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Fentanyl, also known as fentanil, is an opioid pain medication with a rapid onset and short duration of action.[6] It is a potent agonist of μ-opioid receptors. Fentanyl is 50 to 100 times more potent than morphine,[7] but some fentanyl analogues, which are designed to mimic the pharmacological effects of the original drug, may be as much as 10,000 times more potent than morphine.[8]

In the mid-1990s, fentanyl was introduced for palliative use with the fentanyl patch, followed in the next decade by the introduction of the fentanyl lollipop, dissolving tablets, and sublingual spray which are absorbed through the tissues inside the mouth.[9][10] As of 2012, fentanyl was the most widely used synthetic opioid in medicine.[11] In 2013, 1,700 kilograms (3,750 lbs) were used globally.[12] Fentanyl has a relatively wide therapeutic index (270)[13] which makes it a very safe surgical anaesthetic when monitored carefully; however, its potency requires careful measurements of highly diluted fentanyl in solution.

Fentanyl patches are on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[14] Fentanyl was first made by Paul Janssen in 1960.[15] Janssen developed fentanyl by testing chemicals similar in structure to pethidine (meperidine) for opioid activity.[16] The widespread use of fentanyl triggered the production of fentanyl citrate (the salt formed by combining fentanyl and citric acid in a 1:1 stoichiometric ratio),[17] which entered medical use as a general anaesthetic under the trade name Sublimaze in the 1960s.

Fentanyl is illegally made and used as a recreational drug often disguised as other medications or mixed with heroin, leading to thousands of overdose deaths from 2000 to 2017.[8][18][19] Deaths have also resulted from improper medical use.[20]