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Beta-hydroxyfentanyl is a synthetic opioid analgesic and a structural analogue of fentanyl. It acts as an agonist at the mu-opioid receptor, producing effects similar to fentanyl, including analgesia, euphoria, and significant risk of respiratory depression. Beta-hydroxyfentanyl has no currently accepted medical use in the United States and is classified as a Schedule I controlled substance due to its high potential for abuse and lack of accepted safety under medical supervision. It was briefly encountered on the illicit market in the early 1980s before being regulated alongside other fentanyl analogues[1][3][4][10]. Side effects are consistent with those seen in other potent opioids: itching, nausea, miosis (pupil constriction), and potentially fatal respiratory depression[8][10].
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