Fentanyl Addiction

What Is Fentanyl?

Fentanyl is a synthetic opioid. It is incredibly powerful, around 50 to 100 times more powerful than morphine.¹ This prescription medication is usually used in hospitals after major surgeries or treatments, but it is also used in other circumstances. Sometimes, it’s made illegally, which is dangerous to those who choose to use it.

Prescription fentanyl is also known as:

• Sublimaze
• Duragesic
• Actiq

Street names for fentanyl include:

• Dance Fever
• Goodfellas
• Murder 8
• Tango & Cash
• Jackpot
• Friend
• Apache

What Makes Fentanyl So Dangerous?

Fentanyl is dangerous because it’s so much stronger than other opioids. As a synthetic, it’s 50 to 100 times stronger than morphine, a natural opioid. It has to be carefully controlled, or it’s very easy to deliver an overdose.

In fact, in 2017, over 50% of the opioid-related deaths in the United States involved fentanyl.

How Do People Use Fentanyl?

Prescription fentanyl is given as a shot, lozenge or patch. The lozenges are sucked like cough drops, slowly entering the body. Patches allow the drug to pass through the skin slowly and work over time. Shots work quickly, and they are generally administered by anesthesiologists.

When someone is using illicit fentanyl, it may be available as an eye drop, nasal spray, pill, powder or even be dropped onto a blotter paper. Sometimes, fentanyl is mixed in with other drugs, like heroin, cocaine, MDMA or methamphetamine, in order to make the effects stronger. Unfortunately, fentanyl is so strong that it’s very easy to add too much and cause an overdose.

What Are the Symptoms of Fentanyl Abuse?

Fentanyl use can cause many different symptoms. Some of the side effects of fentanyl² include:

• Short-term, intense highs
• Feelings of euphoria
• Nausea
• Fainting
• Seizures
• Death
• Slowed respiration
• Reduced blood pressure
• Pinpoint pupils
• Sedation
• Vomiting
• Urinary retention

Depending on how much of the drug was taken, it’s possible that the effects of fentanyl, such as sedation, reduced blood pressure, slowed respiration or seizures could lead to coma or death.

Is Fentanyl Dangerous?

Fentanyl is dangerous because of how easy it is to overdose on it. An overdose happens when someone takes more fentanyl than their body can handle. An overdose may cause hypoxia, which is a condition in which the brain cannot get enough oxygen. This can lead to death if the overdose is not treated rapidly.

How Is Fentanyl Abused?

When taken illegally, fentanyl is usually injected, snorted, taken orally as a pill or added to blotter paper. Those who have fentanyl gel patches, which are available by prescription, may abuse them by taking the gel content out of the patches and then eating or injecting it.

The DEA has reported seeing those same patches cut into pieces and placed into the cheek cavity or under the tongue.

When fentanyl is produced illicitly, it may be mixed with other drugs. It might be mixed with heroin, cocaine, MDMA or methamphetamine, for example. Mixing these drugs together increases the risk of serious side effects and overdoses.

How Can You Recognize a Fentanyl Overdose?

A fentanyl overdose has a few obvious symptoms. Some of the most common signs of an overdose include³:

• Stupor
• Changes in the size of the pupils
• Respiratory failure
• Cyanosis
• Cold, clammy skin
• Coma

You should know that the presence of respiratory depression, coma and pinpoint pupils suggests that the individual has suffered from opioid poisoning. If you see any of the symptoms above, it’s important to seek emergency medical care for the individual. Failing to do so could lead to severe injury or death.

How Is a Fentanyl Overdose Treated?

A fentanyl overdose can be immediately treated with the use of Naloxone.⁴ Naloxone is an opioid antagonist, which means that it counteracts the behavior of opioid drugs. Also known as NARCAN, this drug is available to the EMS, law enforcement agents, pharmacists and others. Most people who take opioids are given a prescription for NARCAN as well, so that it’s available in case of accidental overdose.

What Are the Symptoms of Fentanyl Withdrawal?

Like other opioids, fentanyl has some specific withdrawal symptoms that you should know about. Some potential withdrawal symptoms include:

• Muscle aches
• Restlessness
• Lacrimation
• Anxiety
• Yawning often
• Trouble sleeping
• Runny nose
• Excessive sweating
• Goosebumps on the skin
• Rapid heart rate
• High blood pressure
• Dilated pupils
• Nausea
• Vomiting
• Abdominal cramping

How Long Does Fentanyl Withdrawal Last?

The good news is that withdrawal symptoms don’t last long. For most people, opioid withdrawal symptoms begin to get better within 72 hours⁵, and within a week dissipate significantly.

How Are Symptoms of Fentanyl Withdrawal Treated?

The symptoms of fentanyl withdrawal tend to be uncomfortable. In some cases, they may be potentially dangerous. This is why patients who seek out medical treatment in a controlled facility often are more successful than those who attempt to stop taking fentanyl cold-turkey or who try to taper at home.

There are various levels of withdrawal to consider throughout the process of detoxification. They may be mild or intense. In some cases, there could be complications.

Mild Withdrawal

Mild withdrawal from fentanyl is uncomfortable but not life-threatening. Usually, it can be treated with medications such as ibuprofen or acetaminophen. Drinking plenty of fluids and getting rest also helps, while medications like hydroxyzine and loperamide can help with nausea or diarrhea.

Intense Withdrawal

When patients develop more serious symptoms, they may need to be hospitalized throughout that portion of withdrawal and detox. Intense symptoms may require treatment with clonidine, which has been shown to reduce the symptoms of withdrawal by around 50 to 75%⁶ in patients.

Other medications that can be used to help treat the symptoms of withdrawal in patients include Suboxone, which is a combination of naloxone and buprenorphine, or the long-term opioid maintenance drug methadone. Each of these drugs can minimize the symptoms of withdrawal, shorten their intensity and minimizing the length of time a person spends in detoxification.

Methadone is an opioid, but it is designed for long-term maintenance. It’s powerful, but since it’s used in a controlled manner, it’s generally considered to be safer than continuing to use other, stronger or more dangerous opioids.

Complications of Fentanyl Withdrawal

Opioid withdrawal isn’t usually dangerous, but it can be extremely uncomfortable. If patients are dealing with complications, some of the most common issues to run into are:

• Severe nausea
• Muscle cramping
• Diarrhea
• Vomiting

With these symptoms, it’s important to monitor them closely. Nausea and vomiting have the potential to lead to aspiration pneumonia from breathing in the vomited material. Diarrhea can lead to an imbalance of the body’s electrolytes, which could lead to circulatory problems. In a worst-case scenario, an electrolyte imbalance could lead to a heart attack and respiratory distress.

Those who suffer from severe muscle cramping may be in significant pain. Some people have reported intense joint pain as well. Fortunately, detoxification programs have options available to treat those symptoms.

What Can You Expect During a Detoxification and Rehabilitation Program?

When someone is addicted to fentanyl and enters into a detox and rehab facility, the first goal is to complete detoxification safely. This may mean taking long-term medications or being monitored while going through withdrawal in order to prevent serious symptoms, such as electrolyte imbalances.

Normally, detox starts within six hours of the last dose of a drug. Then, it takes up to 10 days for symptoms to totally dissipate. However, symptoms of withdrawal aren’t persistent. Some will come in waves. Symptoms usually peak 72 hours after the last dose taken, and they begin to decrease in severity after that time.

After a patient is through the worst of withdrawal, they move on to rehabilitation right away. Rehabilitation focuses on dual-diagnosis treatment, behavior therapy, group therapy, private counseling and other techniques to help educate and support the individual who was abusing a substance. Sometimes, people opt not to go through rehabilitation, but the chances of relapsing increase significantly without rehabilitation. For that reason, it’s a good idea for patients to go through detoxification and rehabilitation in a treatment program designed based on their specific needs and form of addiction or dependency.

Get the Help You Need at Northbound Treatment

At Northbound Treatment, we want you to know that it’s possible to get back into control of your life, so you can enjoy it again. Substance use disorders are sometimes difficult to overcome and can have serious withdrawal symptoms that make it hard to walk away. With the right support system, you can overcome one and get on the path to sobriety. Our supportive treatment counselors are waiting to take your message now and to talk to you about our programs, so they can help you find the right program for your care or to help someone you love.

Sources:

¹National Institute on Drug Abuse. Fentanyl DrugFacts

²United States Drug Enforcement Administration. Fentanyl

³Department of Justice/Drug Enforcement Administration. Drug Fact Sheet – Fentanyl.

⁴Centers for Disease Control and Prevention. What is Fentanyl?

⁵Healthline. Withdrawing from Opiates and Opioids

⁶AMA Journal of Ethics. (2004). Treatment of Dependence on Opiate Medications