Armenian's patient became unconscious 30 minutes after taking the fake Norco and was brought to the emergency department. She expressed concern to the emergency department staff that her usual medications did not affect her this way and showed them the pills she had taken.
The fake pills have the manufacturer's imprint and looks-wise differ only in color from the real pills beige versus white. Her blood tested positive for significant amounts of fentanyl and U, a synthetic opioid, neither of which is an ingredient in brand-name Norco. From March to April, , 12 fentanyl-related fatalities and 40 additional cases of toxicity were reported in Sacramento and Yolo counties in North California due to fake Norco pills containing fentanyl.
Additional cases were identified in the San Francisco area. Many novel psychoactive substances are produced in China, then enter the U.
Since more than psychoactive substances, including six fentanyl analogs, were banned by China in , novel synthetic opioids such as U and W have entered the market, replacing more established and outlawed drugs.
Materials provided by American College of Emergency Physicians. This will allow your doctor to see if the medicine is working properly and to decide if you or your child should continue to take it. Blood and urine tests may be needed to check for unwanted effects. It is against the law and dangerous for anyone else to use your medicine.
Keep your unused tablets in a safe and secure place. People who are addicted to drugs might want to steal this medicine. This medicine will add to the effects of alcohol and other CNS depressants medicines that can make you drowsy or less alert. Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicine, other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics numbing medicines , including some dental anesthetics.
Also, there may be a greater risk of liver damage if you drink three or more alcoholic beverages while you are taking acetaminophen. Do not drink alcoholic beverages, and check with your doctor before taking any of these medicines while you are using this medicine. This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose.
If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Your doctor may also give naloxone to treat an overdose. Signs of an overdose include: cold, clammy skin, coughing that sometimes produces a pink frothy sputum, dark urine, difficult or trouble breathing, irregular, fast or slow, or shallow breathing, nausea, vomiting, pain in the upper stomach, pale or blue lips, fingernails, or skin, pinpoint pupils of the eyes, or yellow eyes or skin.
This medicine may cause sleep-related breathing problems eg, sleep apnea, sleep-related hypoxemia. Your doctor may decrease your dose if you have sleep apnea stop breathing for short periods during sleep while using this medicine. This medicine may cause adrenal gland problems. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin.
These could be symptoms of a serious liver problem. This medicine may cause serious skin reactions eg, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, toxic epidermal necrolysis. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.
This medicine may cause a serious type of allergic reaction called anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.
This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you or your child to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.
Before you or your child have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of certain tests may be affected by this medicine. Do not change your dose or suddenly stop using this medicine without first checking with your doctor.
Your doctor may want you or your child to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, including stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping.
Using this medicine while you are pregnant may cause serious unwanted effects, including neonatal withdrawal syndrome in your newborn baby. Tell your doctor right away if your child has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, sneezing, weight loss, vomiting, yawning, or failure to gain weight.
Check with your doctor right away if you think you are pregnant or if you plan to become pregnant while using this medicine. Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there.
These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.
Using too much of this medicine may cause infertility unable to have children. Talk with your doctor before using this medicine if you plan to have children. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription over-the-counter [OTC] medicines and herbal or vitamin supplements. David is also a public speaker and the author of two books.
David is cohost of the weekly Positive Sobriety Podcast, as well as being a frequent contributor to various articles and recovery based materials.
As a member of the National Association of Alcohol and Drug Abuse Counselors NAADAC , David works closely with Nashville area treatment centers, nonprofit recovery organizations, and consulting with faith-based groups trying to bridge the gap between the recovery communities and faith-based organizations who wish to understand addiction.
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