Fentanyl
Fentanyl is a powerful painkiller that is used in medicine, but also plays a major role on the illegal market. It belongs to the opioids, a group of substances that act similarly to morphine, but fentanyl is much stronger – around 50 to 100 times more potent than morphine. Doctors use it, for example, during operations or to treat severe chronic pain, such as in cancer patients. However, it is also dangerous precisely because of its strength: even tiny amounts can trigger an overdose, which is often fatal. In recent years, fentanyl has contributed to an opioid crisis, particularly in the USA, because it is often produced illegally and mixed with other drugs such as heroin.
But how do you find out if someone has fentanyl in their body? This is where laboratory medicine comes into play. It has developed various methods to reliably detect fentanyl – be it during a medical examination, suspected drug abuse or in forensic medicine, for example after an unexplained death. This evidence is important because it helps to detect overdoses, monitor therapies or clarify criminal law issues.
How is fentanyl detected in the laboratory?
In laboratory medicine, there are several steps and techniques to identify fentanyl. In most cases, samples such as blood, urine or hair are examined. Each sample has advantages and disadvantages: Blood, for example, shows whether fentanyl is currently active in the body, while hair can also reveal use from weeks or months ago.
The first check: screening tests
Laboratories often carry out a so-called immunoassay first. This is a quick test that works in a similar way to a pregnancy test. It shows whether opioids – including fentanyl – are present at all. An antibody that reacts to opioids is used for this. If the test is positive, a signal lights up. However, this test is not particularly accurate: it cannot say for sure whether it is really fentanyl or another opioid such as morphine. It is therefore only a first indication.
Precise analysis: chromatography and mass spectrometry
For reliable detection, it becomes more technical. Methods such as gas chromatography (GC) or liquid chromatography (LC), often combined with mass spectrometry (MS), are used here. These devices separate the substances in a sample from each other and then analyze them precisely. Think of it as a kind of “fingerprint”: Each substance has a unique pattern that the machine recognizes. This allows the lab to confirm not only that fentanyl is there, but also how much of it was in the body. This is particularly important to determine whether a dose was dangerously high.
Special challenges
Fentanyl is not easy to detect. It is rapidly broken down in the body, often within hours, into so-called breakdown products such as norfentanyl. This is why laboratories not only have to search for fentanyl itself, but also for these traces. There are also many variants – so-called analogs such as carfentanil – which are even stronger and look slightly different. Modern laboratories are prepared for this and adapt their methods to find these variants as well.
Why is this so important
The evidence helps in many situations. In emergency medicine, a quick test can save lives by showing whether an overdose has occurred and which antidotes are required, such as naloxone. In forensic medicine, it clarifies whether fentanyl played a role in a death. And in drug control, it ensures that doctors know whether patients are taking their medication correctly.
Fentanyl is therefore a double-edged sword – helpful in medicine, but risky outside it. Laboratory medicine, with its precise methods, has the ability to detect it safely. From simple tests to high-tech analyses, it ensures that we can better understand and control this powerful drug.
Related:
Opioid crisis reaches Canada – and could soon keep German laboratory physicians busy – MedLabPortal
Semaglutide helps with opioid and alcohol addiction – MedLabPortal
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