rates were counted across both the out-of-hospital and ED phases, morphine's and fentanyl's safety levels were extremely close, erasing even the suggestion of a trend toward safety in one drug or the other. Our data do not suggest that further work should be done to try to determine which drug is safer: The low absolute rates and small difference between the two drugs make it unlikely that this difference would become either clinically or statistically significant, even with a larger sample size.
I don't believe the notion that fentanyl is per se more dangerous, rather than being dangerous when misused/poorly handled, is supported.
It’s more dangerous because you don’t know how much you’re getting on the streets. In a prescription, it’s a regulated medicine that is exactly the amount the label says.
I’m not defending the doctor but the point being made doesn’t apply.
jjeaff|8 years ago
stordoff|8 years ago
In a controlled setting, where the dose is precisely known, that is not an issue. I did some reading of fentanyl vs. morphine a while ago, and found that fentanyl is often preferred for acute pain due to faster onset, shorter duration (which may make controlling adverse reactions/overdoses easier), fewer side-effects and less histamine release. Specifically:
> When adverse event rates were counted across both the out-of-hospital and ED phases, morphine's and fentanyl's safety levels were extremely close, erasing even the suggestion of a trend toward safety in one drug or the other. Our data do not suggest that further work should be done to try to determine which drug is safer: The low absolute rates and small difference between the two drugs make it unlikely that this difference would become either clinically or statistically significant, even with a larger sample size.
I don't believe the notion that fentanyl is per se more dangerous, rather than being dangerous when misused/poorly handled, is supported.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924527/
skellera|8 years ago
I’m not defending the doctor but the point being made doesn’t apply.