What is Fentanyl?
Fentanyl is a synthetic pharmaceutical drug that comes in the form of an opioid pain reliever, which is 50 to 100 times more potent than morphine. Fentanyl is usually prescribed to relieve severe pain, such as during cancer treatment or after back surgery.
Since the popularity of fentanyl exploded on the scene a few years ago, the overdose rates have skyrocketed across the nation. Although it is known to be highly addictive and commonly abused, people still don’t know exactly what is fentanyl.
Fentanyl use blocks the pain receptors and increases the production of dopamine, which is the chemical that controls the reward/happiness signals to the brain. Fentanyl street names are China white, china girl, TNT, crush, dance fever, and Apache.
If you think you might have a problem with fentanyl, you might be correct. Fentanyl is, in fact, a potent opioid that can lead to addiction quickly. If you abuse fentanyl, you might already be addicted to it due to its incredibly high potency.
If you take fentanyl for a legitimate medical reason, according to the directions of your doctor, you might become dependent on it and addicted, as long as you continue to follow the instructions of the prescription strictly.
What Is Fentanyl Used For?
Fentanyl is a pain medication is used for very severe pain, in which people who have become tolerant to other opioid medications. It is used for breakthrough pain — episodes of pain that occur even if severe pain is taken care of in a consistent manner.
Fentanyl that is taken by mouth is used no more than four times per day.
The transdermal patch is replaced approximately every 72 hours, and it should only be used when a patient requires 24/7 medication to deal with pain. You can only receive a prescription for the fentanyl patch if your pain cannot be treated with anything else.
Who Uses Fentanyl?
- In 2011, 366,181 people visited the emergency room because of opioid overdoses.
- The number of people who overdosed on opioids because of recreational use went up by 117 percent between 2005 to 2011.
- Emergency room visits for opioid overdoses stayed stable between 2008 and 2011.
- Since 2005, fentanyl has been implicated in overdose deaths because it is commonly used to lace other drugs, such as heroin. Frequently, people do not even know that fentanyl is in the drug they are taking. This results in many unintentional overdoses.
The Substance Abuse and Mental Health Services Administration (SAMHSA) does not have data for everyone who uses fentanyl, but this is what we know about overdoses so far.
Campus Drug Prevention, an initiative by the Drug Enforcement Administration (DEA), says that fentanyl-laced cocaine is a particular concern across college campuses today. If you use any illicit drug, there is the possibility that it is laced with fentanyl.
Is Fentanyl an Opioid?
Yes, fentanyl is one of the more well-known synthetic opioids because of the extensive research that’s been done. It is one of the only substances that is approved for prescription use. Fentanyl was discovered in the 1960s and was only used for surgery. Its clinical use was expanded in the 90s when the skin patch was developed for extended relief of chronic pain.
Synthetic opioids are categorized as psychoactive substances that are known as opiates or produce opiate-like effects. These substances are not naturally occurring, although they get effects similar to naturally occurring drugs from different types of opium poppy plants. These plants are used by humans for recreational and medicinal purposes for thousands of years. Some well-known opiates like heroin and morphine are formed from these plants.
Fentanyl takes many different forms to meet each patient’s needs. Some popular name brands and forms of fentanyl will include:
Commonly referred to as a fentanyl lollipop, it is administered under the tongue for quick pain relief. This form is used for patients who were already taking painkiller medication and have some military applications.
Coming in the form of a fentanyl patch, this type of fentanyl is prescribed to treat severe to moderate pain, with the effects lasting as long as three days.
This form is generally administered in hospitals, usually alongside anesthetics, and is taken through an injectable form. This form of fentanyl is used to manage pain before and after surgery.
This form of fentanyl is a sublingual spray that is administered under an individual’s tongue to deliver pain relief immediately. Its purpose use is for the treatment of breakthrough cancer pain.
Abstral is primarily used for opioid-tolerant patients who experience breakthrough cancer pain. This is a fentanyl pill form of a tablet that dissolves quickly by being placed under the tongue.
This form of fentanyl comes in a nasal spray, which is primarily used with cancer patients needing to treat their pain.
Where Does Fentanyl Come From?
Fentanyl was invented in a laboratory and was created to be between 50 and 100 times more potent than morphine, another well-known pain-relieving narcotic.
The National Institute on Drug Abuse (NIDA) says that fentanyl is a synthetic opioid. It does not come from the opium plant, like heroin and other opioids do.
To relieve pain, fentanyl interacts with the nervous system and brain to change how it responds to pain signals.
It is a Schedule II controlled substance, which means you can only use it with a prescription and precisely as directed.
When used under medical supervision, fentanyl is safe and effective. Despite this, it carries an incredibly high potential for misuse and can be habit-forming.
Risks of Fentanyl Misuse
Of the many risks of misusing fentanyl, death is the most severe outcome. It is common in cases of fentanyl overdose if help is not received quickly enough.
Fentanyl is also a significant cause of overdose deaths relating to other drugs as it gets laced into the mix. Drug deals produce illegal batches of fentanyl and use it to strengthen their supply.
Many users are not aware that their heroin, for example, contains any amount of fentanyl. This, in return, elevates the risk of a severe overdose.
Other risks of fentanyl abuse are:
- Dependence or addiction- Consistent use of fentanyl causes your body to tolerate and depend on it to continue functioning. Your brain eventually gets used to performing with it, making you less likely to feel its effects with your regular dose. This facilitates addiction as you start to crave fentanyl when you are not taking it.
- Aftereffects or accidents caused by misuse– The drug can induce drowsiness, which makes it dangerous to drive or operate machinery. Loss of consciousness, respiratory issues, and confusion can also occur.
- Infections at injection sites- Physical signs of injection will be clear for people who misuse fentanyl in this manner. A 2017 case study published on the International Journal of Drug Policy explains that injecting drugs into your body can lead to infections, blood clots (thrombosis), harmful bacteria or microorganisms that could cause shock or become fatal (sepsis), or inflammation of the endocardium. This is the part of the heart that lines the chambers.
- Overdose- This occurs if too much fentanyl is taken, and its symptoms pose a threat to your life. A fentanyl overdose can be treated with naloxone. But several doses of this antidote may be necessary because fentanyl is much more potent than other opioids.
Fentanyl Side Effects
- Intense cravings for the drug
- Buying the drug even if you do not have enough money
- Previous responsibilities at work, school, or in your relationships to use drugs instead
- Skipping social or family gatherings to use fentanyl
- Needing more fentanyl to reach the desired effect
- Using the medication in ways, it is not intended, such as snorting or injecting it
- Trying to quit but being unable to
- Experiencing symptoms of withdrawal when you do not use regularly
Other signs of fentanyl misuse are:
- Unexpected financial issues– Requests to borrow money that seems unreasonable.
- Haggard’s appearance– A lacking of hygiene.
- Changes in health- Sudden weight gain or loss, bloodshot eyes, or constant fatigue.
- Moodiness– Showing different behavior, such as becoming more secretive or trying to prevent family or friends from entering one’s home or room.
Medical News Today says that fentanyl was first abused in the 1970s. Sometimes, it is misused by people who obtain legal fentanyl and provide it to people who do not have a prescription.
Fentanyl patches are known to have traces of the drug that can still have effects on people, and some people may resort to using these. The most common ways people misuse fentanyl patches are by taking what is left on them and then injecting, snorting, or smoking it. In some instances, they just place the remaining fentanyl under their tongue.
Fentanyl Addiction Symptoms
Some physical symptoms of fentanyl abuse include:
- Nausea and vomiting
- Slow breathing
- Blurred vision
Fentanyl usage harbors a massive risk for abuse and addiction regardless of it being given in the prescription form. The National Institute on Drug Abuse has given warnings that a fentanyl epidemic may develop due to the potency and addictiveness of the substance.
Individuals abuse fentanyl at higher levels than prescribed to experience intense euphoria and relaxation. This is similar to the effects of a heroin high.
Abusing fentanyl becomes especially dangerous for individuals who do not have a tolerance to opioids. Fentanyl, which already comes with an elevated risk of overdose, becomes multiplied when an individual without a tolerance starts abusing it.
Abusing fentanyl will depress the respiratory system to the point of failure, which will lead to a fatal overdose.
To mix fentanyl with other drugs like cocaine or heroin will amplify the drug’s adverse side effects. In fact, illicitly produced fentanyl is often used as an additive to other drugs to increase potency. Users are often unaware and therefore, have a greater risk of overdose
Whether abused recreationally or taken as a prescription, fentanyl is very volatile and can be a highly potential lethal drug. You should only use fentanyl as prescribed by your doctor.
If you have a history of addiction it is best to discuss this with your doctor regarding the use of fentanyl. Individuals that have previously struggled with substance abuse are at a far greater risk of developing a fentanyl dependence.
Fentanyl Withdrawal Symptoms
Some fentanyl withdrawal symptoms will include:
- Nausea and vomiting
- Runny nose
- Muscle pain
- High blood pressure
- Elevated heart rate
- Stomach cramps
Fentanyl withdrawal symptoms make users very uncomfortable and sick. Their cravings to use fentanyl will worsen as they become desperate to make the withdrawal symptoms stop. Fortunately, though, fentanyl withdrawal symptoms can be reduced or avoided for the individuals that are willing to accept help from a fentanyl addiction detox treatment program.
Fentanyl withdrawal symptoms in the initial period after stopping usage will be more physical. From there, the psychological symptoms will kick in.
Fentanyl Withdrawal Symptoms Timeline
Due to its short half-life of roughly 4 hours, fentanyl withdrawal symptoms usually start within 2 to 4 hours of the last dose. This may take longer for individuals who are using fentanyl patches, which is a slower release delivery system. In this case, fentanyl withdrawal symptoms will primarily start within a 24 to 36 hour period of removing the patch.
The length of the fentanyl detox process is hard to predict because everybody will experience a different variety and range of symptoms. Primarily though, withdrawal symptoms will taper off and cease to exist after 5 to 10 days in most cases.
The fentanyl withdrawal timeline will usually follow a general pattern, but there are also specific factors that will affect each patient’s level of withdrawal.
Some of these factors that will affect fentanyl withdrawal include:
- Overall health
- Kidney and liver health
- Previously attempting detox
- Genetic and biological make up
- Co-occurring mental health disorders
- Concurrent use of other drugs
- Use of medically assisted detox
Some individuals will develop symptoms that will last well beyond the acute withdrawal timeline. These are known as protracted withdrawal symptoms, which could last weeks and sometimes months.
Fentanyl Addiction Treatment
Many treatments are available for the misuse of fentanyl. Mayo Clinic explains that even if you are not intentionally misusing fentanyl, you may have become dependent on it. You should slowly decrease your dose until you can live without it.
You should never try to quit taking fentanyl cold turkey without consulting your doctor. They will likely recommend tapering off it. This is a controlled way to lower your dose that can decrease the likelihood of experiencing withdrawal.
Tapering Fentanyl Involves the Following Steps:
- Talk to your doctor about the best way to taper your dosage.
- Undergo blood or urine testing to gauge how much fentanyl is in your system.
- Get a prescription for medications that can help you deal with withdrawal or other health issues as you taper off fentanyl. Most often, you will be switched from fentanyl to buprenorphine or methadone, and then, you’ll taper off that replacement medication.
Fentanyl Detox: How Long Does it Last?
The detox process typically lasts 5 to 7 days but may be extended up to 10 or more in some cases. Some patients will need more or less time, as detox will be unique for each person. A thorough evaluation during the intake process will help to determine the outcome of the length of time needed for a detox.
The detox process will be performed in a specialized substance abuse treatment center. The detox process can be done either in a residential program or an outpatient program, depending on the specific needs of the patient. In a residential facility, detox is referred to as medical detox, due to its inclusion of medical and mental health support provided by treatment professionals giving around the clock service.
The patient’s vital signs will be monitored to ensure their safety, and medications are often administered to help with emotional and physical withdrawal symptoms. Residential detox programs are highly recommended for fentanyl withdrawal because it’s such a powerful opioid.
In some cases, fentanyl will be replaced by a different opioid agonist during the detox process. Combination medications may also be used for post-detox after fentanyl, and all other opioids are entirely flushed out of the system. Supplementary medications are also helpful during medical detox.
If your physician feels this is necessary, you may be prescribed medication that can help you avoid symptoms of withdrawal and make the transition to a drug-free lifestyle.
- Naltrexone– A monthly injection known to prevent opioid cravings. It requires that you are compliant in your treatment. It is known to be safe.
- Buprenorphine- Available on its own or in combination with another medication. It is a sublingual dose of medication known to interact with the same chemical messengers influenced by opioids. It prevents cravings and allows you to deal with symptoms of withdrawal. It is not known to cause a high.
- Methadone- Used by people whose misuse of opioids is serious. It prevents withdrawal symptoms and cravings for opioids. Since fentanyl is such a potent opioid, methadone may be used as a replacement medication for those who have been chronically abusing fentanyl and other potent opioids.
Medical detox is exceptionally beneficial in helping to safely and smoothly remove fentanyl from the system and get back to a healthy physical balance. Detox followed with a substance-abuse treatment program that engages in both pharmaceutical and therapeutic tools, cravings, and other different psychological and behavioral symptoms of addiction and substance abuse will be managed and improved on a long-term basis.
Residential Treatment or Outpatient Treatment for Fentanyl
Inpatient Rehab and Treatment
Inpatient recovery programs are also referred to as residential treatment and require patients to check themselves into a supervised environment to overcome their addiction. Patients will stay at a treatment facility with round-the-clock medical and emotional support. During inpatient treatment, the residents can focus entirely on getting sober without any negative distractions of daily life. A typical day in residential treatment will be scheduled activities and therapy sessions throughout the day.
Psychiatrist, counselors, and psychologists will meet with family individually and then in group settings to help guide the residents through the inpatient recovery program. A standard inpatient program will run between 28 days to six months at times.
The first step, once checked into inpatient treatment, will be to receive a medically assisted detox. The addiction specialists and physicians will monitor the patient’s vital signs while going through the process. Drug cravings and withdrawal symptoms may arise during detox, which is challenging to overcome and could lead to relapse. Therefore, constant medical care will be provided during inpatient treatment to help guard against cravings to relapse.
Treatment staff will be able to provide the necessary medicine and medical expertise to calm the cravings and withdrawal symptoms. Each program will offer a therapist that can help individuals overcome fentanyl addiction.
Outpatient Rehab and Treatment
Outpatient rehab programs are less restrictive than inpatient treatment programs. An outpatient recovery program will usually be 10 to 12 hours per week spent visiting the rehab treatment center.
Outpatient drug rehab is an excellent standalone option for individuals with a mild addiction or added as a phase of a long-term treatment plan. Outpatient rehab treatment programs last roughly 3 to 6 months and, in some cases, up to a year.
Outpatient rehab treatment programs will give recovering addicts the freedom to remain at home during the treatment process. Individuals undergoing outpatient drug rehab are able to continue working and stay close to friends and family members. Inpatient treatment centers will conduct meetings in the early morning or at night to help program members maintain their regular schedules.
The patients with mild to moderate substance withdrawal symptoms will find outpatient detox a more suitable alternative to inpatient detox. Outpatient detox is both safe and effective and takes less time to complete than residential detox. Doctors and clinicians may administer medications to help ease with drawl symptoms like depression, anxiety, and increased heart rate. Each program will offer a therapist that can help individuals overcome fentanyl addiction.
Fentanyl Addiction Therapies
Psychological treatment can address underlying issues that may have led you to misuse fentanyl. Therapy options include:
- Cognitive-behavioral therapy (CBT)– Individual counseling addresses patterns of misuse, triggers, and other possibly co-occurring issues like anxiety or depression.
- Motivational interviewing– A trained specialist with ask you questions and learn about your motivations to use or quit using drugs. It is known to be effective and allows clients to take a more active role in their treatment.
- Family or couples therapy– Your family or partner will become involved in your recovery process. They will learn strategies that can help them assist you in your journey, and it will give you a chance to repair relationships with people close to you.
- Support groups– While 12-step groups are the most renowned support groups, there are also non-12-step options that can help you. These discussions are led by people in recovery who share their struggles and tips with you. They allow you to socialize with people who better understand what you are going through.
This consists of needle exchange programs and safe injection sites that encourage people to test their opioid sources. This approach accepts that some people aren’t yet ready to abstain from drug use altogether, so it aims to mitigate the harm caused by it.
Harm reduction can prevent infections or transmissions of diseases such as HIV or other blood-borne pathogens. If opioids test positive for fentanyl, many people will opt not to take the drug due to the high potential for a fatal overdose.
The National Institute on Drug Abuse (NIDA) explains that treatment must be tailored to your unique needs to be effective. There isn’t a one-size-fits-all approach that works for everyone.
Your treatment team will build a plan that makes sense for your particular fentanyl addiction. This plan will likely change as you progress in recovery.
Get Help Today
Don’t let another day pass where you or a loved one is experiencing a fentanyl addiction. Here at Footprints to Recovery, we know how overwhelming it can be to consider reaching out for treatment but rest assured that by doing so, you’re making a decision that will potentially be lifesaving. Our facility provides top-of-the-line addiction treatment that will not only help you or a loved one become sober but also encourage full physical, mental and spiritual growth making long-term recovery possible.
Our team at Footprints to Recovery can help end addictive behaviors and tendencies and introduce a happy, healthy lifestyle. Contact us today to learn more about our addiction treatment programs.