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Fentanyl Signs, Symptoms, & Effects

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Fentanyl is an opioid prescription drug effective for treating moderate to severe pain, such as surgical or cancer pain. Although fentanyl is a legitimate prescription helpful drug for pain relief, it is habit-forming and has a high potential for abuse and addiction. Fentanyl is also the source of the current epidemic of drug overdose deaths in the US. Unfortunately, potentially dangerous overdoses are only one of the potential side effects of fentanyl. That’s because fentanyl is 100 times more potent than heroin and 50 times stronger than morphine.

Fentanyl has many brand names including Actiq, Fentora, and Duragesic. Doctors prescribe fentanyl in pill form, as a liquid, or as a skin patch. This not only makes it more addictive than other drugs, but it may increase the risk of overdose.

People who use heroin and other street drugs often overdose because drug dealers use fentanyl to cut heroin and other illicit drugs. Drug users take the regular dose of their drug of choice, unaware it contains fentanyl and is far more potent than usual. It’s this use of fentanyl that may be responsible for overdose deaths.

According to the National Institutes of Health, mixing fentanyl with other drugs can be hazardous. Some common drugs involved in overdose deaths from fentanyl often include cocaine, alcohol, benzodiazepines, and other opioid pain medicines. Heroin and morphine also make fentanyl’s effects many times stronger.

Symptoms of Fentanyl Abuse

Like all opioid drugs, fentanyl affects opioid receptors in the brain and nervous system. These opioid receptors are located on millions of nerves and control our ability to perceive pain. Fentanyl also causes brain tissue to release large amounts of dopamine, a chemical responsible for feeling happy. In large amounts, dopamine causes euphoria.

The signs and symptoms of fentanyl abuse will vary from person to person and may include:

Observable and behavioral symptoms

  • Requiring more fentanyl to get the same high (drug tolerance)
  • Needing the drug just to function without the onset of fentanyl withdrawal
  • Sneaky or secretive behavior and evasiveness
  • Declining performance at work or school
  • Continuing to abuse fentanyl despite the negative consequences of that use
  • Neglecting one’s typical responsibilities
  • Withdrawing from friends, family, social engagements
  • Spending increasing amounts of time getting, using, and recovering from the use of fentanyl
  • Frequent absences from work or school
  • Forging prescriptions to obtain fentanyl
  • Visiting multiple doctors to obtain multiple prescriptions for fentanyl (“doctor shopping”)
  • Temper outbursts, particularly if someone is attempting to address their drug or alcohol addiction
  • Severe differences or deterioration in hygiene or physical appearance
  • Increased aches and pains, including muscle aches and headaches
  • Overdosing on fentanyl

Physical symptoms:

  • Slowed movements and reactions
  • Slurred speech
  • Constricted pupils
  • Drowsiness that lasts all day
  • Insomnia
  • Withdrawal symptoms such as depression, shakes, sweating, nausea or fatigue
  • Constipation (opioids like fentanyl slow down digestion and excretion)

Cognitive symptoms:

  • Trouble focusing, trouble paying attention
  • Concentration difficulties
  • Impaired memory
  • Impaired judgment
  • Obsessive thoughts about getting and using fentanyl
  • Suicidal ideation

Psychosocial & emotional symptoms:

  • Euphoria, typically followed by apathy or depression
  • Decreased interest in previously enjoyed activities

Effects of Fentanyl Abuse

When a person continues to abuse fentanyl, wide-ranging negative outcomes may begin to accumulate. As is the case for all opioid use disorders, addiction to fentanyl impacts all areas of functioning, including life at home, at work, in school, or in social settings. Furthermore, an individual’s health is consistently at risk as fentanyl abuse continues.

Examples of various effects that can arise from opioid drug abuse may include, but are not limited to, the following:

  • Academic or occupational failure
  • Suspension or expulsion from school
  • Job loss
  • Financial difficulties
  • Legal interactions due to criminal activity taking place to obtain fentanyl (e.g. forging prescriptions)
  • Disturbed relationships
  • Dry mouth and nose
  • Impaired visual acuity
  • Slowed gastrointestinal activity
  • Suffering from an oxygen deficiency in the body’s tissues (anoxia)
  • Onset of new or worsening of current mental illness symptoms
  • Suicidal thoughts and behaviors
  • Inability to feel pleasure or happiness (anhedonia)

Opioid addiction can be severe and life-threatening. If you’re seeing some of these behaviors in your loved ones, getting them the drug abuse help they need is important. You can discuss your concerns with them, encourage them to speak to their doctor or pharmacist, or have an intervention.

Call us if you need a referral to an interventionist or help to determine the best way to get your loved one into treatment.

Self-Assessment: Am I Addicted?

Short-Term Effects of Fentanyl Abuse

Short-term effects of fentanyl can include the high it provides when abused as well as common side effects of the drug. The short-term effects of fentanyl depend on how much you’ve taken, how you took it (i.e., pill, fentanyl patch, etc.), and your individual physical and psychological makeup.

Short-term fentanyl effects may include:

  • Relaxation
  • Euphoria
  • Sleepiness
  • Mood and perception changes
  • Muscle weakness or rigidness
  • Constipation and stomach pain
  • Dry mouth
  • Skin rashes (in cases of allergic reaction)
  • Nausea and vomiting
  • Confusion
  • Pinpoint pupils
  • Shallow breathing
  • Slurred speech

Long-Term Effects of Fentanyl Abuse

According to the National Institutes of Health, abusing opioids like fentanyl may have serious side effects that could increase your risk for long-term physical and psychological damage. Some of these include:

Fentanyl Withdrawal Symptoms

If you’re addicted to fentanyl, you may experience withdrawal symptoms when you stop taking it. Withdrawal from opioid drugs may be painful and dangerous and should always occur in a medical setting. Withdrawal symptoms are different for everyone but may include:

  • Sweating
  • Vomiting
  • Nausea
  • Diarrhea
  • Muscle cramps and aches
  • Cravings
  • Agitation
  • Insomnia
  • Chills
  • Runny nose and other flu-like symptoms
  • Increased sensitivity to pain
  • Changes in heart rate
  • Low blood pressure


Symptoms of Fentanyl Addiction       

The only way to take fentanyl safely is under the close supervision of a doctor. If you’re taking fentanyl other than as medicine to treat pain as prescribed, you may have a problem.

Here are some common signs of fentanyl addiction:

  • Taking higher doses of fentanyl than prescribed
  • Taking fentanyl more frequently than prescribed
  • Unable to decrease or quit taking fentanyl
  • Needing fentanyl to feel normal or function during your day
  • Legal or financial trouble tied to drug use
  • Needing increasing amounts of fentanyl to get the same effect
  • Preoccupied with using fentanyl or getting more of it
  • Continuing to take fentanyl despite adverse effects on your health, relationships, and quality of life
  • Experiencing withdrawal symptoms when you don’t take fentanyl
  • Extreme mood swings
  • Depression and anxiety
  • Engaging in dangerous activities while on fentanyl that put you or others at risk for injury or death
  • Seeing multiple doctors to get more fentanyl
  • Withdrawal from family and friends
  • Hallucinations or delusions
  • Loss of interest in activities that once brought you pleasure

Signs of a Fentanyl Overdose

Because of its potency, a fentanyl overdose can happen quickly — even seconds or minutes after taking the toxic amount. People using drugs like heroin or cocaine cut with fentanyl can be at increased risk for fentanyl overdoses because they unknowingly ingest more opioids than their bodies can process.

Drinking alcohol or using other opioid pain relievers can also lead to respiratory depression and other symptoms, like the following:

Symptoms of overdose from fentanyl include:

  • Loss of consciousness
  • Clammy or cold skin
  • Low blood pressure
  • Constricted pupils
  • Vomiting
  • Grayish or blue skin
  • Going limp
  • Shallow breathing
Picture of an individual kneeling, expressing distress or discomfort with hands on their head.

How Do You Treat Fentanyl Addiction?

Fentanyl addiction treatment is the same as care for other opioid use disorders. Medication-assisted treatment (MAT) combined with behavioral therapies and relapse prevention training have proven to be effective in treating opioid addictions. MATs like buprenorphine and naltrexone attach to the opioid receptors in the brain in the same way as fentanyl, heroin, and other drugs.

Unlike fentanyl, buprenorphine and naltrexone don’t cause euphoria. They help prevent cravings and withdrawal symptoms that distract you from focusing on the treatment you need to get better.

If you want to stop using fentanyl, help is available at Footprints to Recovery. Opioid addiction treatment begins with medical detox. You’ll receive 24/7 medical attention while you safely eliminate drugs and alcohol from your system. Detox may include a taper schedule and medications to ease withdrawal symptoms. Nurses will monitor your comfort level and vitals around the clock.

Following detox, a formal treatment program will help you address the reasons behind your substance abuse and learn healthy coping skills for long-term recovery. Fentanyl addiction treatment may include:


  • Individual therapy
  • Group therapy
  • Family therapy
  • Treatment for co-occurring disorders like depression and anxiety
  • Alternative approaches such as mindfulness, yoga, chiropractic services, and art and music therapy
  • Continuing care planning

Dual Diagnosis Treatment

Dual diagnosis treatment is provided for people struggling with fentanyl addiction and a co-occurring mental illness. Typical mental health disorders that occur with drug addiction include bipolar disorder, depression, anxiety disorders, and posttraumatic stress disorder (PTSD).

Looking for Help?

Opioid addictions are difficult to overcome, but recovery is very possible with the right treatment and determination to get better. If you or a loved one is struggling, reach out. We’ll provide a free, confidential consultation. We’ll talk about what’s been going on and work together to find the best treatment program and location for you.

Questions about treatment options?

Our admissions team is available 24/7 to listen to your story and help you get started with the next steps.

Medically Reviewed by Lindsay Hutchison, MS, LPC, LCADC
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