What is Fentanyl? Overdoses and Treatment for Fentanyl Addiction

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picture showing the potency of fentanyl in comparison with heroin and morphine

Fentanyl, a strong synthetic opioid, contains 50 to 100 times more potency than morphine. Both prescribed by doctors and illegally manufactured, fentanyl reduces severe pain, such as after surgery. It also treats chronic pain in patients without response to other opioid medications.

Synthetic opioids, like fentanyl, influence the most drug overdose deaths in the US. A lethal dose is small, and approximately 150 individuals die every day from synthetic opioid overdoses with fentanyl and similar drugs. These rates have increased dramatically in recent years according to the Centers for Disease Control and Prevention (CDC).

Pharmaceutical fentanyl and illicitly manufactured fentanyl (IMF) are available in two forms:

  • Powdered fentanyl mixes into drugs like heroin, cocaine, methamphetamine, and counterfeit pills.
  • Liquid IMF appears in nasal sprays, eye drops, and candy-like lozenges.

Doctors use pharmaceutical fentanyl to treat extreme pain after surgery and advanced-stage cancer. However, most recent fentanyl-related overdose incidents connect to illicit and illegal forms (IMF) sold on the drug market for heroin-like effects.

Because of its power, fentanyl is often added to other street drugs, making them cheaper, more potent, more addictive, and more deadly. Street names for IMF include Dance Fever, Goodfellas, Jackpot, Murder 8, Friend, Tango & Cash, China Girl, Apace, and many others.

Brands and Forms of Fentanyl

Fentanyl, a Schedule II drug according to the Drug Enforcement Administration (DEA), has a significant risk of being abused, even among illicit drugs. Fentanyl is only legal when prescribed by a licensed physician for medicinal purposes in branded forms:

Actiq (Lozenges)

This formulation of fentanyl is a lozenge on a plastic stick that is given under the tongue like a lollipop. Usually, doctors prescribe this form to patients already taking painkillers and military service members.

Abstral (Tablets)

Abstral is the fast-dissolving tablet given under the tongue for quick pain relief in opioid-tolerant cancer patients with “breakthrough” pain.

Lazanda (Nasal Spray)

Lazanda is a fentanyl nasal spray taken like over-the-counter nasal decongestants. Doctors prescribe it to cancer patients.

Subsys (Oral Spray)

Subsys is a pain-relieving sublingual spray delivered under the patient’s tongue. It lifts acute cancer pain.

Duragesic (Skin Patch)

Fentanyl patches relieve moderate to severe pain for up to three days through an extended “transdermal“ patch.

Sublimaze (Injectable)

Sublimaze is an injectable fentanyl formulation controlling pain before and after surgical procedures.

Effects of Fentanyl on the Brain

Fentanyl—like heroin and morphine—binds to the body’s opioid receptors that regulate pain and emotions. After repeated use, the brain adapts to the medication, reducing drug response, increasing tolerance, and making it difficult to experience pleasure from other sources.

After the first exposure, fentanyl effects can create immediate difficulty for people who function normally in everyday life:

  • Confused thinking
  • Extreme sedation
  • Breathing difficulty
  • Unconsciousness
  • Elevated mood
  • Severe drowsiness
  • Persistent nausea

Like other synthetic opioid addiction, the long-term effects of regular fentanyl use cause discomfort and dangers in several systems of the body and mind:

  • Mood instability
  • Reduced libido
  • Constipation
  • Menstrual problems
  • Respiratory depression

Treatment of Fentanyl Overdose

Drug traffickers combine cheap fentanyl with other illegal drugs including, heroin, cocaine, MDMA, methamphetamine, and pills, making it impossible to determine which substance truly caused the overdose.

When dispensed quickly, life-saving drugs like naloxone can reverse an opioid overdose, blocking the effects of opioids by attaching to the same opioid receptors. However, because fentanyl is more potent than other opioids like morphine, several naloxone doses can be needed.

Because of this, the most important thing to do if you think someone has overdosed is to call 911 for urgent emergency treatment. If an opioid is suspected, first responders can deliver naloxone on arrival. People saved by naloxone should be watched for at least two hours after receiving a dose to monitor breathing.

Naloxone is available as a nasal spray (Narcan® and Kloxxado®) and injectable solution, usually as a prescription drug. But, to save lives after record-breaking overdose death statistics, several states have legislated that pharmacists can give naloxone without a prescription. Naloxone nasal spray and naloxone injections can help friends, relatives, and others save someone who overdoses.

table of short- and long-term effects of synthetic opioid abuse with fentanyl

Fentanyl Addiction Treatment

Together, medication and therapy are proven to effectively treat fentanyl addiction, as evidence for opioid dependency and addiction suggests.

Detox

Most substance use disorder treatment programs begin with detoxification. Detox eliminates drugs from persisting in the body and cuts painful withdrawal symptoms under medical supervision. Medical detox opens the door to further healthcare treatment options. Detox alone is typically ineffective for full, relapse-resistant recovery, but it is a vital first step.

Medication

Buprenorphine and methadone reduce cravings and withdrawal symptoms by binding to the same opioid receptors in the brain as fentanyl. Another drug, naltrexone, inhibits the effects and mechanism of fentanyl by blocking those opioid receptors.

Behavioral Therapies

Behavioral therapies for fentanyl addiction help individuals strengthen their mental health while adjusting attitudes and actions toward drug use, improving life skills, and committing to treatment:

  • Cognitive-behavioral therapy aids in modifying drug use, expectations, and behaviors while managing triggers and stress.
  • Contingency management therapy gives patients “points” based on positive steps toward recovery such as negative drug tests. Patients redeem points for items or activities that promote health and wellness.
  • Motivational interviewing targets the mixed feelings, resistance, and beliefs that patients have about change. It uses the patient’s own ideas about recovery to motivate engagement and encourage action.

Fentanyl Withdrawal Symptoms

When someone uses fentanyl for a long time, their body adapts to functioning without the drug. Symptoms of withdrawal can start 12 hours after the last dose, and symptoms usually last up to a week. In early detox, discomfort can be severe without a doctor’s medication-assisted treatment and monitoring. Many fentanyl withdrawal signs create pain and cravings for relief:

  • Vomiting and nausea
  • Watery eyes
  • Runny nose
  • Muscle weakness
  • Excessive sweating
  • Appetite loss
  • Spontaneous chills
  • General insomnia
  • Mood depression
  • Acute pain
  • Digestive issues
  • Racing heart
  • Increased blood pressure
  • Severe irritation

Heal Fentanyl Abuse with The Recovery Team

The Recovery Team uses supervised detox and medication-assisted treatment through inpatient and outpatient recovery to treat synthetic opioid substance use disorder. To get better and stay better, contact a compassionate specialist to learn about your personal treatment options.