More about fentanyl… In gratitude for two years of freedom from it.

A 33-year-old upstate New York man is facing two years in state prison after pleading guilty Tuesday to selling the fentanyl patches that caused a teenager to overdose fatally when he sucked on them.

This guy, James Slingerland, apparently stole his father’s supply of patches after his father, who was being treated at home for end-stage cancer pain, was taken to the hospital. Of course when you’re taken to the hospital, you don’t bring your drugs with you because they give you drugs from the hospital pharmacy.

So Slingerland had this brainwave: he would nick his dad’s drugs and sell them for a bit of extra pocket change. Except the middle-man sold them to a teenager who then chewed one and died.

This is what a brand-name Duragesic fentanyl patch looks like.

Duragesic fentanyl

Brand-name Duragesic fentanyl patch, 75 micrograms.

Fentanyl is so strong it’s measured in micrograms, not milligrams. (A microgram is one-onethousandth of a milligram. Very small amount.)

Can you see the gel inside there? People squeeze the gel out and suck on it. I have a friend from Opiate Detox Recovery who used to call brand-name Duragesic patches his “ketchup packets.” Because he said as soon as he tore the envelope off the first one and saw how squishy it was, he knew what he’d do with it. He couldn’t stop himself. (It’s part of addiction, the not-being-able-to-stop-yourself.)

Aside from drastically increasing the risk of fatal overdose by sucking the gel (in other words, you can kill yourself by doing this), the other agents in the gel are also toxic to organ systems. The gel is NOT GOOD FOR YOUR LIVER when it is eaten. Please do not eat it.

I used to buy the generic Mylan fentanyl patches.

Generic fentanyl patch

Generic Mylan fentanyl patch, 100 micrograms.

This is exactly what my fentanyl patches looked like. 100mcg. Boy does this bring back memories…

In the news stories about the upstate New York overdose, the cops were saying fentanyl is “about 80 times more powerful than morphine.” Morphine is the gold standard against which other opioids are compared, and I’ve heard lots of different estimates bandied about. Truth is, they don’t really know how to measure how much more powerful than morphine fentanyl is, because of the varying rates of absorption. If you have not a lot of body fat, fentanyl will metabolize more quickly than if you have more body fat. If you have more body fat, fentanyl will hang around in your body longer and take longer to excrete, because it’s fat-soluble. If you work out, or if your temperature runs even a degree high, and you put a patch on your skin, fentanyl will be absorbed more quickly.

People have found all kinds of ways to warm up the patches so they’ll be absorbed more quickly—so the blood levels will “spike” and they’ll feel some kind of high.

And if you stick it in your mouth, where it’s the warmest in the body—where does the nurse take your temperature?—the fentanyl will be absorbed the fastest of all. If you fall asleep (“nod”) with it in your mouth—it can kill you.

For all the readers out there who get to this post by searching on phrases like “is it quicker to eat fentanyl patch or stick it”—THINK ABOUT WHAT YOU’RE DOING. Think about the people who have died.

Fentanyl is, if you’ll excuse my French, Nothing To Fuck With. It is only for opioid-tolerant patients with high levels of pain who are being overseen regularly by a physician.

Extra fentanyl worked wonders when I had an appendectomy and when I broke my elbow. For pain in the tissues, opioids do a crack job (to use a small pun). For neurological conditions, not so much. Fentanyl suckers (“Actiq” lollipops) are marketed for neurological problems such as headaches. In my experience all Actiq did for my migraines was make me not-care about them. They didn’t take away much pain—they just made me not-care about it.

And for addiction, they’re hell. There’s almost nothing harder to get free of than fentanyl. You want to up your tolerance, you’re in for some serious debt when you pay the piper, take it from me.

Fentanyl was my ball-and-chain for three years, until I hired a detox physician to help me get free. And two years ago this week I woke up free of fentanyl. I was on Suboxone for two more months—which is another story for another day soon—but I was free of fentanyl. Thank god.