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alfentanylAlfentanil, otherwise known as R-39209 or by the trade names Alfenta and Rapifen, is a highly potent synthetic opioid and analgesic drug that is used as an anaesthetic in surgery. It is an analogue of the drug fentanyl. Fentanyl and its analogues like alfentanil are in the same class of pain killers as morphine and heroin. With respect to its potency, duration and rapidity of onset the following can be said:

  • It is 10% to 25% as potent as fentanyl.
  • This still makes it more than 100 times more potent than heroin or morphine.
  • It has a much shorter duration of action, lasting only 15 minutes. This is 33% the duration of fentanyl.
  • The effects begin 4 times faster than fentanyl after administration.

It causes fewer cardiovascular side effects than fentanyl but causes greater respiratory depression. This is what makes alfentanil such a dangerous recreational drug. It causes greater respiratory depression than the already dangerous fentanyl, and it is many times more potent than heroin.

In terms of physical and mental euphoria, it is reported to produce a less intense “high” than morphine or heroin, but one more akin to oxycodone.

Alfentanil is a Schedule II drug in the USA, meaning that its use and distribution is tightly controlled.

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It was first discovered by Janssen Pharmaceutica in 1976. Later it would be involved in the Estonian fentanyl analogues crisis of the early 2000s.

The side effects of alfentanil are typical of fentanyl analogues.

This includes itching, nausea and vomiting, intense and scary dreams and the aforementioned respiratory depression.

It is known to be a highly addictive drug. With regular use, individuals will build a physical dependence.

Withdrawal from fentanyl analogues is known to be very difficult. Common symptoms of the withdrawal include cramps and muscle pain, intense headaches, fever, cold seats, insomnia, fatigue, anxiety, depression, rapid heart rate, vomiting and nausea. This combination of horrible effects lasts for up to a week. However the most intense symptoms and cravings should subside within a few days.

It is this challenging withdrawal and the psychological addiction that causes most addicts to continue using, and find quitting very difficult.

Alfentanyl can be particularly toxic if combined with other drugs. Dangerous and life threatening combinations include combinations with depressants including alcohol, with stimulants and with dissociatives.

In particular combination with alcohol, barbiturates, GHB/GBl, benzodiazepines or methaqualone can result in fatal respiratory depression or death by inhalation of vomit in a compromised state. Muscle relaxation, sedation and amnesia are also enhances leading to unexpected loss of consciousness.

In the advent of overdose, the individual should be put in the recovery position. They should be lying on one side, with the head tilting downwards, so that in the event of vomiting the airways do not become blocked. If possible naloxene can be used as an antidote to the overdose. Intravenous or intramuscular injection will reverse the effects of the alfentanil.