Paramedic here... I agree wholeheartedly. I see both the best and worst of fentanyl. I have woken up plenty of folks who took a much bigger dose than they expec

Paramedic here... I agree wholeheartedly. I see both the best and worst of fentanyl. I have woken up plenty of folks who took a much bigger dose than they expected (because it was cut with more fentanyl than usual), and pronounced more than a couple people dead for the same reason... That being said, it's my go-to tool for analgesia. It acts a lot faster than morphine, and wears off faster as well (which is a useful property in the event of an adverse reaction). Before we carried fentanyl, it would not be uncommon for some patient's pain to remain untouched by morphine. I've yet to have that happen with fentanyl. Carrying fentanyl means the difference between "Let's get some pain medication in place before we manipulate your broken leg in order to splint it" vs "Morphine is gonna take 20 minutes to reach a meaningful therapeutic effect, and we don't have time for that, so just grit your teeth and we'll try to be quick".