Fentanyl is a powerful opioid painkiller that is often misused and abused.Fentanyl, which was first used in medical settings in the 1960s, began to be illicitly used in the 1970s. The drug binds to the opioid receptors in the user’s brain and creates a euphoric rush of dopamine. It also rewires the brain, which means people quickly build a tolerance to it and this ultimately contributes to how addictive and deadly it is.
Opioids like fentanyl depress the respiratory system and can also cause bradycardia, which is a slow, irregular heartbeat.
One of the serious and frequently deadly side effects of using fentanyl is something called chest wall rigidity, also referred to as wooden chest syndrome.
What is Chest Wall Rigidity?
Before looking at why fentanyl causes chest wall rigidity, it can be helpful to have an understanding of what this is.
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Chest wall rigidity refers to what happens when the thoracic muscles become rigid, which impacts respiration. It can also impact the abdominal muscles and similarly cause them to become rigid. It makes breathing hard, but naloxone can reduce the symptoms when this happens because naloxone reverses opioid effects.
Chest wall rigidity is most often associated with using opioids like fentanyl intravenously and there has been research recently showing that at least some of the deaths related to injecting fentanyl illicitly could be attributed to chest wall rigidity.
Until very recently, it wasn’t reported as a factor in drug abuse deaths. Now, doctors and researchers are pushing for people to understand that the development of chest wall rigidity is another way they can die from the use of fentanyl and similar drugs.
Along with fentanyl causing chest wall rigidity, the condition has also been shown to occur with the rapid intravenous use of other synthetic opioids that are related to fentanyl.
Fentanyl has become a big part of the illicit heroin market because it’s often much stronger than heroin, leading to an increase in the intravenous use of the drug that is thought to be related to the rise in the number of deaths in recent years.
In rare cases, the use of fentanyl in anesthetics has also been shown to lead to chest wall rigidity.
Understanding fentanyl and chest wall rigidity are important as the opioid epidemic continues to grow. In fact, 75 percent of men and women in Massachusetts who died from an unintentional overdose in 2016 had fentanyl in their system.
There is often little to no warning when a fentanyl overdose occurs. One of the reasons might be because of wooden chest syndrome.
Wooden chest syndrome makes CPR incredibly difficult to perform on someone who may be experiencing a medical emergency or overdose. When the person’s brain is cut off from oxygen, even for a short time, brain cells start to die.
Why Does Fentanyl Cause Chest Wall Rigidity?
It’s believed that fentanyl causes chest wall rigidity because of the general effects the drug has on the respiratory system. Opioids like fentanyl directly impact the respiratory center.
There is thought to be some interaction between the slowing of the entire respiratory system and the paralyzing of the chest muscles that are related to one another.
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