By Dom Cioffi
Back in the late 1950s, Dr. Paul Janssen and his team of scientists at Janssen Pharmaceuticals first started synthesizing a new drug for pain management. The extremely potent, synthetic opioid they developed was known for its rapid onset and short duration of action. They eventually realized it was also 100 times more potent than morphine and heroin.
They called the new drug fentanyl and released it for medical use in hospitals as a general anesthetic. It’s popularity skyrocket and led to a number of copycat compounds.
In the mid-1990s, a new line of fentanyl was introduced for palliative use (pain management) with the fentanyl patch. A decade later a fentanyl lollipop was developed, along with dissolving tablets and a sublingual spray that is absorbed through the skin inside a patient’s mouth.
Because of its effectiveness with intense pain, fentanyl is generally used on cancer patients and individuals experiencing severe chronic pain like spine injuries. Unfortunately, I have an intimate knowledge of fentanyl since I was on it for several months during and after my recent cancer treatments.
I was first given the drug via a transdermal patch that would slowly release the active agent into my bloodstream over the course of three days. I was initially given a small dose, but as the intensity of my pain grew, so did the potency of my patch.
By the time I had topped out – just prior to the end of my treatments – I was ingesting 150 mg of fentanyl every three days. This is considered a very potent level, but it was the level required due to the extreme pain I was experiencing. To be honest, I don’t remember much during this period–I was in a hazy, zombie state that rendered me fairly useless.
I continued at this level for a month after my treatments ended. During this time, I was back at home, but hardly comfortable. I was becoming more and more aware of fentanyl’s adverse effects on me. While it did handle my pain beautifully, fentanyl wreaked havoc on me in other ways.
For one thing, I developed overly-heightened senses. This may not sound bothersome initially, but I can tell you from experience that it is not something to wish for. Any minor sound my wife or son made was super-intensified. A pot being washed in the sink or an abruptly shut front door felt like a bullet to the back of my head. Particular foods or fresh laundry smelled so strong that I would have to leave the room.
In fact, the outside world was simply too painful so I spent the better part of my first month of recovery locked away in my bedroom with no TV or radio. It was just me quietly sitting in a recliner in the corner waiting for the day to pass. I would slide in and out of sleep throughout the day, dreaming of a time when I wasn’t dealing with cancer.
And then it came time to wean off the fentanyl.
It took me a little over six weeks to “titrate down” from a 150 mg patch to a 12 mg patch and in that time I experienced a constant and ever-changing slew of maladies. Once the human body gets a taste of Fentanyl, it becomes very angry when you take it away and makes you pay for it in a variety of ways.
There were so many times when I just wanted to maintain the milligram level I was at for a couple weeks just so I could fend of the withdrawal symptoms for a little while. But I stuck to my plan and persevered and constantly reminded myself that there was an end in sight and one day I would not be sick.
That day turned out to be Jan. 17. I had put my last three-day, 12 mg patch on a week earlier. When I awoke that morning, I crawled out of bed and walked into the kitchen. I stood there for a moment analyzing my health until finally concluding: I don’t feel sick!
My dance with fentanyl was over. I took a walk that afternoon and as the warming sun shone down upon me I nearly broke down with joy and gratitude for just feeling normal.
I’m thankful that the fentanyl was there to aid me when I needed it, but I was even more thankful to get away from the dependency my body had developed. My days drifting through La La Land were over and I was ready for the next stage of my recovery.
This week’s film also features a La La Land, but in this case it refers to the sunny and exciting environment of Southern California.
“La La Land,” starring Emma Stone and Ryan Gosling, is a musical love story that follows the relationship ups and downs of two star-struck Hollywood minions as they reach for the fame and fortune that the big city promises.
Check this one out if you love a musical with catchy tunes and a bouncy storyline. And with the Oscars just around the corner and this film already making waves with its Golden Globe’s Best Picture win, it’s definitely one of the required films to see.
A dopey “A-” for “La La Land.”
Got a question or comment for Dom? You can email him at firstname.lastname@example.org.