According to the Center for Disease Control (CDC), drug overdose deaths in the U.S. have mushroomed over the past few years. Fentanyl, a synthetic opioid 80 to 100 times stronger than morphine, caused many of the deaths. Prescribed as an injection, pill, lozenge, or patch to control pain, fentanyl is also a popular drug of abuse.
What Is Fentanyl?
Unlike opium, which comes from the poppy plant, synthetic opioids are created in a lab. Fentanyl is the strongest opioid pain reliever available in medical settings. Developed as a skin patch to treat cancer patients, it is often mixed with heroin or falsely labeled as heroin, making its use even more deadly. Most illicit fentanyl comes from Mexico.
Fentanyl has many street names, including Apache, China Girl, China White, Dance Fever, Goodfella, Jackpot, He-Man, Serial Killer, TNT, and Shine. Illicit fentanyl may be sold as a powder, on blotter paper, as tablets that look like weaker opioids, or mixed with heroin.
Why Is Fentanyl So Dangerous?
Like heroin and other opioids, fentanyl affects the areas of the brain associated with emotions and pain control. It binds to opioid receptors, causing “feel-good” neurotransmitters to surge and to create a state of relaxation and euphoria. Because opioid receptors are in the part of the brain that slows down or speeds up the breathing rate, fentanyl can make it difficult or impossible to breathe.
Fentanyl’s strength makes it more dangerous than less potent drugs. It may also contain cocaine or heroin, making it even stronger and deadlier than it is by itself. It’s difficult for users to know what ingredients illicit fentanyl contains, and it only takes 2 or 3 milligrams to suppress breathing and to lead to coma or death.
Fentanyl abuse started in the 1970s with supplies diverted from pharmacies or made in illegal labs. Even fentanyl patches that have been used and thrown away can contain sizable amounts of the drug. Users remove the gel from discarded packages and eat it, place it under the tongue, or inject it. Illegal fentanyl may be taken by mouth, snorted, or injected, and all methods are equally unsafe.
How Do Doctors Use Fentanyl?
Doctors prescribe fentanyl for hard-to-treat pain in cancer patients or as anesthesia for patients who have heart problems or heart surgery. They may also use it for severe chronic pain or administer it into the base of the spinal cord to relieve pain during childbirth.
Prescription names for fentanyl are Actiq, Duragesic, Durogesic, Fentanyl citrate, Lazanda, Nasalfent, Sublimaze, and Subsys.
What Are the Side Effects of Fentanyl?
Everyone experiences side effects when they use fentanyl, but older people have the highest risks, especially for shallow breathing, coma, and death. Look for these signs if you suspect fentanyl use in a friend or family member:
- Decreased heart rate
- Dilated pupils
- Dry mouth
- Inability to concentrate
- Loss of consciousness
- Tightness in the throat
- Rigid or stiff muscles
- Slowed breathing
Less common side effects include anxiety, headache, low blood pressure, chest pain, abnormal heart rhythm, inability to get warm, and a bloody cough. Some people have kidney problems, rash, dizziness, or nightmares. There may also be swelling in the face or limbs. Hallucinations, although infrequent, may also be a side effect. Fentanyl users may hear voices or see things that don’t exist.
Transdermal patches may cause redness or rashes to the area where it’s applied. Usually, people who misuse fentanyl don’t use patches because the drug enters the body slowly and doesn’t lead to a high.
What Are the Withdrawal Symptoms of Fentanyl?
Fentanyl users may develop a dependency, tolerance, or addiction. Signs of physical dependence start when the drug is stopped suddenly. Withdrawal symptoms usually begin within 12 hours of the last dose and last for seven days or longer.
Look for these symptoms of fentanyl withdrawal:
- Constricted pupils
- Hot and cold flashes
- Runny nose
- Severe pain
- Vomiting and diarrhea
Users quickly develop a tolerance and need higher doses of fentanyl to get high, creating cravings that lead to addiction. Addiction is a chronic relapsing disease that follows dependence, and that leads to a constant need for a fix.
What Are the Symptoms of Overdose?
One dose of fentanyl can be deadly, especially if it’s illegal or not taken as prescribed. These symptoms occur with an overdose:
- Clammy, cold skin
- Blue lips or fingertips
- Dizziness, confusion, or feeling faint
- Lack of responsiveness
- Limp body
- Shallow, slow breathing, or no breathing
- Slow heartbeat
- Severe sleepiness
- Trouble walking or communicating
How Can Fentanyl Overdose Be Prevented?
Sometimes, individuals who are dependent on heroin replace it with fentanyl, but it’s a dangerous practice. Fentanyl is potent, and it’s difficult to measure. The pure powder is hard to dilute, making it difficult to control the dose and the outcome. Therefore, death can occur quickly.
The CDC recommends several measures to prevent opioid overdose, including improving guidelines for prescriptions, preventing opioid use disorder, treating and/or reversing overdose, and educating patients and medical providers. Prescription monitoring programs, writing state prescription drug laws, working with insurance companies, increasing treatment options, and improving awareness can also help.
Can Fentanyl Overdose Be Reversed?
If you think someone has overdosed on fentanyl, call 911 immediately. Naloxone, also known as Narcan, may reduce overdose effects and save a life before the medics arrive. An overdose occurs when fentanyl completely blocks the opioid receptors in the brain, slowing down or stopping breathing. Naloxone, available as an injection or nasal spray, rapidly reverses an overdose. When administered correctly, it can block fentanyl from entering the opioid receptors.
Naloxone does not require a doctor’s prescription and is available to anyone who needs it. It might be a good idea in cases like these:
- If you or a loved one has a prescription for opioids
- You or a loved one just finished rehab for opiate addiction
- Planning to be around people who might overdose and would like to have it in case
What Is the Emergency Procedure for Overdose?
- Call 911. If your loved one is unresponsive, position him or her on a side on the floor. Keep the legs bent, and place one arm under the head. This keeps the individual from inhaling vomit. Be prepared to give as much information as you can to emergency providers.
- Administer Naloxone. Naloxone only works for opiate overdoses, but it’s not harmful if you find out later that the overdose didn’t occur from opioids. Therefore, you should give it if you can.
- Give CPR. If the person isn’t breathing, tilt the head back, pinch the nose with your fingers, and administer one slow breath every five seconds until help comes or breathing starts. Watch to see if the chest is rising and falling with each breath.
- Offer support. If breathing resumes, keep the person calm and in the same position until help arrives. After the emergency has passed, it may be a good time to suggest treatment for fentanyl dependence.
How Is Fentanyl Addiction Treated?
A combination of medication and behavioral therapy is the standard treatment for fentanyl addiction. Methadone and buprenorphine, two medications used to treat opioid dependence, bind to the same opioid receptors that opioids do, reducing withdrawal symptoms and cravings. Naltrexone, a similar medication, blocks the same receptors and keeps fentanyl from causing a high.
Psychotherapy, especially when combined with medication, is also helpful. Cognitive behavioral therapy (CBT) helps patients change the way they think and act, replacing unhealthy behaviors with more useful ones. Rewarding patients for positive results, such as providing negative drug tests, encourages a more wholesome lifestyle and discourages drug use. Patient-centered counseling, especially in 12-step programs, is another way to motivate change.
What Is Holistic Care?
Holistic care focuses on the “whole” person, treating the addiction but also caring for the patient’s overall well-being. Holistic techniques include those related to emotional, physical, social, and spiritual wellness. Rehab centers that include traditional medical care, 12-step programs, and holistic practices have higher recovery rates and lower relapse rates.
Holistic recovery programs promote a healthy diet, exercise, and a balanced lifestyle. They also include activities, such as meditation, therapeutic writing, and yoga, to promote relaxation, to encourage self-expression, and to teach social skills that make life easier after rehab.
At Granite Recovery Centers, we believe addiction starts as a way to self-medicate buried trauma, a dysfunctional childhood, or an emotional disorder. Our therapists help patients uncover the causes for their drug use and learn to recognize the triggers that cause the habit to continue.
10 Facts to Remember
- Fentanyl is similar to morphine, but it may be as much as 100 times stronger.
- Fentanyl is a prescription painkiller, but illicit forms are sold on the street.
- Synthetic opioids, including fentanyl, are the most common cause of drug overdoses.
- Fentanyl is even more deadly when mixed with other drugs or alcohol than it is alone.
- It’s difficult to know what ingredients are in illegal fentanyl.
- Fentanyl’s strength increases its risk of overdose.
- Users often underestimate the strength of a dose of fentanyl.
- Medication and behavioral therapy are effective ways to treat fentanyl addiction.
- If given in time, a drug called naloxone can reverse fentanyl overdose ad save lives.
- In 2019, over 36,000 people died from fentanyl and other synthetic opioid overdoses.
We Can Help
If you or a loved one has a problem with fentanyl, it’s never too early to ask for help. Our experienced team of professionals knows how to work with adults who have addictions that occur alone or with other mental illnesses, such as PTSD or depression. Co-occurring conditions make each disorder harder to treat, and having a program that focuses on both makes it easier to get clean and to stay sober.
Our treatment centers offer evidence-based talk therapy, support groups, and medication-assisted medical supervision to help patients deal with the cause of their fentanyl use and to find healthier ways of coping. Unlike facilities that offer only detox or rehab, our facility offers both, making the entire process seamless and less stressful. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.
Our inpatient rehab provides 24-hour supervision for patients who want to “get away” for recovery or for those who prefer around-the-clock support. For people who want to return to their homes or other supportive settings at night, we have an outpatient program.