Hidden Threats: Understanding Fentanyl Misuse and Toxicity
Target Audience: Pharmacist
Course Overview
The use of fentanyl and fentanyl analogs has increased significantly in the past ten years due to the influx of illegal forms of fentanyl. The consumption of these drugs is a primary contributor to the current opioid crisis in the United States. Illegally manufactured fentanyl is widely available on the street, and it is a relatively common adulterant in heroin. Unfortunately, some of the beneficial pharmacologic properties of fentanyl, such as the rapid onset of action and its high potency relative to other opioids, also make it very dangerous when it is misused. Physicians, nurses, pharmacists, and other healthcare professionals are tasked with identifying potential fentanyl misuse and may need to manage acute opioid toxicity in the clinical setting.
Learning Objectives
Upon completion of this educational activity, participants should be able to:
- Describe the pharmacologic profile of fentanyl
- Explain the benefits and risks of fentanyl and its role in the opioid crisis
- Describe treatment options in situations of fentanyl toxicity
- Discuss the role of healthcare professionals in the management and prevention of fentanyl toxicity
Faculty
I. Introduction
II. Fentanyl Medical Uses
A. Reservoir System
B. Matrix System
III. Fentanyl and the Opioid Crisis
A. Fentanyl as an Adulterant
B. The Pattern of Fentanyl Misuse
IV. Transdermal Fentanyl Absorption
V. Preventing Fentanyl Overdose
VI. Detecting Fentanyl Overdose
A. Screening for Fentanyl: Urine Samples
B. Screening for Fentanyl: Fentanyl Test Strips
VII. Pediatric Exposure to Fentanyl
VIII. An Emerging Threat: Fentanyl Adulterated with Xylazine
IX. Treatment of Opioid and Fentanyl Overdoses
A. Naloxone and Opioid Overdoses
B. Naloxone and Fentanyl Overdoses
C. Dispensing and Administering Naloxone
D. Buprenorphine
E. Monitoring Fentanyl Overdose Patients
X. Education on Opioid Overdose and Response
XI. Interprofessional Collaborative Approach
XII. Case Study: Fentanyl Transdermal for Chronic Pain
Discussion
XIII. Summary
From May 3, 2025 through May 3, 2028, participants must:
- Read the "learning objectives" and "author and planning team disclosures"
- Study the section entitled "educational activity"
- Complete the Course Test and Evaluation form. The Course Test will be graded automatically. Following successful completion of the Course Test with a score of 70% or higher, a statement of participation will be made available immediately. (No partial credit will be given.)
Credit for this course will be automatically uploaded to CPE Monitor®.
Faculty Planner Disclosure
The following individuals were involved in developing this activity: Liz Fredrickson, PharmD, BCPS, and Pamela Sardo, PharmD, BS. Pamela Sardo and Liz Fredrickson have no conflicts of interest or financial relationships regarding the subject matter. There are no financial relationships or commercial or financial support relevant to this activity to report or disclose by RxCe.com or any of the individuals involved in the development of this activity.
Unlabeled Use Disclosure
The information provided in this course is general in nature and it is solely designed to provide participants with continuing education credit(s). This course and materials are not meant to substitute for the independent, professional judgment of any participant regarding that participant’s professional practice, including but not limited to patient assessment, diagnosis, treatment and/or health management. Medical and pharmacy practices, rules, and laws vary from state to state, and this course does not cover the laws of each state; therefore, participants must consult the laws of their state as they relate to their professional practice. Healthcare professionals, including pharmacists and pharmacy technicians, must consult with their employer, healthcare facility, hospital, or other organization, for guidelines, protocols, and procedures they are to follow. The information provided in this course does not replace those guidelines, protocols, and procedures but is for academic purposes only, and this course’s limited purpose is for the completion of continuing education credits. Participants are advised and acknowledge that information related to medications, their administration, dosing, contraindications, adverse reactions, interactions, warnings, precautions, or accepted uses are constantly changing, and any person taking this course understands that such person must make an independent review of medication information prior to any patient assessment, diagnosis, treatment and/or health management. Any discussion of off-label use of any medication, device, or procedure is informational only and such uses are not endorsed hereby. Nothing contained in this course represents the opinions, views, judgments, or conclusions of RxCe.com LLC. RxCe.com LLC is not liable or responsible to any person for any inaccuracy, error, or omission with respect to this course, or course material.
Please ensure the device you plan to use meets these requirements:
- Operating System: Windows 7, 8, 10, or 11 / Mac OS X 10.9 or later / iOS / Android
- Supported Browsers: Microsoft Edge, Firefox, Google Chrome, Safari, Opera
- A connection to the internet
Accreditation
In support of improving patient care, RxCE.com is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.