How many doses does a point (0.1 grams) equate to?
Given fentanyl's brief duration of action, does it have to be consumed more frequently than H (for example)? The vast majority of H users consume three doses per day and where I am, that's around 50mg per dose (a point costs £10 and my HR friends inform me that local H is around 50% pure).
I would not be at all surprised if a market for a much longer-acting opioid springs up. Long ago I knew a chemist in Russia who made methadone which was sold on the street because the state didn't and doesn't provide it.
FYI given it's huge potency, I suspect the doses of methadone needed to prevent WD in someone dependent on fentanyl might be dangerous as methadone is known to be cardiotoxic. A few years ago a friend got off H and was doing really well only to suffer a fatal heart attack. He was consuming something like 240mg methadone/day.
While by no means cheap, there is a methadone derivative shown to be some x212 methadone in potency and equally important, it's half-life is 20.5 hours compared with just 8 hours for methadone (although some methadone metabolites are active). Now ORLAAM was briefly used and proved convenient because it could be consumed three times a week BUT it proved to be even more cardiotoxic.
But as far as I know, levoacetylspiridone (a name used for convenience) is not cardiotoxic.
It's duration isn't as long as ORLAAM (a massive 2.6 days) but it strikes me that it may represent a medicine with a higher MOR affinity than most fentanyl analogues (thus it will blockade the receptors), has high oral bioavailability (no need for needles) and I think key, it appears that onset (when consumed orally) is very slow indeed. Combine slow onset and long duration and you have a medicine not suited to 'abuse'.
FYI until a few years ago Dutch HR agencies sometimes used a related high-potency, long-duration, slow-onset medication in substitution therapy but for political reasons it's usage was discontinued.
I find it hard to fathom that levoacetylspiridone isn't used medically. While one could not patent the compound, in this day and age I feel fairly certain that it's use in substitution therapy could be patented. I can only conclude that US culture still doesn't accept the disease model of addiction and thus isn't really trying to find a way to reduce the tidal wave of fatal overdoses.
