The information and recommendations below were developed to address a wide area release of fentanyl as a weapon of terrorism, and are not specifically intended to address exposures associated with fentanyl use as an illicit drug. NIOSH is currently in the process of reviewing more recent research and publications regarding appropriate emergency response guidelines for fentanyl. Consequently, some of the guidelines presented on this page may be different than recommendations for emergency response personnel responding to fentanyl used as an illicit drug. Please see this website for information for emergency response personnel responding to fentanyl as an illicit drug: https:///niosh/topics/fentanyl/ .
Risks of Use in Patients with Increased Intracranial Pressure, Brain Tumors, Head Injury, or Impaired Consciousness: In patients who may be susceptible to the intracranial effects of CO 2 retention (., those with evidence of increased intracranial pressure or brain tumors), ACTIQ may reduce respiratory drive, and the resultant CO 2 retention can further increase intracranial pressure. Monitor such patients for signs of sedation and respiratory depression, particularly when initiating therapy with ACTIQ. Opioids may also obscure the clinical course in a patient with a head injury. Avoid the use of ACTIQ in patients with impaired consciousness or coma.