Fentanyl Addiction

What is Fentanyl?

Fentanyl is a strong analgesic (or painkiller) that is part of the opiate family. This drug is considered one of the most potent prescription opioids available. Fentanyl is typically prescribed to patients as a solution for severe pain from a terminal disease or similar issue. Fentanyl’s effects can be compared to morphine, oxycodone, and even heroin.

Fentanyl’s Effects

Fentanyl works like other opiates by binding to your brain’s opioid receptors, the part that controls pain and emotions. By binding to your opioid receptors, fentanyl blocks sensations of chronic pain.

Typical sensations caused by fentanyl may include:

  • Euphoria
  • Sedation/tiredness
  • Confusion
  • Nausea
  • Unconsciousness
  • Slowed breathing

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.

Synthetic VS Natural Drugs: What’s the Difference?

Fentanyl is a synthetic drug, meaning it is not made from natural ingredients. This makes fentanyl easier and less expensive to manufacture. While fentanyl and morphine are similar, morphine is considered a natural drug because it is made from the poppy plant. Fentanyl is made synthetically in a lab.

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.

Fentanyl Comparisons

The most potent prescription opioid available is fentanyl. The below comparisons provide an idea of how it compares to similar opioids:

Morphine

  • Morphine is made from the poppy plant; considered natural.
  • Schedule 2 drug
  • Production is regulated

Oxycodone | 1.5x stronger than morphine

  • Chemically similar to morphine; also made from the poppy plant.
  • Schedule 2 drug
  • Production is regulated

Heroin | 2-5x stronger than morphine

  • Heroin is made from morphine
  • Schedule 1 drug
  • Production is UNREGULATED

Fentanyl | 100x stronger than morphine

  • Made synthetically in a lab
  • Schedule 2 drug
  • Production is semi-regulated; it can also be made in unauthorized labs for use in the illegal drug market

Carfentanil: A New Risk on the Horizon?

Carfentanil is a drug that is used to treat pain in large animals. It is 10,000x stronger than morphine and at least 100x stronger than fentanyl. It is also even cheaper to make than fentanyl. Human use almost always results in death from overdose.

Fentanyl Prescriptions

Patients who receive a prescription for fentanyl will often find that their pharmacy provides them with patches to wear or lozenges to suck on, like a cough drop. They may also be prescribed a shot or a nasal spray.

The most common name brands of fentanyl prescriptions include:

  • Actiq®
  • Duragesic®
  • Sublimaze®

Fentanyl Interactions and Precautions

Patients with a fentanyl prescription should consider the following warnings:

  • Do not mix prescription fentanyl with any other drugs, including alcohol. Mixing fentanyl with other medications or alcohol can cause complications and puts you at risk for an overdose.
  • Discontinue the use of fentanyl once your doctor tells you to do so.
  • Talk to your doctor if you experience any troubling side effects, such as respiratory depression, itching of the skin, anxiety, or confusion.

If you don’t have a fentanyl prescription yourself, avoid using fentanyl for any reason.

In addition to using a fentanyl prescription properly, patients must also take care to dispose of their used patches properly to avoid risk for accidental exposure. According to the FDA, “there is enough fentanyl left to cause illness, overdose, or death in babies, children, adults, and pets” in a used fentanyl patch.

Fentanyl Side Effects

Fentanyl does have some risks even when it’s used as directed.

The most common side effects may include:

  • Constipation
  • Chills or feeling cold
  • Trouble sleeping
  • Unusual drowsiness

Because fentanyl is so potent, patients must make sure to always take the exact dose that is prescribed and to avoid missing a dose. Just one missed dose can put the user at risk for overdose when the next dose is taken.

Additionally, fentanyl carries the same risks as all Schedule II drugs. Fentanyl has a high likelihood that the user will become addicted or dependent after regular use. Prescription fentanyl also has a high probability of being abused. People who use fentanyl as directed by their doctor still run the risk of becoming dependent on the medication, which can lead to addiction.

Drug 101: What Are Drug Schedules?

The Drug Enforcement Administration (DEA) has placed all known drugs into categories, or schedules, to determine their usefulness and risks.

  • Schedule 1: No currently accepted medical use and a high potential for abuse. (Ex: Heroin)
  • Schedule 2: High potential for abuse with the likelihood of addiction. (Ex: Fentanyl, morphine)
  • Schedule 3: Moderate to low potential for abuse and addiction. (Ex: Tylenol with codeine)
  • Schedule 4: Low risk of abuse or addiction. (Ex: Tramadol, Xanax)
  • Schedule 5: Lower potential for abuse than Schedule IV. Typically used to treat issues other than pain, like stomach/digestive issues or coughing. (Ex: Robitussin AC)

Fentanyl Abuse and Addiction

Fentanyl may seem appealing to illicit drug users for 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 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.

Since fentanyl is relatively cheap to produce, it can also be pressed into counterfeit pills that are made to look like a different medication. Illegal fentanyl labs also manufacture fentanyl on blotter paper that dissolves on the tongue.

“Clandestine fentanyl is distributed in the United States in the same manner as heroin. It is sold in powder form in glassine bags or wax envelopes, often stamped with brand names. It is often sold as heroin, with many users not aware of the presence of fentanyl in the substance.”

—DEA National Drug Threat Assessment 2016

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 Overdose Symptoms

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 (a common brand is Narcan®).
  4. Stay with the person who has overdosed until help arrives.

Fentanyl Overdose Risks

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. You should also make sure you don’t tamper with the prescription method. If you are provided with a patch, use it as a patch. If you receive lozenges, only use them as lozenges.

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.

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 treatment options and what to expect along your journey to recovery.

Fentanyl Withdrawal

If you have become addicted to fentanyl, your first step will be to discontinue the use of fentanyl. This first step is known as detoxing. The safest method of detox is tapering with medical assistance; quitting without tapering or without the use of medically appropriate support can cause seizures or coma.

What Can I Expect From Fentanyl Withdrawal?

Withdrawal from fentanyl, like other opiates, can be unpleasant and even dangerous without proper medical support.

If someone goes through withdrawals, they may experience one or more of the following symptoms:

  • 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 supervised detox lessen the above withdrawal symptoms, it will also prevent more severe complications like seizures or coma.

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 prescribed medication 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.

During MAT, a doctor or other healthcare provider will prescribe the recovering addict medication to help return their brain chemistry to normal.

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)

According to the CDC, many fentanyl-related deaths are occurring as a result of fentanyl being mixed into other drugs, such as heroin or cocaine, and being sold to users who are not aware that it has been mixed in with their other drugs. Fentanyl can also be made into pill form and disguised as a legal prescription drug, like oxycodone.

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.

General Fentanyl FAQs

What is fentanyl?

Fentanyl is a synthetic opiate or pain medication created in a lab that is prescribed to patients with a terminal illness or extreme pain. It is highly addictive and 100x stronger than morphine.

Is fentanyl addictive?

Yes. As a Schedule II drug it is considered highly addictive with a strong potential for misuse.

How does fentanyl make you feel?

Fentanyl can create feelings of pain relief, euphoria, drowsiness, nausea/vomiting, slowed breathing, and unconsciousness.

Where does fentanyl come from?

Fentanyl is synthetic, so it is made in a lab. A large portion of fentanyl is made in unregulated laboratories for distribution within the illegal drug community.

What does fentanyl look like?

Raw fentanyl looks like a white powder, but this drug is produced legally as fentanyl patches, shots, and lozenges. Illegally it is also made into pills that look like other opiates, such as oxycodone. It is also being mixed into other street drugs—namely heroin, meth, and cocaine—and is impossible to detect without a testing kit.

Show Sources & Author Last Edited: October 1, 2021
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