Updated on January 28, 2019. Medical content reviewed by Dr. Richard Koffler, MD, Board Certified Physiatrist
Despite restrictions on prescribing fentanyl-based drugs like Abstral, fentanyl has become a major threat in the opioid crisis sweeping the United States. Abstral and other kinds of fentanyl are 50 to 100 times more potent than morphine and more dangerous than heroin. Fentanyl causes some of the strongest opioid highs out there and in turn has the most risks.
Abstral is a fentanyl tablet that goes under the tongue — also called a fentanyl sublingual tablet. Only a patient with breakthrough cancer pain who already has a high tolerance to opioids can receive an Abstral prescription. Doctors generally prescribe it in situations where nothing else will relieve the pain, and the patient must be over 18.
Fentanyl-based medications like Abstral can cause side effects like:
When these symptoms become severe or long-lasting, a patient should immediately contact a doctor. You should get medical attention if you experience any of the following symptoms:
If someone overdoses on Abstral, they can stop breathing, leading to death. Patients who take fentanyl on a regular basis are often advised to keep naloxone, an overdose drug, on hand. A caregiver or loved one can administer naloxone if an overdose happens.
Abstral addiction can happen to people who are new to opioids and prescribed patients alike. Even when using Abstral as directed, a patient can develop a tolerance or dependence without realizing it. Often, this leads to the accidental misuse of Abstral, which only make side effects worse. Or, they might take larger doses on purpose to take advantage of the “high” it can cause. Prescription drugs like Abstral can act as a “gateway drug” to illegal forms of fentanyl that could contain traces of cocaine or heroin.
People without a tolerance to opioids are especially vulnerable to fentanyl — they can easily overdose on a single dose of Abstral. This makes recreational use of fentanyl incredibly dangerous.
In certain cases, someone can become addicted to fentanyl without realizing they’re taking it — many street drugs marketed as other medications can contain fentanyl. Traffickers add fentanyl to illegal painkillers and narcotics to make their drugs more potent, and when combined with other drugs, fentanyl becomes even more dangerous. When fentanyl trafficking boomed in 2013, it took the lead in lethal prescription drug overdoses in the United States.
Cannabis medicine could help patients avoid developing an addiction to fentanyl and reduce its availability to drug abusers. Patients generally get fentanyl after they’ve already gone through extensive opioid treatment, so reducing the number of prescriptions they need to manage the same symptoms could help them avoid taking stronger medicines at all.
Researchers have studied the effects of cannabinoids on fentanyl’s safety and efficacy. Studies show that cannabinoids let fentanyl relieve pain more effectively without making any side effects worse. For instance, one such study discovered that tetrahydrocannabinol (THC) made fentanyl more effective. This data shows we can lower the dosage of fentanyl and other opioids, then replace it with safer, non-addictive medical marijuana.
Medicinal cannabis could be the solution to the opioid crisis happening throughout the country. For more information on medical marijuana and opioids, read our guide to opioid addiction and cannabis medicine. Then, consult a cannabis-friendly doctor for personalized advice on medical marijuana treatment.
Check out our resources on specific opiates and medical marijuana: