Actiq is a brand-name version of fentanyl citrate. Actiq is described as a transmucosal lozenge, and it’s intended to be prescribed to patients with cancer to manage breakthrough pain. For someone to be prescribed Actiq, they should already be opioid-tolerant for around-the-clock treatment of underlying pain. The qualifications for someone to be considered opioid tolerant include having taken around-the-clock dosages of certain medications like morphine, transdermal fentanyl or hydromorphone for a week or longer. To use Actiq, patients should stay on their around-the-clock opioid medications. Actiq shouldn’t be used in people who aren’t already opioid-tolerant, and it’s not to be used to manage pain stemming from operations, acute pain, dental pain, or for headaches or migraines. Actiq is part of something called the TIRF REMS Access Program, which indicates very specific guidelines as to how Actiq can be prescribed to reduce the misuse potential. Actiq can only be prescribed to people who are enrolled in the program.
The reason the use of Actiq is so closely controlled and regulated is that the active ingredient is fentanyl. Fentanyl is an extremely powerful synthetic opioid that acts on the brain and body similarly to morphine but is anywhere from 50 to 100 times more potent. Some illicitly-manufactured versions of fentanyl sold on the black market can be thousands of times stronger than morphine. Actiq and other products containing fentanyl should only be prescribed to patients with severe pain. Other brand-name versions of Fentanyl include Duragesic and Sublimaze.
Actiq comes as a lozenge placed on the end of a stick. Essentially, it’s like a fentanyl lollipop, and the fentanyl is combined with flavoring such as berry. Actiq is sometimes called the Actiq lollipop or the fentanyl lollipop. This is a way to deliver fentanyl directly to the patient, and the active medication dissolves directly through the mouth lining and then goes into the bloodstream. The reason this is beneficial is that the fentanyl can be absorbed quickly into the system of the patient, which is necessary to relieve severe breakthrough pain. At the end of the fentanyl stick, the dosage strength of the medication is printed.
Fentanyl is an opioid, also called a narcotic. It’s a Schedule II prescription drug in the U.S., and it’s incredibly potent. The potency is why it should only be used by patients who are already opioid-tolerant. Otherwise, it can cause an overdose. Along with the high risk of overdose, fentanyl is very addictive. On the streets, fentanyl is referred to as China Girl, Dance Fever, Murder 8 and many other slang names. As an opioid, fentanyl binds to receptors in the central nervous system. Since fentanyl is especially powerful, in doing so, it can trigger a strong euphoric response because of the flood of chemicals like dopamine. Once that response begins, it can create cycles of pleasure and reward in the brain, giving rise to addiction. The effects of fentanyl and Actiq are similar to heroin. Along with euphoria, other desirable effects that can lead people to misuse these drugs include relaxation, drowsiness and sedation. Less desirable effects can occur as well including nausea, respiratory depression, unconsciousness, coma and death.
While some people misuse fentanyl by diverting it from medical use, as would be the case with Actiq, fentanyl is available from other sources on the black market as well. There are non-pharmaceutical versions of fentanyl sold. These are often sold in different forms such as spike blotter paper, as a powder, mixed with heroin or in tablets. Unfortunately, some people may not even realize they’re buying fentanyl, and because of its powerful effects, they can overdose after using it one time.
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