Fentanyl activates m-opioid and serotonin receptors. It is about 100 times more powerful than morphine, and approximately 50 times stronger than heroin. Some fentanyl analogues, such as carfentanil, are 10,000 times more powerful than morphine.
Paul Janssen was the first to make fentanyl in 1960. It was approved in the United States for medical use in 1968. Globally, 1,600 kilograms (3.500 lb.) of fentanyl were used for healthcare in 2015. Fentanyl was the most commonly used synthetic opioid in medicine in 2017, with over 1.7 million prescriptions. It is listed on the World Health Organization’s List of Essential Medicines.
Fentanyl has been disrupting the North American illegal drug market in recent years. It capitalizes on pre-existing demand for opiates like heroin and prescription drugs. Fentanyl and its analogues were responsible for more than 20,000 overdose deaths in 2016, which is about half of all opioid-related death. Many of these deaths were caused by illegally manufactured fentanyl. The growing demand for synthetic drugs may make it attractive to organized crime and other criminals, particularly those who operate in the Golden Triangle region in Southeast Asia or Shan State in Myanmar. This area has seen a dramatic increase in production over the past decade. It is much more potent than heroin and has higher profit margins. Because it is compact, it has easier logistics. It can be used to reduce, or even completely replace, heroin and other opiates.
These patches are beyond their official expiration date (max 1 year), testers report no difference in effect.
