APIC243882243 - CME/CMLE - Fentanyl Testing-APIC243882243

APIC243882243 - Educational Activity
Pdf Summary
This educational commentary by Corey Swackhammer from Texas Tech University Health Sciences Center provides an in-depth overview of fentanyl testing, its medical use, public health impact, and testing challenges.<br /><br />Fentanyl, a synthetic opioid developed in 1959, is far more potent than morphine or heroin and is widely used medically for anesthesia and pain management via intravenous, transdermal, and other delivery methods. While therapeutically vital, fentanyl's synthetic nature allows cheap, rapid illicit manufacturing, making it a major contributor to the opioid crisis and overdose deaths in the US. Illicit fentanyl often appears as powder or counterfeit pills laced with other drugs, causing accidental overdoses. Since 2013, synthetic opioid overdose deaths have sharply increased, with fentanyl implicated in the majority of these cases.<br /><br />Testing for fentanyl serves both clinical and harm reduction purposes. Screening methods, including immunoassays and over-the-counter fentanyl test strips, detect fentanyl presence in urine or drug supplies to guide treatment and reduce harm. Confirmatory testing relies on advanced techniques like liquid chromatography–tandem mass spectrometry (LC-MS/MS) to measure fentanyl and metabolites with high specificity. However, new fentanyl analogs complicate detection, necessitating ongoing updates in testing protocols and technology. Emerging point-of-care tests promise quicker, more accessible detection.<br /><br />Occupational safety is critical due to fentanyl’s high potency and risk of exposure for first responders, healthcare workers, and laboratorians. Personal protective equipment (PPE) guidelines vary by exposure risk level, emphasizing nitrile gloves, respirators, and decontamination with soap and water. Rapid naloxone administration remains the primary treatment for fentanyl overdose, though multiple doses may be needed due to fentanyl’s potency and the presence of other sedatives like xylazine.<br /><br />In conclusion, fentanyl testing is vital for managing its medical use and combating illicit use amid an evolving drug landscape. Advances in testing and safety protocols, alongside harm reduction strategies, are essential to address the ongoing public health crisis caused by fentanyl and its analogs.
Keywords
Fentanyl
Synthetic opioid
Opioid crisis
Overdose deaths
Fentanyl testing
Immunoassays
LC-MS/MS
Fentanyl analogs
Harm reduction
Occupational safety