SUBSTANCE ABUSE
Fentanyl
Fentanyl addiction can be deadly. According to the Centers for Disease Control and Prevention (CDC), more than 28,000 people have died from overdose deaths involving synthetic opiates such as fentanyl in 2017. Furthermore, synthetic opiate overdose fatalities have become more common, and most of these deaths are believed to be a result of illegal fentanyl.1
Facts about fentanyl addiction provide information about this deadly drug so that those who use the drug (as well as their loved ones) can be aware of warning signs and seek out treatment. Here, we learn about the history of fentanyl, in addition to signs and symptoms of addiction and withdrawal, misconceptions about the drug, and treatment options. With knowledge and effective treatment, recovery from fentanyl addiction is possible.
Defining Fentanyl
Fentanyl is a powerful opiate drug, and it can be as much as 100 times stronger than morphine. It is used to treat severe pain following surgeries and may be prescribed to treat chronic pain if other medications are not effective.2 According to experts, fentanyl has been available as a prescription for more than 50 years, and it was introduced in patch form in the early 1990s for the treatment of cancer-related pain and severe chronic pain. Recently, it has become popular in the pain management field because it has limited effects on the heart, works quickly, and is relatively inexpensive to produce.3 People may take prescribed Fentanyl in the form of a patch placed on the skin, lozenges that are consumed similarly to cough drops, or as an injection.
While fentanyl can be prescribed legally for legitimate medical purposes, people can also produce, sell, and use the drug illegally. According to the National Institute on Drug Abuse (NIDA), dealers sometimes combine fentanyl with heroin or cocaine to cheaply increase the high that users experience. People who produce illicit fentanyl can create it in the form of a powder, or as a pill that appears similar to other pain medications. With fentanyl being produced illegally, overdose deaths from the drug have increased in recent years. The CDC reports that since 2013, there has been an increase in overdose deaths related to fentanyl.4
Why is it Addictive?
Fentanyl works by attaching to the brain’s opiate receptors, which are responsible for managing pain and emotions. Fentanyl produces a pleasurable effect, but with continued use of the drug, the body becomes less sensitive to it, and a person only feels pleasure when taking the drug. People can also develop a tolerance to fentanyl, which results in them needing more of the drug to achieve the same effects. It is through this process that people become addicted to fentanyl and begin seeking it out to the detriment of their health and wellbeing.
Other Names for Fentanyl
People may refer to illegal fentanyl using code words or slang terms, which can include any of the following:
- Apache
- China Girl
- China White
- Dance Fever
- Friend
- Goodfellas
- Jackpot
- Murder 8
- Tango & Cash
SIGNS AND SIDE EFFECTS OF FENTANYL USE
As an opiate drug that impacts the brain’s pleasure and pain centers, fentanyl produces pleasurable effects such as extreme euphoria; however, it also has unpleasant side effects, which can include the following:
•Sedation and sleepiness
•Breathing difficulties
•Nausea
•Confusion
•Constipation
In extreme cases, fentanyl use can also result in a person losing consciousness.
FENTANYL OVERDOSE
Overdose is another potential side effect of fentanyl use, and it can occur when a person’s breathing slows or stops after use of the drug. Taking enough fentanyl to cause an overdose can cut off the oxygen supply to the brain, resulting in coma, brain damage, or death. Illegal fentanyl production and use has resulted in an alarming increase in overdose deaths during the past decade. According to data from the U.S. Department of Health and Human Services, there were 1,663 fatal fentanyl overdoses in 2011 and 1,615 in 2012. In 2016, this number jumped to a staggering 18,335 overdose deaths.5 First responders can treat a fentanyl overdose by administering naloxone to reverse the overdose, but because fentanyl is so potent, they may have to administer more than one dose.
Currently, fentanyl is responsible for more than half of fatal opiate overdoses. According to 2017 data, fentanyl was the cause of 59 percent of opiate-related overdose deaths in 2017, up from just 14.3 percent in 2010. Synthetic opiates like fentanyl are the drugs most commonly involved in fatal overdoses in the United States.
Signs of Fentanyl Addiction
Fatal overdose is a potential consequence of fentanyl abuse, and addiction is another risk associated with using it. A person who has developed an addiction to fentanyl will display some or many of the following symptoms of a substance use disorder, as per criteria in the Diagnostic and Statistical Manual of Mental Disorders:6
•Inability to stop using fentanyl, or difficulty cutting back on the use of the drug
•Spending a significant amount of time using fentanyl, obtaining it, or recovering from the side effects of this drug
•Continuing to use fentanyl despite suffering from health problems related to drug use
•Severe cravings for fentanyl
•Ongoing fentanyl use in spite of personal problems, such as arguments with family regarding drug use
•Giving up important life activities, such as going to work or spending time on hobbies because of drug use
•Developing a tolerance to fentanyl, meaning more of the drug is needed to achieve the desired effects
•Withdrawing from fentanyl
•Using fentanyl when it is dangerous to do so, such as when driving a car
•Consuming larger quantities of fentanyl than intended
Withdrawal from Fentanyl
When a person becomes addicted to fentanyl and develops a substance use disorder, he or she may experience withdrawal. The withdrawal symptoms associated with fentanyl abuse can be significant and even prevent recovery, as people may continue using the drug to avoid withdrawal symptoms.
Common fentanyl withdrawal symptoms include:
•Pain in the muscles and bones
•Sleep disturbances
•Gastrointestinal symptoms
•Cold flashes
•Goosebumps
•Intense drug cravings
•Involuntary leg movements
Experts report that fentanyl withdrawal symptoms can be painful and can begin within hours of the last fentanyl dose. Since fentanyl withdrawal is so painful, there are medications available to help people cope with withdrawal. The FDA-approved medication lofexidine can alleviate withdrawal from fentanyl.
Recovering from Fentanyl Addiction
According to NIDA, the combination of counseling and medication is an effective treatment option for fentanyl addiction. When medications are added to a counseling regimen, this is referred to as medication-assisted treatment (MAT). Because fentanyl withdrawal can be intense and highly unpleasant, people may begin recovery from fentanyl addiction with a detox program, where they are supervised by medical staff and provided with medications that can ease withdrawal symptoms. After completing detox, a person can then begin ongoing treatment for the addiction.
In treatment, opiate replacement medications like buprenorphine and methadone can be used in combination with counseling to assist with recovery from fentanyl addiction. These medications can ease cravings and alleviate withdrawal because they attach to opiate receptors in the brain. Some people may take the prescription drug naltrexone, which blocks the effects of fentanyl.
Counseling to Support Recovery
In addition to medications, there are various forms of counseling for fentanyl addiction. One effective form of counseling is cognitive behavioral therapy, which helps people to correct maladaptive ways of thinking and learn to cope with triggers and stress. Another type of counseling involves contingency management, in which a person receives monetary rewards for remaining abstinent from drug use. A third form of counseling called motivational interviewing can help a person explore reasons for change and overcome any uncertainties they may have about recovery from fentanyl addiction.
Levels of Care
Counseling and MAT can occur on either an inpatient or outpatient basis. Those who have a more severe fentanyl addiction may begin treatment in an inpatient or residential treatment setting and then transition into outpatient treatment once they are stabilized and have the resources necessary for maintaining sobriety in the community. People who have a less severe addiction and access to safe housing and social support may complete outpatient treatment. Sometimes, people may enroll in an intensive outpatient program, which requires more weekly treatment sessions than standard outpatient programs. Other people may complete a partial hospitalization program for fentanyl addiction, which involves spending most of the day in a treatment program and then going home at night. An intake specialist or other addiction professional can determine which level of treatment is most appropriate for each unique individual.
Misconceptions about Fentanyl Addiction
Addiction Only Comes from Illegal Drug Use
While fentanyl use has become more common, there are still numerous misconceptions surrounding the drug. One such misconception is that fentanyl addiction only occurs through illegal drug use. In reality, this is not the case, as someone can become dependent upon fentanyl when using it as prescribed by a doctor. Because fentanyl is addictive, people who take it as a prescription may be unable to stop using it, despite the damage it can do to their life.
People are Aware of Fatal Doses
Another common misconception is that people who overdose on fentanyl know that they are taking a powerful drug that could cause a fatal overdose. Unfortunately, this is not always the case. Drug dealers may combine fentanyl with other drugs such as heroin, cocaine, or methamphetamines, and when people use these drugs, they may not realize that they are also ingesting a drug as potent as fentanyl. It is possible to consume fentanyl and then experience an overdose unknowingly.
Medication Assisted Treatment is Still Addiction
A third misunderstanding surrounding fentanyl addiction is that opiate replacement medications such as buprenorphine are harmful when used in treatment because they create a new addiction that replaces fentanyl. In reality, medications are helpful, and experts report that they can make treatment more effective when used in combination with counseling. It is also important to note that when replacement medications are prescribed in the treatment of fentanyl addiction, a doctor completes careful monitoring to reduce the risk of any adverse effects.
Resources
- https://www.cdc.gov/drugoverdose/data/fentanyl.html
- https://www.drugabuse.gov/publications/drugfacts/fentanyl
- https://www.jpain.org/article/S1526-5900(14)00905-5/abstract
- https://www.cdc.gov/drugoverdose/epidemic/index.html
- https://web.archive.org/web/20220402101135/https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_03-508.pdf
- https://sites.utexas.edu/asrec/facts-myths/exploding-drug-myths
SAFE HARBOR TREATMENT CENTER
You Can Beat Fentanyl Addiction
Fentanyl can be a dangerous and sometimes misunderstood drug, but recovery from fentanyl addiction is possible. If you or a loved one is struggling with an addiction to fentanyl or another opiate drug like heroin, reaching out for help is the first step toward recovery. With treatment, you can overcome your fentanyl addiction and live a healthy, drug-free life.