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1EMT-P

Abandoning Fentanyl?

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Should EMS abandon the use of Fentanyl in the field? Based on the fact that it’s a highly abused and addicting substance. It’s not like we don’t have alternatives. Please share your thoughts.

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Yes we do have alternatives but I say keep it.

A great mentor one time told me this,  if a person is going to get hooked off one single EMS administration of a drug we give them, then they are probably hooked on something already.  

 

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Yes.  Fentanyl is addictive with potential for misuse.  Morphine is also addictive with potential for abuse.  As are the benzos we carry for seizures/sedation.  Ketamine?  Well, that's so blatantly addictive/misused that it has it's own street name.

When used appropriately it is exceptionally effective.  With what do you suggest it be replaced?

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I want to add to my post

Fentanyl is a great drug.  It can be used on most anyone.  I've used it from 2 year olds to 80 year olds and probably older but I can't remember.  I don't remember a patient ask me personally to give them fentanyl, but remember I've been out of the field full time for 9 years, (part time for several), but I've been asked to give patients dilaupid(yeah I know it's spelled wrong) more times than I have fingers and toes.  

There is abuse potential in a lot of stuff we give.  Hell there's abuse potential in flexeril as well, that's what a friend of mine was hooked on and what eventually killed him in an over dose when he took an entire bottle (90) pills because he was just tired of livin and wanted out.  

So I do not believe we should get rid of fentanyl just because it's the soup du jour of the addicts this year and last.  

10 years ago, I believe diluadid was the soup du jour of addicts in my emergency room.  It's what they asked for by name.  

Who knows what will be on the menu in 3-5 years from now.  

But for goodness sake, don't take a tool out of our arsenal because a small subset of the population have made it their drug of choice to abuse and kill themselves with.  That would be I believe foolish and a knee jerk reaction, but then again, it's what we in america are known for, knee jerk reactions to a problem without finding a solution first.  

Edited by Just Plain Ruff

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On 4/17/2019 at 6:28 PM, 1EMT-P said:

Should EMS abandon the use of Fentanyl in the field? Based on the fact that it’s a highly abused and addicting substance. It’s not like we don’t have alternatives. Please share your thoughts.

Almost every controlled drug in my daily carry has significant abuse potential in the wrong hands. Why should best practice patient care be compromised because someone might abuse it? What opiate would you suggest a service carry instead when all opiates, benzo's etc. have abuse potential?

 

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Almost every med EMS carries has the potential of abuse. I do prefer Fentanyl as a medic because of the short half life and by the time we arrive at the ED, the doctor can do a good assessment of the patient. If you won't use Fentanyl, what would be your drug of choice? 

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