E–G

ecstasy See METHYLENEDIOXYMETHAMPHETAMINE
(MDMA).

ethchlorvynol A sedating hypnotic DRUG, similar
in physiologic action and effects to BARBITURATES,
doctors may prescribe as a sleep aid to treat
insomnia. Ethchlorvynol (brand name Placidyl)
has high potential for physical DEPENDENCE and
ADDICTION, however, and is seldom the medication
of first choice in a therapeutic setting. It is a
schedule 4 drug in the United States; possession
and use are legal only with a doctor’s prescription.
TOLERANCEto ethchlorvynol develops after about
one week of taking it regularly, which means the
body requires a higher DOSEto achieve the same
effect. Taking ethchlorvynol for three weeks or
longer often establishes physical dependence;
abruptly stopping the drug after this time is likely to
result in withdrawal symptoms such as NAUSEA, agi-
tation, HALLUCINATION, tremors (“shakes”), and pos-
sibly seizures. It is important to taper the amount of
drug over days to weeks to stop taking it. As a drug
of abuse, ethchlorvynol produces an intoxicating
effect. As with other hypnotics, combining the drug
with ALCOHOLenhances the sedating effect and can
result in OVERDOSE. People who abuse substances
such as METHAMPHETAMINE or COCAINE may use
ethchlorvynol to ease the transition between the
“high” of the stimulant and the “crash” of returning
to normal state.
See also CHLORAL HYDRATE; DEPRESSANTS; HYP-
NOTICS; PRESCRIPTION DRUG ABUSE; SCHEDULED DRUGS;
STIMULANTS; WITHDRAWAL SYNDROME.

fentanyl A narcotic PAINreliever about 80 times
more potent than morphine. Fentanyl’s primary
therapeutic uses are for intravenous anesthetic
during surgery and for analgesia (pain relief) after

major operations such as OPEN HEART SURGERYor to

treat significant CHRONIC PAINsuch as may occur

with terminal cancer. Fentanyl is a schedule 2

DRUGin the United States, strictly regulating its

legitimate use. Numerous analogs (pharmacologic

derivations) of fentanyl are available illicitly,

though only a few are available for legitimate use.

As a drug of abuse fentanyl produces effects

similar to those of HEROINthough is significantly

more potent. The most common method of

administration, as with heroin, is intravenous

injection (using a needle to inject the drug directly

into a VEIN). Other forms of fentanyl subject to

abuse are transdermal patches (Duragesic) and a

“lollipop” that allows the drug to enter the BLOOD

circulation by being absorbed through the mucous

membrane of the MOUTH (transmucosal absorp-

tion). The risk for OVERDOSE is very high with

abuse of these forms of fentanyl, as their structure

releases a consistent amount of the drug over an

extended period of time and consuming them

faster than intended releases excessive amounts of

the drug. Fentanyl has a high risk for DEPENDENCE

and ADDICTION, with significant withdrawal symp-

toms when stopping the drug.

See also ANALGESIC MEDICATIONS; ANESTHESIA;

ILLICIT DRUG USE; KETAMINE; OPIATES; PHENCYCLIDINE

(PCP); PRESCRIPTION DRUG ABUSE; SCHEDULED DRUGS;

WITHDRAWAL SYNDROME.

fetal alcohol syndrome A constellation of BIRTH

DEFECTSthat may occur as a result of a woman’s

ALCOHOLconsumption during the early stages of

PREGNANCY. About 6,000 infants are born with fetal

alcohol syndrome (FAS) each year in the United

States. Up to five times as many more infants are

born with symptoms of alcohol exposure during

prenatal development, although they do not have

334