@Mik said in Treating fentanyl addiction tricky:
https://www.cincinnati.com/story/news/2022/12/27/fentanyl-addiction-tricky-to-treat-even-with-medication-expert-says/69705401007/?NLcohort=A&utm_source=cincinnati-DailyBriefing&utm_medium=email&utm_campaign=daily_briefing&utm_term=hero&utm_content=PCIN-1019EQ-E-NLETTER65P
I'm no addiction specialist, but I have questions about what this article says.
First of all the half-life of fentanyl in the body is about 8 hours. That means that after 3 half lives, 97% of it is out of your body. Completely gone.
The duration of action of fentanyl is 60-90 minutes. As blood levels start to fall, the effect of the drug does as well.
Fentanyl binds to the µ receptor, and I've never heard of it being "sticky." That sounds like a made-up concept to me. If the drug is "stuck" to the receptor, the duration of its effect should be prolonged. From having given thousands (yes, thousands) of doses of fentanyl, I can assure you that 60-90 minutes is how long it lasts.
If this guy's patients are undergoing withdrawal because of suboxone taking over the µ receptor, I wouldn't be surprised if there's something else hanging out on the receptor, and that's not fentanyl.
And, on an unrelated note, I had a conversation with a guy who's a pain doc. We talked about oral absorption of fentanyl, and he agreed that it's not a thing UNLESS, the dose is so huge that some does get absorbed. More likely, is that people are grinding the pills up and putting them between cheek and gum, and getting absorption that way.
As I said, he's a pain doc, and he's a big proponent of medical cannabis. He told me that some of his patients are using medical cannabis for pain relief, but ALSO for a buzz. Some of them are getting their cannabis from places other than licensed dispensaries, and guess what shows up in their urine?
Yeah, fentanyl metabolites.
