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74DESIGNER DRUGSFENTANYL AND ITS ANALOGUESFentanyl was introduced to the United States in 1968 by theJanssen Pharmaceutical Company and marketed under thetrade name Sublimaze. Its primary purpose was for use as anintravenous anesthetic and analgesic. It is 100 times more potentthan morphine in reducing pain, and its duration of action is only30 minutes (compared to morphine, which lasts several hours).Over the years, fentanyl has proved to be an extremely usefuldrug, and to date, it is still widely used for surgeries, childbirth,pain associated with cancer and other diseases, and the treatmentof trauma-related injuries. Although fentanyl solutions are oftengiven intravenously, pill forms of the drug are also available.Due to the success of fentanyl, Janssen and other pharmaceuticalcompanies started to produce other legal fentanylanalogues with a wider range of potency and duration ofaction, including:• Alfentanil—also known as Alfenta®, it is very shortacting(5–15 minutes), 20–30 times more potent thanmorphine, and used for dental, diagnostic, and otherminor surgical procedures.• Sufentanil—also known as Sufenta®, it is extremelypotent (2,000–4,000 times more potent than morphine),and is used for heart surgery and childbirth.• Carfentanil—also known as Wildnil®, it is 10,000times more potent than morphine and is often usedby veterinarians and wild animal researchers toimmobilize large animals.• Lofentanil—another extremely potent fentanylderivative that is 6,000 times stronger than morphineand is very long-acting (i.e., hours), so it is used onlyfor prolonged surgical procedures and treatment ofmultiple trauma-related injuries.