Fentanyl Addiction

About Fentanyl Addiction

Fentanyl has become one of the most abused opioids due to its explosive growth on the black market. In addition to being significantly stronger than morphine, it has caused the overdose deaths of thousands of people.

However, prescription fentanyl has a legitimate medical use—particularly for individuals with severe pain. It is considered safe to use under the direction of a physician or similar medical professional.

Learn more about this potent opioid, including what you should know if you use it legally, what potential side effects it can cause when abused, and what to expect from addiction and recovery from opioid use disorder.

What Is Fentanyl?

Fentanyl is a strong painkiller (i.e., analgesic) and one of the most potent prescription opioids available. Doctors typically prescribe fentanyl for chronic or severe pain patients.

This list provides some context for fentanyl’s potency and how it compares to other opiates:

• Morphine: Commonly used when lesser painkillers are no longer effective.
• Oxycodone: 1.5x stronger than morphine
• Heroin: 2-5x stronger than morphine
• Fentanyl: 50-100x stronger than morphine

Prescription Fentanyl VS Illicit Fentanyl

Prescription fentanyl is commonly prescribed as a wearable patch, but doctors may also prescribe it as a tablet, intravenous shot, or nasal spray.

The most common name brands of fentanyl prescriptions include:

• Actiq®
• Duragesic®
• Sublimaze®

Fentanyl carries the same risks as all Schedule II drugs, having a high likelihood of abuse, dependence, and addiction. Use as directed by your doctor or healthcare provider to reduce your risk.

Illicit fentanyl, unlike its prescription drug counterpart, is mass-produced in unsafe facilities (like underground basements) in China and Mexico.

In recent years, fentanyl is also being mixed in with other drugs—including heroin, meth, ecstasy, and cocaine. It has also appeared in other drugs like marijuana.

As of 2022, the U.S. Drug Enforcement Administration (DEA) posted a public health alert to announce that 6 out of 10 fake pills contain a potentially lethal dose of fentanyl.

Illegal fentanyl is referred to by street names such as “China White” or “Dance Fever.” In its raw form, fentanyl is a white powder with no taste or smell and can only be detected in other substances through testing.

Fentanyl Abuse and Addiction

Fentanyl can seem appealing to illicit drug users due to its potency. In contrast, other illicit drug users may not be aware that fentanyl is present in the drug they are taking (typically cocaine, methamphetamine, ecstasy, and heroin).

Someone abusing pharmaceutical fentanyl will typically misuse fentanyl patches or pills. The fentanyl patches are chewed, sucked on, inserted, or scraped to remove the gel to inject it. Pills are consumed normally or crushed to be smoked, snorted, or injected.

The following warning signs may indicate a person is abusing fentanyl:

• Pinpoint pupils
• Being unusually drowsy, potentially coming in and out of consciousness
• Used fentanyl patches that appear scraped
• Crushed pills
• Multiple prescriptions, sometimes from more than one doctor

People hiding an addiction may also self-isolate and lose interest in activities they once enjoyed. They may also begin to have issues at work or in relationships as they become more devoted to their fentanyl habit.

Additional behavioral changes like poor hygiene, abnormal sleep schedules, or financial problems may also indicate a substance use problem.

Side Effects of Fentanyl Abuse

Fentanyl works like other opiates by binding to your brain’s opioid receptors, which control pain and emotions. When fentanyl binds to this part of your brain, it blocks sensations caused by chronic pain.

Fentanyl is also a respiratory depressant, which slows down your breathing and heart rate. When a person abuses fentanyl, they risk causing their heart rate or breathing to slow down to life-threatening levels.

Additional effects that fentanyl may cause are:

• Euphoria
• Confusion, inability to focus
• Nausea
• Pinpoint pupils
• Constipation
• Chills or feeling cold
• Trouble sleeping
• Slowed breathing
• Unusual drowsiness and sedation
• Unconsciousness

Risks of Fentanyl Abuse

Fentanyl is incredibly potent and designed to treat severe or end-of-life pain. As a result, abusing fentanyl has a high risk of causing addiction, overdose, and death.

Unfortunately, some drug users seek out fentanyl due to its potency. It is approximately 50 times stronger than heroin, putting the user at a greater risk of overdose.

Some illicit drug distributors have also started adding fentanyl to other substances to make them stronger and more addictive. In many cases, these drug users are unaware that their drugs contain fentanyl and that they have a much higher chance of overdosing.

The CDC reports 71,000 deaths resulting from a drug overdose in 2019. Of those 71,000 deaths, nearly 73% resulted from synthetic opioid overdoses.

The most common synthetic opioid is fentanyl.

Fentanyl Overdose

Because fentanyl is so potent, even a tiny amount can lead to an overdose. A victim of fentanyl overdose will first become drowsy and fall asleep, and it will be difficult to wake them.

The most common fentanyl overdose signs include:

• Small or pinned pupils
• Slowed or no breathing
• Unconsciousness
• Cold, clammy skin
• The body is unusually limp
• Unresponsive to touch or sound
• Vomiting
• Shallow, gasping breaths (also known as the “death rattle”)
• Blue or grayish tint to the skin, especially around the eyes and mouth

What to Do for a Fentanyl Overdose

1. Immediately call 911 and report an overdose.
2. Try to awaken the victim. You can speak loudly, pinch them, or perform a sternum rub by running your knuckles up and down the bony center of their chest.
3. Administer naloxone (e.g., Narcan®). Note that naloxone only pauses the effects of the fentanyl. The victim may become conscious, but this DOES NOT mean the overdose is over!
4. Encourage the overdose victim to wait for emergency personnel, as they can return to an overdose once the naloxone wears off.
5. Stay with the victim until help arrives. 

As of April 2021, federal funding became available for purchasing rapid fentanyl testing strips. These rapid tests will help users and communities determine whether drugs have fentanyl hidden within them, which should decrease the current trend of overdoses.

Fentanyl Addiction Treatment

If you have found yourself addicted to or abusing fentanyl and want to stop, you’ve come to the right place. We’ve compiled a list of fentanyl treatment options and what to expect along your journey to recovery.

Medical Detox

Medical detox is highly recommended as the first step in fentanyl addiction treatment.

Not only will a medically supervised detox lessen the potential withdrawal symptoms, but it will also prevent more severe complications like seizures or coma.

Fentanyl withdrawal symptoms can include:

• Chills
• Muscle aches or soreness
• Restless leg syndrome
• Runny nose
• Trouble sleeping
• Anxiety
• Strong cravings for fentanyl
• Nausea, stomach cramps, vomiting, or diarrhea

During your medical detox from fentanyl, a healthcare provider may also prescribe a safer opioid medication to help your body get used to the lack of fentanyl in your system. This process is also known as tapering.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) is often recommended during and after medical detox as part of fentanyl addiction treatment.

During MAT, a doctor or other healthcare provider may prescribe the recovering addict medication to help return their brain chemistry to normal while reducing cravings, lessening the intensity of withdrawal symptoms, and decreasing the chances of overdose.

The most common MAT prescribed for fentanyl addiction recovery include:

• Buprenorphine (Suboxone®, Subutex®)
• Naltrexone (Vivitrol®)
• Methadone

Fentanyl Rehab Programs

After the detox process for fentanyl addiction, the next step is to choose a rehabilitation program. Fentanyl rehab programs can assist with medical treatment, mental health support, and relapse prevention.

There are a few different options for this type of treatment, including inpatient and outpatient programs.

No matter which option you choose, each program will include behavioral therapy (typically through individual and group counseling sessions) plus additional resources and education to help prevent relapse and encourage lifelong abstinence from fentanyl abuse.

• Inpatient Rehab: An inpatient rehab program is a residential facility for patients to receive 24/7 care and support. Inpatient rehab lasts anywhere from 28 days to 6 months.
  Inpatient rehab is ideal for individuals with a moderate to severe addiction, a previous history of substance use disorder, and/or a need to remove themselves from their living situation.
• Partial Hospitalization Program (PHP): The PHP is an outpatient style of rehab that offers much of the same care and structure as inpatient rehab but without requiring a residency.
  A PHP may be recommended for recovering fentanyl addicts who need more regular care and support but cannot attend a residential program.
• Intensive Outpatient Program (IOP): An IOP offers the lowest level of treatment for dealing with fentanyl addiction. It can be recommended for patients with a minor addiction.
  IOP may also be recommended after the person completes a more involved program, such as a PHP or residential rehab stay.

Fentanyl Statistics

The overall statistics for fentanyl abuse and addiction may seem grim.

Since 2016, the number of fentanyl-related overdoses has increased 540%. Fentanyl is so potent that even a dose as small as a grain of sand can cause overdose and death.

According to the National Institute on Drug Abuse (NIDA), synthetic opioids (including fentanyl) are now the most common drugs involved in drug overdose deaths in the United States.

In 2017, 59.8% of opioid-related deaths involved fentanyl, compared to 14.3% in 2010.

The Centers for Disease Control and Prevention (CDC) reports a major rise in opioid-related overdose deaths since May 2020. Experts believe this increase was partly due to the isolation many people experienced during the COVID-19 lockdowns.

When examining fentanyl alongside the overall opiate epidemic, current research indicates that 136 people die each day due to an opioid-related overdose—and synthetic opioids make up nearly 73% of those overdose deaths.

What to Do If Your Loved One Has a Fentanyl Addiction

If you’re concerned about a loved one who may have fentanyl or opioid addiction, the first thing to remember is that you aren’t alone. It can be incredibly difficult to cope with the different parts of their addiction, from worry for their well-being to frustration and anger about their drug use.

Support groups such as Nar-Anon exist specifically for friends and family members of people with drug addiction. These groups provide support and empathy from other people with similar experiences who can relate to what you’re going through.

Ultimately, while challenging, it’s important to remember that the addicted person can only get help if they are willing; they cannot be coerced or forced to seek fentanyl addiction treatment.

That said, providing resources and information about fentanyl addiction can be effective. You may also consider staging an intervention or doing something as simple as holding a firm boundary about behaviors you will not tolerate.

Find Fentanyl Addiction Treatment Near You

If you need to find resources for dealing with a fentanyl addiction for either yourself or a loved one, you can check out SAMHSA’s online treatment locator or call their toll-free helpline at 1-800-662-4357 (HELP).

This free, confidential program can help you locate treatment options in your area.