The effort has been categorized as a Health Alert Network Advisory signaled to a multitude of professionals within the health field. The advisory explains four key action points. Those points include the (a) local need to expand the distribution and use of naloxone and overdose prevention education, (b) expand awareness, access, and availability of treatment for substance use disorders, (c) intervene early with individuals at highest risk for overdose, and (d) improve detection of overdose outbreaks to facilitate more effective response.Another initiative is a social media campaign from the United States Drug Enforcement Administration (DEA) called "One Pill Can Kill". This social media campaigns goal was to spread awareness of the prevalence of counterfeit pills that are being sold in America that is leading to the large overdose epidemic in America. This campaign also shows the difference between counterfeit pills and real pills. This campaign also offers resources for help with drug addiction and rehabilitation.In New Jersey another initiative was started called "The Partnership for a Drug-Free New Jersey" (PDFNJ) was created to inform the people of New Jersey the harm of taking drugs and where to dispose of expired or unneeded prescription medications. Some of this programs campaigns also focus on children and teaching children how to deal with the influence and peer pressures of these drugs. Pharmacology
Classification
Fentanyl is a synthetic opioid in the phenylpiperidine family, which includes sufentanil, alfentanil, remifentanil, and carfentanil. Some fentanyl analogues such as carfentanil are up to 10,000 times stronger than morphine. Structure-activity
The structures of opioids share many similarities.
This is much more profound in patients who have an already increased sympathetic drive, like patients who have high blood pressure or congestive heart failure. It does not affect the contractility of the heart when regular doses are administered. Muscle rigidity
If high boluses of fentanyl are administered quickly, muscle rigidity of the vocal cords can make bag-mask ventilation very difficult. The exact mechanism of this effect is unknown, but it can be prevented and treated using neuromuscular blockers. Wooden chest syndrome
A prominent idiosyncratic adverse effect of fentanyl also includes a sudden onset of rigidity of the abdominal muscles and the diaphragm, which induces respiratory failure; this is seen with high doses and is known as wooden chest syndrome. The syndrome is believed to be the main cause of death as a result of fentanyl overdoses.Wooden chest syndrome is reversed by naloxone and is believed to be caused by a release of noradrenaline, which activates α-adrenergic receptors and also possibly via an activation of cholinergic receptors.Wooden chest syndrome is unique to the most powerful opioids—which today comprise fentanyl and its analogs—while other less-powerful opioids like heroin produce mild rigidity of the respiratory muscles to a much lesser degree. Overdose
Fentanyl poses an exceptionally high overdose risk in humans, due to having an extremely unpredictable fatal dosage when mixed with other drugs. In its pure form, overdoses are only moderately unpredictable, with most overdose deaths occurring at serum concentrations of between 150 and 250 ng/mL.