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Fentanyl is a narcotic (opioid) pain medicine.

It is used to treat "breakthrough" cancer pain that is not controlled by other medicines. Fentanyl is a Schedule II drug under the Controlled Substances Act with an accepted medical use as a pain reliever. 

Abstract

Fentanyl is a narcotic (opioid) pain medicine.

Fentanyl buccal is used to treat "breakthrough" cancer pain that is not controlled by other medicines. Fentanyl buccal is taken together with other non-fentanyl narcotic pain medicine that is used around the clock. This medication is not for treating pain that is not cancer-related, such as general headaches or back pain.
[1]

Street Names

China girl
China town
China White
Dance fever
Friend
Goodfellas
Great bear
He-man
Jackpot
King ivory
Murder 8
Tango
Cash
TNT
[2]

Brand Names

Fentora
Onsolis
[1]

Uses

Fentanyl is used to manage moderate to severe pain, usually in people who have chronic pain. Fentanyl is often used when your other pain medicines no longer work.
Besides such clinical uses, illicit uses of fentanyl is also well known. Because the effects of fentanyl last for only a very short time, regular users may become addicted very quickly.
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History

Fentanyl was first synthesized by Paul Janssen under the label of his relatively newly formed Janssen Pharmaceutica in 1959. In the 1960s, fentanyl was introduced as an intravenous anesthetic under the trade name of Sublimaze. In the mid-1990s, Janssen Pharmaceutica developed and introduced into clinical trials the Duragesic patch, which is a formation of an inert alcohol gel infused with select fentanyl doses which are worn to provide constant administration of the opioid over a period of 48 to 72 hours. After a set of successful clinical trials, Duragesic fentanyl patches were introduced into the medical practice.
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Pharmacology

The chemical formula for fentanyl is: C22H28N2O

The mechanism of action of fentanyl is best described by its agonist interaction with the opioid µ-receptor. These sites of interaction are primarily distributed throughout the central nervous system via the brain, spinal cord, and other tissues. As a lipophilic compound, the central nervous system penetrability of fentanyl is 100 times greater than that of morphine. Fentanyl also possesses less of an emetogenic potential and weaker allergenic activity compared with that of morphine or meperidine.
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Scheduling

Fentanyl is a Schedule II drug under the Controlled Substances Act with an accepted medical use as a pain reliever. Hydromorphone has a high potential for abuse and use may lead to severe psychological or physical dependence.
Also some fentanyl analogues are classified as Schedule I drug, which means, they have "no currently accepted medical use
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Psychological and physical addiction liability

In some people, fentanyl impairs balance, coordination, or the ability to think. Do not drive or operate any type of equipment if you are taking fentanyl. If you have severe side effects, call your doctor, and stop taking this medicine.

Drowsiness
Lightheadedness
Weakness and fatigue
Feelings of elation (euphoria).
Dry mouth.
Difficulty urinating.
Difficulty breathing.
Constipation
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Withdrawal Effects

According to a range of Medical journals there is also an often under-emphasized potential for withdrawal syndrome which may last until after the initial short-term. Withdrawal syndrome may induce or mimic psychiatric disorders temporarily or long term such as Depression (clinical), Anxiety disorder, Psychosis and in rare cases, even Suicidal ideation. Post-acute-withdrawal syndrome will continue for some months (usually 1–3 months or more) after prolonged cessation of usage.
If patients have only taken low doses of fentanyl for short periods of time, experts recommend that they quit "cold turkey" and weather the uncomfortable physical fentanyl withdrawal side effects.
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Long term effects

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; fainting; hallucinations; muscle rigidity; seizures; severe or persistent dizziness, headache, or light-headedness; slow or irregular heartbeat; slow or shallow breathing; trouble breathing; weakness.

A number of fatal fentanyl overdoses have been directly tied to the drug over a period of years. In particular, manufacturers of time-release fentanyl patches have come under scrutiny for defective products. While the fentanyl contained in the patches was safe, a malfunction of the patches caused an excessive amount of fentanyl to leak and become absorbed by patients, resulting in life-threatening side effects and even death.
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Physical Effects

Commonly observed physical effects of fentanyl are:

Dry mouth
Difficulty urinating
Difficulty breathing
Skin reactions, such as irritation, itching, or hives
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Medical Treatment options

In cases of severe dependence, medical detoxification is recommended to ensure that the patient acquires the professional attention need to safely and comfortably come off of the drug. Generally, patients will receive medication specific to opiate abuse to assist in creating a comfortable transition from dependence to abstinence. A medical detox facility greatly reduces the chance of relapse as most of the physical withdrawal symptoms are decreased due to medication.

Psychological treatment options

Inpatient addiction treatment centers are among the most successful options when combating Fentanyl addiction. Most treatment facilities offer a variety of therapy options to help the addict realize the root of their addiction and various programs to ensure long term sobriety is achieved. Many addicted patients have realized success through 12-step meetings. Continued care is recommend to increase chances of long-term sobriety. Sober living homes offer a safe place for addicted patients to transition back into society while still holding them accountable to their sobriety and maintaining structure. Outpatient treatment has also been successful in helping addicted patients achieve sobriety. Outpatient services may include group and individual therapy, case management and random urinalysis testing

Related Drugs

The drugs that are related to fentanyl are:

Opium
Codeine
Heroin
Methadone
Hydrocodone
Oxycodone

Related Synthetics

The related synthetics to fentanyl are:

Oxycodone
Hydrocodone
Buprenorphine
Hydromorphone
Methadone
Naloxone

References:

[1] http://www.drugs.com/fentanyl.html
[2] http://www.drugabuse.gov/drugs-abuse/fentanyl
[3] http://www.webmd.com/pain-management/fentanyl
[4] http://www.justice.gov/dea/concern/fentanyl.html
[5] http://www.drugs.com/sfx/fentanyl-side-effects.html
[6] http://www.dependency.net/learn/fentanyl/
[7] http://www.ncbi.nlm.nih.gov/pubmed/1517629