Fentanyl Addiction

What Is Fentanyl?

Fentanyl is a strong analgesic (or painkiller) and one of the most potent prescription opioids available. Fentanyl is typically prescribed to patients for chronic or severe pain.

Fentanyl is a synthetic drug, which means it is not made from natural ingredients. Prescription fentanyl is created in a lab, while illicit fentanyl is mass-produced in unsafe facilities (like underground basements) in China and Mexico. While fentanyl and morphine are similar, morphine is considered a natural drug because it is made from the poppy plant.

This list provides some context for fentanyl’s potency and how it compares among 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

Fentanyl Prescriptions

Prescription fentanyl is commonly provided as a wearable patch, but can also be prescribed as a lozenge, intravenous shot, or nasal spray. If prescribed fentanyl patches, be sure to take off the old one when applying a new patch. Fentanyl patches are cumulative, so if old patches aren’t removed they can cause respiratory suppression and ultimately overdose.

The most common name brands of fentanyl prescriptions include:

• Actiq®
• Duragesic®
• Sublimaze®

Fentanyl carries the same risks as all Schedule II drugs with a high likelihood of abuse, dependence, and addiction.

Side Effects of Fentanyl Use

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.

Additional effects that fentanyl may cause are:

• Euphoria
• Confusion
• Nausea
• Unconsciousness
• Slowed breathing
• Constipation
• Chills or feeling cold
• Trouble sleeping
• Unusual drowsiness

Prescription fentanyl is considered safe to use for a short time as directed by a doctor or healthcare provider, but it also comes with the risk of addiction and abuse. It should only be used under the careful supervision of a healthcare provider to treat chronic pain.

Fentanyl Abuse and Addiction

Fentanyl can seem appealing to illicit drug users due to its potency. Illegal fentanyl is referred to by street names such as “China White” or “Dance Fever.” In its raw form, fentanyl appears as a white powder that has no taste or smell.

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

Illegal fentanyl labs also manufacture fentanyl on blotter paper that dissolves on the tongue, or as counterfeit pills.  An estimated 2 in every 5 of these counterfeit pills contain a lethal dose of fentanyl. Two common examples are the fake blue “Oxy 30s” and the two-milligram Xanax “bars.” Typically these pills are made solely of fentanyl and fillers.

The Drug Enforcement Agency (DEA) reports an increase in fentanyl-related deaths resulting from fentanyl being mixed into other drugs, such as heroin or cocaine. Many drug users and drug dealers are not aware that fentanyl has been mixed in with these other drugs.

Risks of Fentanyl Abuse

In addition to being sought after for its strong effects, drug dealers also add fentanyl to their other products to make them stronger and more addictive. This also makes these drugs even more dangerous. If a drug user is unaware that the drugs they’ve purchased contain fentanyl, they are at a much higher risk of overdose and death.

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

The most common synthetic opioid is fentanyl.

Fentanyl Withdrawal

If you have become addicted to fentanyl, your first step will be to discontinue the use of fentanyl. This is known as detoxing. The safest method is detoxing with medical assistance. Withdrawal from fentanyl, like other opiates, can be unpleasant and even dangerous without proper medical support.

Fentanyl withdrawal symptoms can include:

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

Medical detox is highly recommended when quitting a drug addiction for fentanyl. Not only will a medically-supervised detox lessen the above withdrawal symptoms, but it will also prevent more severe complications like seizures or coma.

Fentanyl Overdose

If you have a prescription for fentanyl, be sure to take it exactly as directed. If you miss a dose, do not take twice as much next time. Do not change the ingestion method from how it is prescribed; use lozenges as lozenges, patches as patches, and so on.

As of April 2021, federal funding is 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.

“This is a major step forward in the ongoing and critical work to prevent overdose and connect people who have substance use disorders to evidence-based treatment options.”

—Tom Coderre, Acting Assistant Secretary for Mental Health and Substance Use at SAMHSA

Signs of Fentanyl Overdose

A victim of fentanyl overdose will first become drowsy and fall asleep, and it will be difficult to wake them.

Additional fentanyl overdose signs include:

• Small or pinned pupils
• Slowed or no breathing
• Unconsciousness

The skin may get cold or clammy and the body is usually very limp. Vomiting may also occur along with a gurgling noise and shallow, staggered breathing (known as the “death-rattle”). Lighter-skinned victims often get a blue or grey tint to their skin, especially around the eyes or mouth.

If you suspect someone has overdosed on fentanyl, here are the steps to take:

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 boney center of their chest.
3. Administer naloxone (such as Narcan®).
4. Stay with the victim until help arrives.

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 detoxification is usually the first step in fentanyl addiction treatment.

During your medical detox, a healthcare provider will help you wean off fentanyl. This process may include a prescription for a less potent, safer opioid (such as Suboxone®) to allow the body to adjust its need for fentanyl use. This process is also known as tapering.

Over time the patient will take smaller doses of the methadone or Suboxone until they have safely eliminated their body’s need for opioids. Medically detoxing helps the addict by decreasing withdrawal symptoms while safely eliminating the body’s dependence on fentanyl.

Fentanyl Treatment Programs

After the detox process for fentanyl addiction, the next step is to choose a rehabilitation program. Rehab will assist you with further treatment and mental health support, and help you to avoid relapse or future drug addiction.

There are a few different options for this type of treatment, which include inpatient programs and outpatient programs. No matter which option you choose, the most important part is taking that first step toward your recovery.

Inpatient Rehab Program

An inpatient rehab program is an on-site facility for you to receive 24/7 care and support for your fentanyl addiction. This type of program lasts anywhere from 28 days to 6 months. It can be more expensive than other treatment options but is often the most successful for people seeking treatment for fentanyl addiction. This is often the recommended treatment for someone who is heavily addicted.

Partial Hospitalization Program (PHP)

The partial hospitalization program, or PHP, is often recommended for patients who need more regular care and support. They will visit a hospital or treatment center a few times weekly for roughly 25-30 hours each week to receive therapy, assessments, and similar help.

Intensive Outpatient Program (IOP)

An intensive outpatient program, also known as an IOP, is an off-site program. The typical length is about 3 months and takes a commitment of about 15-20 hours per week. The patient will receive counseling, assessments, and additional support. An IOP is often recommended for someone who is struggling with a mild addiction to drug use.

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment, or MAT, focuses on improving the recovering addict’s mental health after rehab. Medication and behavioral therapy will help the patient stay sober and avoid falling back into fentanyl abuse in the future. MAT typically occurs alongside additional treatment options.

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

The most common MAT medications prescribed are:

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

The patient will also receive behavioral therapy to help them recover from the psychological and emotional effects of addiction. This counseling will help strengthen the overall mental health of the former addict.

Fentanyl Statistics

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.

Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States. In 2017, 59.8 percent of opioid-related deaths involved fentanyl compared to 14.3 percent in 2010.

—DrugFacts, National Institute on Drug Abuse (NIDA)

The Centers for Disease Control and Prevention (CDC) reports a major rise in opioid-related overdose deaths since May 2020. The organization suspects fentanyl abuse is the main reason for this increase.

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

Is Your Loved One Struggling With a Fentanyl Addiction?

If you’re concerned about a loved one who may have fentanyl or opioid addiction, we’re here for you, too. Substance abuse doesn’t just affect the addict. Family members and friends of addicts are also negatively impacted. Understanding the effects of fentanyl may be helpful, but if you are seeking additional support you have options.