What Is Fentanyl?
Fentanyl is a prescription painkiller designed to treat the most severe pain. Fentanyl is usually the last option available in treating pain because it is so strong. In fact, fentanyl is 50-100x stronger than morphine.
Legally Prescribed Fentanyl
Legal prescription fentanyl comes as a lozenge, a nasal spray, or as an injectable. Individuals with a fentanyl prescription are strongly encouraged to always take their fentanyl dosage on time and exactly as prescribed (i.e. not crushing and snorting pills or chewing patches).
Common prescription fentanyl brand names include:
Fentanyl is a synthetic opioid, meaning it is created in a lab. Fentanyl is not made organically like opiates such as morphine (and subsequently, heroin). However, fentanyl is also relatively cheap to produce and is made illegally on the black market.
The Rise and Risk of Illegal Fentanyl
Illegal fentanyl can be found in powder form and is sometimes pressed into counterfeit pills to make it look like other medications. Alternatively, fentanyl is also mixed into other drugs (usually unbeknownst to the drug user) increasing overdose deaths each year.
Heroin & Fake Fentanyl
Many times fentanyl is mixed in with heroin to create a more intense high for the drug user. While this poses a risk to drug users, the theory is that dealers are hoping to keep users coming back to them for the better, more addictive drugs.
Heroin and fentanyl both affect the brain similarly and can produce a similar high. However, fentanyl is 50 times stronger than heroin, making it extremely easy to overdose on heroin if it’s laced with fentanyl.
Cocaine & Fake Fentanyl
The effects of fentanyl and cocaine are generally unknown. These two drugs act very differently in the body, and users of cocaine may not be used to having any type of opiate in their bodies, let alone one as strong as fentanyl. As a result, cocaine-related fentanyl deaths are not uncommon.
Methamphetamines & Fake Fentanyl
Methamphetamines, or meth, are illegal stimulants. Mixing stimulants with opioids is known as “speedballing,” but the combination of two strong chemicals can be deadly. This combination can result in stroke, heart attack, coma, or death.
Why Is Fentanyl So Dangerous?
Opioid addiction has become such a serious problem in the United States that in 2017, it was declared an official public health emergency.
According to the National Institute on Drug Abuse (NIDA), a total of 56,516 synthetic opioid overdose deaths (mainly fentanyl) were reported in 2020.
Side effects of fentanyl use themselves can be incredibly dangerous. A lethal dose of fentanyl is incredibly small compared to a lethal dose of heroin, morphine, or other opioids. Because fentanyl is so potent, making it highly addictive, the development of substance use disorder is highly likely. Individuals that struggle with drug addiction increase their chances of experiencing an overdose over time.
Signs and Symptoms of Fentanyl Abuse
Abuse of fentanyl occurs when someone takes fentanyl outside of their prescribed dosage or takes fentanyl without having a prescription at all.
Fentanyl and other opioids work by targeting the brain’s opioid receptors, increasing the amount of dopamine in your system. This increase of dopamine results in a feeling of euphoria and often leads to opioid addiction, as users continue to “chase” this particular high.
Other symptoms of fentanyl use include:
- Pinned pupils
- Significant drowsiness
- Respiratory depression (slow breathing)
Some of these fentanyl side effects will also appear during a fentanyl overdose.
Signs of a Fentanyl Overdose
As mentioned, fentanyl overdose may not be immediately apparent as some of the side effects of fentanyl use can also appear during an overdose.
Signs of a fentanyl overdose will usually include:
- Severe confusion
- Pinned pupils
- Slowed or stopped breathing
In the event of an overdose, Naloxone (NARCAN®) can be administered to halt the overdose and keep it from getting worse. However, if you suspect someone is experiencing a fentanyl overdose, you could call 911 immediately, even if you have administered Naloxone.
Detoxification happens as a result of quitting fentanyl use after a dependency has formed. In general, quitting fentanyl without medical intervention is NOT recommended. Instead, medical detox provides a safe alternative to the “cold turkey” method of quitting.
Overall, fentanyl withdrawal symptoms are not usually life-threatening. However, withdrawal symptoms (including cravings during withdrawal) can often lead a user to return to fentanyl abuse. Unfortunately, even after having fentanyl out of their systems for a short time, returning to fentanyl again often leads to accidental overdose and death.
Medical detox provides recovering fentanyl addicts with a safe, monitored way to taper their fentanyl use and avoid major relapse risks. Medical detox for fentanyl can occur at the inpatient or outpatient level, depending on your individual needs.
Fentanyl Rehab Options
For most recovering addicts, addiction treatment doesn’t just stop after detox. Treating opioid addiction can be a challenging process without support.
Selecting the right opioid treatment program can help recovering addicts avoid relapse and cope with any of the underlying issues that may have encouraged them to begin using fentanyl in the first place.
The good news is that long-term recovery from fentanyl addiction is possible with the right support system and treatment plan.
Inpatient Rehab for Fentanyl
Inpatient rehab provides the highest level of care and support for recovering addicts. Patients who sign up for inpatient treatment will live at a rehab center for a minimum of 30 days. During their stay, they will undergo medical detox (roughly 1 week) along with additional therapies.
Medical care can also be provided during inpatient rehab, particularly during the withdrawal period. Patients have 24/7 access to medical staff in some of the more intensive inpatient programs.
Not all drug rehab requires a recovering addict to live at a facility. Outpatient treatment is another option for individuals recovering from fentanyl addiction who may have a more minor or moderate addiction. Outpatient rehab provides a few different care levels depending on an individual’s needs.
Partial Hospitalization Programs offer the same type of daily treatment as one might expect from an inpatient addiction treatment center, but without requiring residency. A partial hospitalization program is a good option for those who may be unable to commit to living at a rehab center full-time or that have a lower risk for relapse.
Similarly, the Intensive Outpatient option provides an even smaller time commitment, with patients attending daytime (or evening) sessions a few times a week for an average period of a few months.
During treatment for fentanyl addiction, a doctor may prescribe a medication to assist you. These prescription medications can be used to taper off fentanyl and lessen the withdrawal symptoms, help users avoid relapse or both.
Addiction medications used to treat opioid use disorder include:
Sometimes, part of your long-term recovery plan can include medication-assisted treatment that will be taken over time. Other times, users may only need medication for a short period.
Therapy Used in Fentanyl Addiction Treatment
During fentanyl addiction treatment, recovering addicts will participate in a variety of different behavioral health therapies designed to improve their overall well-being. In many cases, addiction stems from underlying mental health issues from trauma to co-occurring disorders, such as depression.
Through therapy both during rehab and afterward, recovering addicts can create better coping mechanisms, improve their habits, and process much of the internal struggles that led them toward addiction in the first place.
Psychotherapy is a generalized term for different specific counseling types that generally involve the patient talking about their troubles or trauma. Through discussing these issues with a licensed therapist or counselor, many individuals can achieve a better understanding of themselves and how to make healthier choices when future problems occur.
Cognitive Behavioral Therapy (CBT)
Cognitive-behavioral therapy focuses on working with a counselor through individual or group therapy to identify negative thought patterns. Over time, patients will learn how to re-wire or change these patterns into more positive ones.
Cognitive-behavioral therapy is often used in addiction treatment because it helps individuals in recovery to self-assess and learn what may have triggered their addictive behaviors so they can make different choices in the future.
Contingency management is a type of therapy where patients can earn certain rewards or privileges for positive behavior. Behaviors that can earn rewards can include clear drug tests, participation in group therapy, volunteerism, and so on. Over time, these rewards can increase in value to encourage the recovering addict to keep moving forward.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy is especially useful in addiction recovery because it aims to help those who may still be at high risk for relapse. Through dialectical behavior therapy, counselors help recovering addicts recognize their part in their addiction and help encourage positive change through acceptance.
12-Step Program for Fentanyl Recovery
Group therapy is popular at most treatment centers and 12-step programs provide a specific structure to these support groups. Through 12 specific, linear steps, recovering addicts will work through their addiction and recovery alongside peers and often with the help of a sponsor.
Groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) are hosted both inside rehab programs and outside in the community. Many recovering addicts continue to attend 12-step programs after completing their rehab program as part of their long-term recovery journey.
Fentanyl Addiction CAN Be Treated
If you or a loved one is struggling with fentanyl addiction, it’s not too late to get help but it is important to act quickly. You can speak with your doctor about the options available for you or your family member, or you can use SAMHSA’s program locator to find a substance abuse treatment provider near you.