fentanyl
Enable an AI agent to recognise fentanyl, assess the identity and condition of fentanyl-bearing material, and determine which evidence and authorisations are required before handling or use.
Research draft, second pass
A second pass drafted this model: the structure a model of this thing needs, and what is known about it in the world. The line under this one says how the second half was obtained - researched against sources, or recalled without web access, in which case nothing here was read anywhere and every claim is a lead to verify. Unreviewed either way.
Researched by: Codex + Grok
Purpose and description
Enable an AI agent to recognise fentanyl, assess the identity and condition of fentanyl-bearing material, and determine which evidence and authorisations are required before handling or use.
Fentanyl is a synthetic 4-anilidopiperidine µ-opioid receptor agonist used clinically as a high-potency analgesic and anaesthetic and, as illicitly manufactured powder or counterfeit tablets, as a principal opioid in much of the North American illegal supply.
It can be Classify a material as suspected, analytically supported or unresolved fentanyl-bearing material.; Request qualified analysis and constrain conclusions to the method and tested portion.; Reconcile fentanyl quantities while preserving chemical-form, unit and denominator distinctions.; Flag material for containment, quarantine or specialist review when identity, integrity or handling conditions are unresolved.; Check whether a proposed transfer, storage, clinical handoff or disposal has the necessary evidence and authorisation.; Link a suspected exposure to the appropriate emergency or clinical workflow..
Distinguishing features
Require identity evidence that distinguishes fentanyl itself from related compounds; a report using the collective term fentanyls does not establish the parent substance.
Record whether an identifier and reported mass describe fentanyl base, a salt or fentanyl-equivalent content before comparing materials.
Distinguish a fentanyl-specific result from a generic opiate screen: widely used class screens may omit fentanyl. [CDC toxicology guidance](https://www.cdc.gov/overdose-prevention/hcp/training-modules/guideline/page1323207.html)
Distinguish chemical identity from product authenticity: fentanyl can occur in pharmaceutical products and counterfeit pills, so appearance alone does not establish either identity or origin. [DEA fentanyl factsheet](https://www.dea.gov/factsheets/fentanyl)
For a transdermal presentation, distinguish total fentanyl content from labelled delivery rate; a rate in micrograms per hour is not a measurement of total material content. [DailyMed fentanyl system label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=242759ef-cb6d-4e3e-9f8d-5e31efa1f289)
Scope
+ Fentanyl identity, explicitly distinguishing the parent substance, salt form and related compounds.
+ Evidence of fentanyl presence or absence in a specified sample, including analytical limitations.
+ Fentanyl quantity, concentration and distribution within material, with an explicit reporting basis.
+ Material presentation, integrity, storage history and residual fentanyl.
+ Provenance, exposure-relevant properties and context-specific restrictions on handling.
- Independent models of fentanyl analogues, precursors and metabolites.
- Complete pharmaceutical product, packaging and delivery-device specifications.
- Patient diagnosis, opioid tolerance assessment, prescribing and dose selection.
- Overdose diagnosis, emergency treatment and substance use disorder care.
- Chemical synthesis procedures and manufacturing process design.
- Organisation-wide controlled-substance compliance and criminal investigations.
Characteristics
- Identity evidence state
- claimed | presumptive | confirmed within method scope | inconclusive | not detected within method limits Prevents an allegation or screening result from becoming an unqualified identity claim.
- Chemical form
- base | specified salt | unresolved; associated identifier and reporting basis Controls interpretation of substance identifiers and quantity comparisons.
- Material presentation
- bulk substance | solution | solid mixture | transdermal system | other specified formulation | residue | unknown Determines which sampling, integrity and exposure questions apply.
- Fentanyl amount
- micrograms or milligrams per explicitly identified sample or item; fentanyl-equivalent or specified salt basis Separates the amount of fentanyl from the total mass of its carrier material.
- Fentanyl concentration
- micrograms/mL, milligrams/g or mass fraction; matrix, uncertainty and analytical method required Supports comparison without conflating liquid concentration, solid composition and item content.
- Labelled delivery rate
- micrograms/hour for an applicable delivery product; otherwise not applicable or unknown Keeps product release claims separate from measured quantity and actual exposure.
- Sampling coverage
- tested portion linked to parent item or lot, sampling locations and representativeness evidence Limits how far a result can be applied to untested material.
- Co-constituent evidence
- identified substances linked to results; untested constituents explicitly unresolved Fentanyl detection alone does not characterise a mixture.
- Material condition
- integrity, expiry assessment, storage excursions, contamination and used or unused status recorded separately Determines whether labelled properties and handling assumptions remain applicable.
- Origin and authenticity
- documented pharmaceutical origin | documented other origin | suspected counterfeit or diverted | unresolved Separates evidence about origin from chemistry and possession status.
- Action authorisation
- material linked to actor, proposed action, jurisdiction, date and applicable authority Permission depends on context rather than on a universal substance-level flag.
Where this came from
wikidata · CC0 1.0
Drafted structure
Bundle to layer to finding to question, as the second pass will find it: 6 bundles · 11 layers · 18 findings · 28 questions.
Fentanyl identity Establish what the fentanyl designation refers to and how strongly the material supports that designation.
Fentanyl, its salts, related compounds and fentanyl-bearing products must not become interchangeable identities.
Substance boundary
Define the parent-substance identity and its relationship to named chemical forms.
Parent substance and chemical form
Record the asserted identity, form-specific identifiers and relations to separately modelled compounds.
- Does this record denote fentanyl itself, a specified salt, or a material containing fentanyl? definition
- Which identity evidence excludes an analogue, precursor or metabolite being mistaken for fentanyl? boundary
Analytical recognition
Attach identity conclusions to the methods and specimens that support them.
Identity result and limits
Preserve the distinction between claimed identity, screening evidence and confirmatory identification.
- Which specimen, method, laboratory or operator, date and original report support the result? provenance
- What detection limits, cross-reactivity and compound coverage constrain a positive or negative conclusion? measurement
Fentanyl content Describe how much fentanyl is present and how far the measurement can be generalised.
Presence, concentration, item content and delivery rate answer different questions.
Quantity basis
Make each fentanyl quantity interpretable without implicit conversions.
Content, concentration and rate
Keep measured content, label claims and delivery specifications distinct.
- What fentanyl amount or concentration was measured, with which units, uncertainty and base-or-salt basis? measurement
- Does the reported number describe total content, concentration, labelled release rate or an independently recorded administration event? boundary
Mixture and sampling
Represent the carrier matrix, other constituents and the coverage of testing.
Composition and representativeness
Prevent a result from one portion from becoming an unsupported claim about an entire item or lot.
- Which matrix and co-constituents were characterised, and which remain untested? measurement
- What sampling evidence supports applying this fentanyl result to other portions, items or the lot? boundary
Presentation and condition Record the physical context that affects containment, release and continued reliance on product claims.
Bulk material, a solution and a transdermal system require different state assessments.
Formulation interface
Link fentanyl-bearing material to its formulation and any delivery system.
Presentation-specific properties
Capture relevant formulation claims while leaving complete product design to the product model.
- What physical presentation contains the fentanyl, and which authenticated product record, if any, describes it? definition
- Which release, route or sterility claims apply to this exact presentation, and what supports them? provenance
Integrity and residue
Assess changes that affect exposure or suitability, including material remaining after use.
Condition-dependent release and remaining material
Record damage, storage excursions and residual content; heat exposure is specifically relevant to fentanyl transdermal systems. [DailyMed fentanyl system label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=242759ef-cb6d-4e3e-9f8d-5e31efa1f289)
- What evidence records packaging integrity, expiry, leakage, damage or storage excursions, including heat where applicable? provenance
- After use or a condition change, what supports an assessment of remaining fentanyl and the need for quarantine or disposal? action
Exposure and use boundaries Connect material properties to exposure assessment and qualified decisions about use.
Recognising fentanyl does not establish the severity of a particular exposure or suitability for a patient.
Exposure context
Describe a plausible or observed exposure without treating substance presence as proof of absorbed dose.
Material-to-exposure relationship
Separate material evidence, contact circumstances and clinical observations.
- What route, physical form, containment breach and timing are documented for the possible exposure? provenance
- What observations require an emergency or clinical handoff, and which conclusions remain outside this material model? action
Clinical use interface
Identify prerequisites for referring a pharmaceutical presentation into a prescribing or administration workflow.
Product-specific use prerequisites
Require the relevant product and clinical records before a use decision; do not infer substitutability from shared fentanyl content.
- Which authenticated product instructions and authorised clinical decision govern the proposed use? provenance
- Which patient-specific eligibility, interaction and monitoring assessments must be resolved by the linked clinical workflow? boundary
Origin and controlled disposition Establish material provenance and the basis for a particular handling or disposition decision.
Chemical identity does not establish pharmaceutical authenticity, lawful custody or permission to transfer.
Origin and custody
Separate verified supply history from packaging claims and suspected diversion.
Authenticity and traceability
Link origin claims to supplier, lot and custody evidence while preserving unresolved discrepancies.
- Which supplier, manufacturer, lot and custody records substantiate the claimed origin? provenance
- What evidence distinguishes authenticated pharmaceutical material, suspected counterfeit material, diversion and unknown origin? boundary
Permitted disposition
Evaluate a named action against current authority and material-specific conditions.
Action-specific authority
Record the basis for storage, testing, transfer, return or disposal rather than assigning blanket permission.
- Which jurisdiction, effective date, actor credentials and applicable authority govern the proposed action? provenance
- What material-specific containment, custody and disposal requirements must be satisfied, and what evidence records completion? action
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Kinds and varieties
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Injectable pharmaceutical fentanyl citrate (peri-operative analgesia and anaesthesia)
- Transdermal therapeutic-system patches (chronic severe pain)
- Oral transmucosal products (lozenge, buccal tablet, sublingual tablet/film for breakthrough cancer pain)
- Intranasal pharmaceutical spray
- Illicitly manufactured fentanyl (IMF) as powder
- Counterfeit pressed tablets containing fentanyl (e.g. fake oxycodone "M30")
- Fentanyl analogues treated in forensic and scheduling practice as a class (acetylfentanyl, furanylfentanyl, carfentanil, and others)
- Veterinary injectable and transdermal preparations
- Which of these kinds and varieties hold for the sense of fentanyl this model covers, and on what evidence? provenance
Identifiers and schemes
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Wikidata - Q407541 - Item for the chemical substance fentanyl.
- CAS Registry Number - 437-38-7 - Fentanyl free base.
- CAS Registry Number - 990-73-8 - Fentanyl citrate, the usual pharmaceutical salt.
- UNII - UG90S8Z5YD - FDA substance identifier for fentanyl.
- UNII - MUN5QT37C2 - Fentanyl citrate.
- ATC - N01AH01 - Opioid anaesthetic.
- ATC - N02AB03 - Phenylpiperidine analgesic.
- PubChem CID - 3345 - Compound record for fentanyl.
- InChIKey - PJMPHNIQZUBGLI-UHFFFAOYSA-N - Standard InChIKey for fentanyl.
- INN - fentanyl - WHO International Nonproprietary Name.
- DEA Controlled Substance Code Number - 9801 - U.S. CSA code for fentanyl; analogues have separate codes.
- Which of these identifiers and schemes hold for the sense of fentanyl this model covers, and on what evidence? provenance
Standards and regulation
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- United Nations Single Convention on Narcotic Drugs, 1961, Schedule I - United Nations
- U.S. Controlled Substances Act, Schedule II (ACSCN 9801) - U.S. Drug Enforcement Administration
- Misuse of Drugs Act 1971, Class A - United Kingdom
- WHO Model List of Essential Medicines (anaesthesia and palliative care) - World Health Organization
- USP monograph Fentanyl Citrate - United States Pharmacopeia
- FDA approved product labeling for injectable, transdermal, transmucosal, and nasal fentanyl - U.S. Food and Drug Administration
- Class-wide control of fentanyl-related substances (2019) - China National Narcotics Control Commission
- NIOSH/CDC guidance on occupational exposure for emergency responders - U.S. National Institute for Occupational Safety and Health
- Which of these standards and regulation hold for the sense of fentanyl this model covers, and on what evidence? provenance
Real-world use
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Intraoperative anaesthesia and immediate postoperative analgesia by intravenous bolus or infusion in hospitals.
- Transdermal patches prescribed for opioid-tolerant patients with chronic severe pain, including cancer pain.
- Oral transmucosal and nasal products for breakthrough cancer pain in opioid-tolerant patients.
- Veterinary peri-operative analgesia and anaesthesia.
- Illicit opioid markets: sold as powder, mixed into heroin or cocaine, or pressed into counterfeit oxycodone or benzodiazepine tablets.
- Harm-reduction drug checking with fentanyl immunoassay test strips.
- Emergency reversal of overdose with naloxone, often at higher or repeated doses than for heroin.
- Which of these real-world use hold for the sense of fentanyl this model covers, and on what evidence? provenance
Typical measurements
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Typical adult IV analgesic bolus - 25-100 - µg
- Commercial transdermal delivery rate - 12-100 - µg/h
- Parenteral potency relative to morphine - 50-100 - fold (mass)
- Publicly cited lethal dose in an opioid-naïve adult - about 2 (highly variable with tolerance and co-intoxicants) - mg
- IV terminal elimination half-life - 3-12 - h
- Molecular mass (free base) - 336.5 - g/mol
- Plasma protein binding - 80-85 - %
- Reported fentanyl content of counterfeit tablets - highly variable; outbreak series often ~0.1-2 - mg per tablet
- Which of these typical measurements hold for the sense of fentanyl this model covers, and on what evidence? provenance
Failure modes and hazards
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Dose-dependent respiratory depression and fatal apnoea, worsened by benzodiazepines, alcohol, xylazine, or other sedatives.
- Rapid intravenous injection can cause skeletal-muscle and chest-wall rigidity that prevents ventilation.
- Illicit dose is unknown to the user; a single counterfeit tablet can contain a lethal quantity.
- Transdermal absorption rises with heat (fever, heating pads, exertion), causing overdose from a labelled patch.
- Paediatric accidental exposure to discarded or unsecured patches.
- Misuse by extracting residual drug from used patches.
- Dependence, tolerance, and a severe withdrawal syndrome on cessation.
- Occupational hazard is primarily inadvertent inhalation or mucous-membrane contact with powder, not brief intact-skin contact; panic and poor scene practice have been documented alongside real contamination risk.
- Some analogues (notably carfentanil) are substantially more potent and may not be identified by routine immunoassay.
- Which of these failure modes and hazards hold for the sense of fentanyl this model covers, and on what evidence? provenance
Regional variation
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- United States and Canada: illicitly manufactured fentanyl, not diverted pharmaceutical product, has been the main driver of opioid-overdose deaths since the mid-2010s.
- Western and Southern Europe: heroin and diverted medicines still dominate many markets; IMF is present but generally a smaller share than in North America.
- Estonia and some neighbouring states had an earlier epidemic of 3-methylfentanyl.
- Mexico is a major trafficking and synthesis corridor into the United States; China scheduled fentanyl-related substances as a class in 2019 after earlier analogue export.
- Street names (Apache, China White, Dance Fever, "blues" for fake 30 mg oxycodone tablets, and many others) are North American law-enforcement usage and do not map cleanly to pharmaceutical nomenclature.
- Licensed transmucosal brand set and patch strengths differ by market (e.g. Actiq/Instanyl/Lazanda availability).
- Which of these regional variation hold for the sense of fentanyl this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Morphine - Naturally derived phenanthrene opioid of much lower mass potency; separated by structure and by chromatographic retention/mass spectrum, not by a clinical µ-agonist effect.
- Diamorphine (heroin) - Diacetylmorphine; GC-MS or LC-MS identification. Lateral-flow fentanyl strips detect fentanyl-class compounds and do not identify heroin.
- Oxycodone (including counterfeit "M30" tablets) - Tablets may be visually identical to pharmaceutical oxycodone but contain fentanyl; only chemical testing (immunoassay strip plus confirmatory LC-MS) separates them.
- Sufentanil, alfentanil, remifentanil - Closely related 4-anilidopiperidines used in anaesthesia; distinguished by potency, onset/offset, and targeted LC-MS, not by class immunoassay alone.
- Carfentanil - Fentanyl analogue on the order of 100 times more potent by mass, historically a veterinary immobiliser; requires targeted mass spectrometry because many clinical fentanyl immunoassays are unvalidated for it.
- Nitazenes (e.g. isotonitazene) - Benzimidazole opioids, not 4-anilidopiperidines; many fentanyl test strips do not cross-react, so a negative strip does not rule them out.
- Xylazine - Veterinary α2-agonist co-adulterant in some IMF supplies; not an opioid and not reversed by naloxone; identified by a separate assay.
- Which of these neighbouring kinds and how to tell them apart hold for the sense of fentanyl this model covers, and on what evidence? provenance
Sources
- Drug Fact Sheet: Fentanyl - Illicit supply form, Schedule II status, commonly cited 2 mg lethal-dose figure, street names, and analogue/counterfeit-tablet practice.
- PubChem Compound Summary for CID 3345, Fentanyl - Chemical identity (formula, CAS, InChIKey, UNII), pharmacological class, and identifier crosswalk.
- Fentanyl: Preventing Occupational Exposure to Emergency Responders - Occupational exposure guidance, routes of concern for first responders, and the distinction between incidental dermal contact and inhalation/ingestion risk.
- WHO Model List of Essential Medicines - Legitimate medical status of fentanyl as an essential anaesthetic and palliative-care opioid.
- Single Convention on Narcotic Drugs, 1961 - International narcotic control: fentanyl is listed in Schedule I of the Convention, which UN member states implement in domestic law.
- DURAGESIC (fentanyl transdermal system) prescribing information - Licensed transdermal strengths and rates, heat-related absorption increase, paediatric accidental-exposure hazard, respiratory depression, and other labelled risks.
What the second pass must settle
- Does an existing Vercy world model already own fentanyl, requiring vr.tr.fentanyl to link to it rather than receive a separate publication?
- Which authoritative chemical identifiers and salt relationships should define this entry, given its missing registry definition?
- Which analytical methods and acceptance criteria support fentanyl identification and quantification in each intended matrix?
- Which product-specific evidence establishes stability, integrity and residual-content assessment across the presentations the registry needs to support?
- Which jurisdictions and authorised workflows must the initial model cover, and how will their changing requirements be maintained?