AGI – Fentanyl is a synthetic opioid with narcotic analgesic properties. It is about 100 times more potent than morphine, but also about 100 times more toxic. Its analogues, more than 150 illicit analogues currently on the black market, are up to a thousand times more potent than morphine. The most common examples are Sufentanyl or Carfentanyl. In Italy, Fentanyl is used for permitted purposes and under medical supervision as a general anesthetic in major surgery operations and in palliative therapy for terminal cancer pain. In the drug market, however, it can be used as a cutting agent for heroin or even in place of heroin itself.
Fentanyl and its analogues can be produced in so-called kitchen laboratories, illegal kitchen laboratories and this, in addition to making the substance more potent, also makes it possible to spread it at a lower price. It should be kept in mind that if it is true that it is a product one hundred times more powerful than morphine, it is equally true that it is 100 times more toxic as it binds much more powerfully to the brain opioid receptors. This mechanism makes, among other things, more difficult, almost impossible, to reverse a Fentanyl overdose with naloxone, which is the drug generally used to intervene in opioid overdoses.
Neither heroin laced with Fentanyl nor Fentanyl alone is the ‘zombie drug’. This is defined as a preparation of heroin or fentanyl cut with xylazine, a veterinary anesthetic and muscle relaxant, currently used very little in Italy, but instead used by the illicit market to make a cut that gives more power to the preparation but costs less. Xylazine produces skin ulcers in the upper and lower limbs, especially where heroin street preparations are injected. These deep ulcerations make users zombies: hence the name used to define this drug.
The third degree alert (third degree alert) is a communication of maximum urgency that is sent to all operators who deal with consumers of substances of abuse. The recipients of this communication include: forensic toxicology, police forces, the Ministry of Health, AIFA (Italian Medicines Agency), regional health departments, emergency rooms, hospitals. The alerts are coordinated by the Department of Anti-drug Policies, whose operational arm is the National Center for Addiction and Doping of the Higher Institute of Health, it is warned that there is a health alert for drug users. The level 3 alert refers to substances that can cause severe poisoning or deaths, such as Fentanyl. At the moment, in Italy there is a national alert plan on Fentanyl started on March 12th by the Presidency of the Council of Ministers. The first case in Italy occurred in Perugia in which a street preparation containing this synthetic opioid was detected and at the moment all the police forces are alerted, together with the Central Anti-Drug Services Directorate. Investigations are underway to see if the phenomenon is limited or widespread. The judiciary is also alerted, which must give authorization to the analysis of street preparations.
