Sublimaze Addiction and Abuse

Sublimaze is a brand name for fentanyl citrate. Fentanyl citrate is a powerful pain reliever that’s roughly 80 times more powerful than morphine. Sublimaze and other forms of fentanyl citrate are highly addictive.

Sublimaze can only be administered by a trained anesthesiologist. Sublimaze overdose can easily occur if doses are not titrated specifically to each patient. Patients should be educated on the addictive potential of opioids prior to administration.

Potential side effects of Sublimaze include apnea, slow heart rate, and muscle rigidity. If doses are not titrated appropriately, symptoms can deteriorate into circulatory depression, respiratory arrest, and heart failure. Other side effects may include blurred vision, nausea, high blood pressure, low blood pressure, dizziness, vomiting, urticaria, anaphylaxis (severe allergic reaction), and diaphoresis.

Sublimaze is indicated as a pain reliever during invasive surgery. Sublimaze may also be administered in a preoperative setting or for the management of post-operative pain. Vitals should be routinely monitored for respiratory depression. Overdose cases are typically the result of severe respiratory depression and can lead to severe carbon dioxide toxicity, hypoxia, coma, and death.

Doses are titrated specifically to each patient’s pain management needs and unique metabolism. Factors that influence Sublimaze dosage include opioid tolerance, route of administration, the type of surgical procedure being performed, patient age, weight, kidney and liver function, and overall health.

Sublimaze is primarily metabolized by the liver. Decreased liver function can result in extended clearance rates and elevated plasma concentrations of the drug. Elderly patients age 62 or older tend to require lower doses due to poor metabolic function.

The average clinical dose of Sublimaze for most patients falls between 50 mcg to 100 mcg. As a premedication, Sublimaze is administered intramuscularly 30 to 60 minutes prior to surgery. For anesthesia induction and maintenance for children ages 2 to 12, doses may be as low as 2 to 3 mcg/kg of body weight.

Sublimaze is categorized as a Schedule II substance by the Federal Drug Administration (FDA). Although Sublimaze rarely makes it into the hands of recreational users, many individuals who misuse narcotic opioids were first introduced to them in a hospital setting.

When the patient’s prescription runs out, drug cravings and opioid dependency may remain. Those who are reliant on the drug may engage in drug-seeking behavior such as faking injuries to gain admittance to the emergency room. Emergency room staff are trained to identify drug-seeking behavior and to recall frequent visitors. Programs are in place within the US to track the number of narcotic medications prescribed to individuals across hospitals.

Patients must be closely monitored postoperatively. Several cases have been reported where the patient experiences a spontaneous rebound of severe respiratory depression. In the event of clinically significant respiratory and circulatory depression, the administration of an opioid antagonist may be necessary to reverse the effects of the drug. Opioid antagonists like naloxone can precipitate the onset of post-acute withdrawals and should only be administered when necessary.