Fentanyl DOT Drug Test

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A_Frank

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A_Frank
So im writing a paper on DOT drug testing….
I noticed the FAA only tests for hydrocodone, oxycodone, heroin, hydro morphone, and codien….

With the rise in fentanyl use why does the drug test not include fentanyl or other fully synthetic opiods like tramadol, etc?

@bbchien i know youre big into the HIMMs and a seasoned AME and was curious if you had any info on this?

Thanks everyone!
 
It will NOT detect fentanyl. Fentanyl is not metabolized into a morphine compound (which is what the tests detect). There are test strips that are available, that will...but without the calibrated "cutoff" level for background noise. Accuracy not guaranteed!
 
bbchien said:
It will NOT detect fentanyl. Fentanyl is not metabolized into a morphine compound (which is what the tests detect). There are test strips that are available, that will...but without the calibrated "cutoff" level for background noise. Accuracy not guaranteed!
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Thanks for the info! Is it the say with tramadol or am I mistaken? Do you think there are plans in the future to add the fully synthetic opiods with current trends in the us?
 
If a pilot is taking fent, there will probably be other, "lifestyle" indications that make it obvious without needing to detect it on a screening test
 
redbaron said:
If a pilot is taking fent, there will probably be other, "lifestyle" indications that make it obvious without needing to detect it on a screening test
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Perhaps, but there are other synthetic opiods that arent nearly as strong that the pilots could be taking?
 
A_Frank said:
Haha no, im trying to write a paper on the history of DOT testing, how its evolved, and where it could be in the future
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Yeah ... I was kidding. Not to be political at all but the amount of this stuff coming over the southern border is staggering, if what is being reported is even close to correct ...
 
Daleandee said:
Yeah ... I was kidding. Not to be political at all but the amount of this stuff coming over the southern border is staggering, if what is being reported is even close to correct ...
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Its honestly scary. I was just reading about a spirit pilot who passed away a couple years ago from fentanyl.
 
A_Frank said:
Its honestly scary. I was just reading about a spirit pilot who passed away a couple years ago from fentanyl.
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Fentanyl is an extremely safe drug when used in an appropriate setting by appropriately trained medical personnel using appropriate monitoring equipment. But, out on the street with no monitors, no resuscitation devices available, no narcan available, uncertain potency of medication? There should be no surprise at the result. I use fentanyl every day in my work and am astounded that it is available on the street.
 
^^^^ Same here. The volume of powdered Fentanyl that would kill 50% of the users is incredibly tiny. A granule of Fentanyl the size of your average sugar granule would be lethal to most. Now imagine mixing a large volume of whatever binder/cutting agent they use with Fentanyl to make up pressed tablets or powder packages to shoot/snort. Imagine doing this in one's kitchen with a mixing bowl and a hand mixer. Now you can see how non-homogenous the mix must be and how easy it is for a 'hot dose' to occur. We administer doses of Fentanyl measured in micrograms; one milligram of Fent is lethal without ventilatory and cardiac support. Not that many years ago when an unintentional overdose occurred it was usually expected based on that person's past history. Now, some reckless teenager taking a pill a friend hands them expecting a harmless good time ends up dead the first time they experiment with drugs. Times are different for sure.
 
FORANE said:
Fentanyl is an extremely safe drug when used in an appropriate setting by appropriately trained medical personnel using appropriate monitoring equipment. But, out on the street with no monitors, no resuscitation devices available, no narcan available, uncertain potency of medication? There should be no surprise at the result. I use fentanyl every day in my work and am astounded that it is available on the street.
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When I was scraped off the interstate after being struck from behind while on the motorcycle the angel in the ambulance said something about fentanyl and suddenly I felt so much better ...
 
Daleandee said:
When I was scraped off the interstate after being struck from behind while on the motorcycle the angel in the ambulance said something about fentanyl and suddenly I felt so much better ...
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I'm apparently immune to morphine and dilaudid. I didn't realize this through multiple ER visits until I was finally given fentanyl in post-op for my appendectomy. Oh, the pain can actually go away.....
 
Lindberg said:
I'm apparently immune to morphine and dilaudid. I didn't realize this through multiple ER visits until I was finally given fentanyl in post-op for my appendectomy. Oh, the pain can actually go away.....
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No such thing as immunity to those. Likely just not enough given and or an elevated baseline resistance / tolerance . Also those aren't as potent as fentanyl. Fentanyl is 50-100 times as potent as morphine.
 
FORANE said:
No such thing as immunity to those. Likely just not enough given and or an elevated baseline resistance / tolerance . Also those aren't as potent as fentanyl. Fentanyl is 50-100 times as potent as morphine.
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I don't know how I'd have a tolerance to either, I just know they didn't work like the fentanyl. The first time morphine didn't work, I was in the ER with multiple fractures, and I kept asking for it and they kept insisting they'd given it to me. I just figured the pain was too much for it.

When I had appendicitis, they finally gave me morphine after a few hours in the ER. A little while later how I was doing, I told her I was just waiting for it to kick in, and she said it was supposed to be immediate.... She gave me some more, and then eventually dillauded. Didn't touch the pain and they said all they could give me at that point was something that might cause hallucinations..... I told them I could live with the pain until the surgery.

In post-op, the nurse offered me fentanyl, and the pain went away like someone flipped a switch. Of course she had to remind me to breathe.....
 
The only time I had morphine was for a kidney stone. The nurse started to run it through the IV and said, "If the pain is a 10 now, tell me when it's a 5." She started it, I said "5," she stopped and in 3-2-1 the pain was gone. AHHHH!!! I asked if I could have a to-go syringe but the answer was no..... :(
 
Lindberg said:
I don't know how I'd have a tolerance to either,

Of course she had to remind me to breathe.....
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Any recent usage of narcotics could lead to tolerance.

It's a fine line between agony and apnea.
 
FORANE said:
Any recent usage of narcotics could lead to tolerance.
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That's not it. I didn't even take the Oxy they gave me after elbow surgery (after the breaks) because it just made me feel weird and did nothing for the pain. All I ever take is Tylenol and handfuls of Advil. I guess I'm just weird.

Unless my wife is putting something in my food.
 
Half Fast said:
I asked if I could have a to-go syringe but the answer was no..... :(
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I did the same thing after getting the fentanyl. I told them, "give me a case of that stuff and drop me off at the house!"

I got the same stern answer ... :no:
 
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