The first form of fentanyl that was approved by the FDA was an injectable formulation for use in surgery and other medical procedures. This form of the drug is typically administered by a healthcare provider, and it is used to provide rapid and effective pain relief during and after surgical procedures. The injectable form of fentanyl is still used today in a variety of medical settings, and it is often used in combination with other drugs, such as benzodiazepines or propofol, to provide sedation and anesthesia during procedures.

Over time, additional forms of fentanyl have been developed and approved by the FDA. In the 1990s, a fentanyl patch was approved for use in patients with chronic pain. The patch slowly releases the drug into the bloodstream over a period of 72 hours, providing long-lasting pain relief for patients who are unable to take oral medications. Fentanyl patches are still commonly used today, although there have been concerns about their potential for misuse and abuse.

In addition to injectable formulations and patches, fentanyl is also available in other forms, such as lozenges, nasal sprays, and sublingual tablets. These formulations are typically used for breakthrough pain in patients who are already taking opioids for chronic pain management. For example, a patient with chronic pain may be prescribed extended-release opioid medication to manage their pain, but they may also be given a fentanyl lozenge to use as needed for sudden episodes of breakthrough pain.

Fentanyl has also been used in a variety of other medical applications over the years. For example, it has been used to manage pain in cancer patients, as well as in patients who are undergoing cardiac surgery or other major procedures. Fentanyl has also been used in emergency medicine to manage pain and sedate patients who are in critical condition.

Despite its many medical applications, fentanyl has also been associated with a growing public health crisis in recent years. Illicitly manufactured forms of the drug, such as fentanyl analogs, have been responsible for a growing number of overdose deaths in the United States and around the world. These forms of the drug are often mixed with other substances, such as heroin or cocaine, and they are extremely potent and dangerous.

In response to this crisis, the FDA has taken a number of steps to try to address the issue of fentanyl misuse and abuse. For example, the agency has worked to increase access to opioid overdose reversal medications, such as naloxone, and it has taken steps to reduce the availability of illicitly manufactured fentanyl analogs. The FDA has also worked to improve prescribing guidelines for opioids, including fentanyl, and it has encouraged healthcare providers to consider non-opioid pain management options whenever possible.

In conclusion, fentanyl was first approved by the FDA in 1968, and it has since been used in a variety of medical applications, including pain management and anesthesia. The drug is extremely potent and effective, but it is also associated with a growing public health crisis related to opioid misuse and abuse. The FDA has taken a number of steps to address this crisis, including improving prescribing guidelines and increasing access to overdose reversal medications. Despite these efforts, the issue of fentanyl misuse and abuse remains a significant public health concern.