Abstral Overdose: Side Effects, Dosage & Uses

Abstral is a brand name sublingual of the powerful analgesic opioid fentanyl. It’s intended to treat breakthrough pain in opioid-tolerant cancer patients. Fentanyl products are up to 80 to 100 times more potent than standard morphine. Abstral is highly addictive and, like all fentanyl-based products, has a high overdose potential.

Only individuals who are already tolerant of around-the-clock opioid pain relief are eligible for treatment with Abstral. “Opioid tolerant” is defined as taking the equivalent of 60 mg of morphine per day for at least a week.

Abstral is contraindicated for use in patients with suspected gastrointestinal obstruction, acute or severe bronchial asthma, non-opioid tolerant patients, and for the management of acute or postoperative pain. Abstral is not approved for use in the emergency department.

The amount of Astral necessary to overdose varies greatly depending on the patient’s body fat percentage, liver and kidney health, age, and drug tolerance. Children are at the highest risk for overdose. There have been several cases where young children have died after finding and taking forgotten fentanyl prescriptions.

Symptoms of Abstral Overdose

Symptoms of an Abstral overdose are the same as those from other opioid overdose cases. The patient will present with severely decreased respiration, decreased level of consciousness, and pinpointed pupils that are unresponsive, even to light. They may present with extreme somnolence that rapidly progresses to unresponsiveness. If left untreated, the individual may lose consciousness entirely.

A depressed respiratory drive is the primary risk factor associated with Abstral overdose. Abstral acts directly on the brain stem to reduce the patient’s instinct to breathe. The patient may become toxic from a build-up of carbon dioxide while the cells are deprived of oxygen.

Abstral Overdose Signs

Abstral reaches its full effect within 30 minutes of administration. Doses must be calculated carefully and adjusted according to the patient’s unique metabolic factors. Never mix medications of any kind with Abstral without doctor approval. A failure to follow this recommendation can dramatically increase the risk of severe complications, overdose, and death.

Benzodiazepines like Xanax present the highest risks when taken alongside Abstral. Other central nervous system depressants including non-benzodiazepine sedatives/hypnotics, tranquilizers, general anesthetics, other opioids, anxiolytics, muscle relaxants, antipsychotics, and alcohol should also be avoided.

How Much Abstral to Overdose?

The amount of Abstral necessary to overdose can be surprisingly low for some patients. Extreme caution must be exercised when introducing Abstral into a patient’s system. Even in opioid-tolerant users, the initial dose of Abstral should be limited to 100 mcg. The one exception is for patients who are switching to Abstral from Actiq. Actiq is pharmacologically similar enough to allow for a low-risk transition.

Individuals with impaired liver function may have an increased risk for overdose. Abstral is metabolized primarily by the liver. A poorly functioning liver can lead to elevated blood plasma levels of the drug and an extended plasma clearance time. As a result, Abstral may linger in the system at higher than therapeutic doses.

Abstral Overdose Treatment

In the event of an Abstral overdose, standard procedures for opioid overdose management apply. The patient will require administration of naloxone to rapidly reverse the effects of the drug.

Naloxone is the opioid antagonist of choice for treating most opioid overdose cases. Opioid antagonists can reverse the cause of opioid overdose by breaking the drug’s bonds with opioid receptors in the body. In cases of severe overindulgence, multiple doses of naloxone may be necessary.

Oxygen therapy and assisted respiration may be required to support the patient’s breathing. If the patient loses consciousness, they’ll need assisted ventilation. Medical staff may need to insert an intubation tube to secure the airway.

How is Abstral Overdose Treatment?

Follow-up treatment involves closely monitoring the patient for respiratory depression. This is especially critical if the patient is arriving in the emergency room. Individuals arriving through the ER have an unknown variety of risk factors. Patients with a history of chronic pulmonary disease, or who are cachectic or debilitated have a higher chance of life-threatening respiratory depression returning.

Serotonin syndrome is a potentially fatal risk factor when serotonergic drugs are mixed with Abstral. Serotonergic drugs include many common anti-anxiety medications such as SSRIs (selective serotonin reuptake inhibitors). Patients with adrenal insufficiency and a history of hypotension are also at increased risk.

If you or someone you know is struggling with an opioid misuse disorder, The Recovery Village is available to answer any questions you may have.

Visit the following websites to learn about The Recovery Village’s network of rehabilitation facilities. Call today for admissions. Each center is ready to help people learn how to cope with their addiction and uncover the root causes for their substance use disorder.

• Orlando Recovery Center: A premier rehabilitation facility in Orlando, Florida that helps individuals recover from addiction and substance use disorders. The center also offers the opportunity to treat co-occurring disorders.
• The Recovery Village Columbus: Located in Ohio, this facility provides inpatient, outpatient and aftercare treatment for people looking to begin detox. The center provides individualized plans to help patients through recovery while addressing their unique co-occurring disorders or any setbacks that may happen during recovery.
• The Recovery Village Palmer Lake: In Colorado, this facility offers inpatient, outpatient and intensive outpatient treatment for individuals looking to kick-start their journey to recovery.
• The Recovery Village Ridgefield: Located right in southern Washington, this facility provides patients with outpatient and aftercare programs. Just 20 minutes outside of Portland, this facility assists individuals who are ready to begin treatment.
• The Recovery Village: In Umatilla, Florida, this is a rehabilitation facility that provides resources for individuals seeking drug and alcohol treatment. There are inpatient, outpatient, intensive outpatient and partial hospitalization treatment programs available for those suffering from Ambien addiction.
• IAFF Center of Excellence: Specializes in assisting firefighters who struggle with behavioral health problems and addiction. Members can enter the recovery process sooner so they can return back to work as quickly as possible. Inpatient, partial hospitalization and intensive outpatient programs are all available at this facility, where patients can address their Ambien addiction in a safe, supportive environment.
• Denver Mental Health & Counseling: Denver Mental Health and Counseling by The Recovery Village is a physician-led outpatient center specializing in evidence-based addiction and mental health treatments, offering services such as TMS, IOP, and personalized care for both ongoing and new patients, dedicated to fostering long-term recovery and overall well-being.
• The Recovery Village Palm Beach at Baptist Health: The Recovery Village Palm Beach at Baptist Health is a premier physician-led treatment center in South Florida, offering a comprehensive spectrum of services from medical detox to outpatient programs for alcohol, drug, and co-occurring mental health conditions, with a commitment to rejuvenating lives, families, and communities, and facilitating same-day admissions.
• The Recovery Village Atlanta: Located in Roswell just outside downtown Atlanta, is a 62-bed physician-led treatment facility offering a comprehensive range of services, from medical detox to outpatient care, specializing in alcohol, drug, and co-occurring mental health conditions, dedicated to transforming lives, families, and communities throughout Georgia.
• The Recovery Village Kansas City: The Recovery Village Kansas City, an 80-bed facility in Raytown just 10 miles from downtown, offers a comprehensive range of evidence-based treatments for addiction and mental health conditions, overseen by physician leaders, and is dedicated to revitalizing lives, families, and communities throughout the Midwest.
• The Recovery Village Cherry Hill at Cooper Health: The Recovery Village Cherry Hill at Cooper, situated just 20 minutes from Philadelphia, is a leading rehab facility in South Jersey providing comprehensive, evidence-based addiction and mental health treatments, ranging from medical detox to teletherapy, with a dedicated team committed to guiding adults on their path to lifelong recovery.