Fentanyl Addiction

Fentanyl is the strongest opioid. It is possible to die instantly from taking the drug. Fentanyl has become increasingly more accessible over the past decade because it is cheap to make.

Understanding Fentanyl Addiction

Fentanyl is the strongest opioid drug. It is a legal drug that is used to treat severe pain in patients recovering from surgical procedures, those who have cancer and patients who are on narcotic pain relief around the clock and who have breakthrough pain.

Street names of fentanyl include China white, China girl, TNT, crush and apache.

Fentanyl acts on the brain by blocking pain receptors (the opioid receptors) and by increasing the activity of dopamine, which produces feelings of well-being and euphoria. Because it is so potent, it has a high potential for abuse and addiction.

Ingesting it can easily lead to an overdose. It is nearly one hundred times more potent than morphine and is even lethal in doses as little as two milligrams. It is possible for you to die instantly from taking fentanyl since the user doesn’t even have time to metabolize the drug.

Fentanyl has been increasingly available in the past ten years. It is cheap to make, so abusers are turning to it.

Common Forms of Fentanyl

There are several brand names for the drug, which is available in many different forms. It can be injected or ingested. The drug can be pressed into a medication that looks so much like oxycodone that they can be confused with one another. This may lead to unintentional fentanyl overdose.

Various forms of the drug include:

  • Actiq: Actiq is a lozenge form of fentanyl, often called “lollipops.” It is used for people already on narcotic drugs.
  • Duragesic: Duragesic is a fentanyl patch used to treat moderate to severe physical pain, often lasting several days.
  • Subsys: Subsys is a sublingual fentanyl spray used for breakthrough cancer pain.
  • Abstral: Abstral is a rapidly-dissolving tablet that is used sublingually.
  • Lazanda: Lazanda is a nasal spray used to treat pain in patients with cancer.

Symptoms of Fentanyl Addiction

Patients with fentanyl addiction are suffering from opioid use disorder, of which there are eleven major symptoms. Having as few as two of these symptoms qualifies a person as having a fentanyl addiction.

Symptoms of fentanyl addiction may include:

  • Using the drug for a longer period than initially intended
  • Trying to cut down on fentanyl but being unable to control oneself
  • Spending a lot of time and money on fentanyl use, obtaining fentanyl or recovering from its use
  • Having strong urges or cravings to use the drug
  • Being unable to participate in life’s activities because of fentanyl use
  • Using fentanyl even when fentanyl is causing the addict problems in their life
  • Socially withdrawing or missing work and social activities in order to use fentanyl
  • Engaging in risky behavior while using fentanyl and continuing to use it despite the consequences
  • Ignoring the physical and psychological consequences of fentanyl abuse and continuing to use it
  • Developing a physical tolerance to the drug
  • Having withdrawal symptoms when decreasing the use of the drug or stopping the drug

Using fentanyl for a period of time will cause a number of physical and psychological symptoms. These side effects tend not to be seen in those who take fentanyl therapeutically but will be brought out in abusers of the drug.

Physical and psychological symptoms include:

  • Chest pains
  • Seizures
  • Confusion
  • Blurry vision
  • Irregular heartbeat
  • Passing out
  • Labored breathing
  • Chest tightness
  • Lightheadedness or dizziness
  • Decreased urine flow
  • Mild cough
  • Decreased appetite
  • Mood changes
  • Anxiety
  • Pale skin
  • Fever
  • Chills
  • Back pain

Availability of Fentanyl

Fentanyl addicts resort to several types of behavior to get the drug. They may get it from relatives, classmates, coworkers or even drug dealers. They may buy fentanyl patches and chew them up to get a fast high. Additionally, health care professionals may steal the drug from work and sell it to fentanyl addicts for money.

This was case until about 3 or 4 years ago when fentanyl became widely available on the streets. This type of fentanyl was in the form of heroin laced with fentanyl or, more commonly, fentanyl mixed with fillers to look like and be sold as heroin.

The number of synthetic opioid (mostly fentanyl) overdose deaths soared to 29,406 in 2017, up more than 50% from 2016.

The majority of this type of fentanyl is made in Chinese labs and sold over the internet and shipped via the U.S. Postal Service. These kilos of fentanyl are then “cut” with fillers to yield about 20 kilos of product and over a million dollars in profits per kilo of uncut fentanyl.

The U.S. Postal Service, unlike commercial carriers such as FedEx or UPS, do not require bar coded data that would identify the sender and receiver of packages. Such information would allow U.S. Customs and Borders agents to better identify these kilos of fentanyl coming over from China.

Fentanyl Overdose and Withdrawal

Medically-supervised fentanyl use is carefully planned out so there is typically little chance of an overdose. On the other hand, as a person increases their dose for recreational purposes, tolerance builds up quickly. This is what leads to addiction. People addicted to fentanyl have many adverse side effects and a high rate of overdose.

Signs of an overdose include shallow and slow breathing with an increased risk of respiratory arrest and death.

Long-term use of fentanyl will lead to:

  • Depression
  • Feelings of discouragement
  • Muscle weakness
  • Muscle stiffness
  • Apathy
  • Diarrhea
  • Back pain

Stopping fentanyl or decreasing the dose will lead to numerous withdrawal symptoms—none of which are life-threatening but most of which are very uncomfortable.

These withdrawal symptoms include:

  • Feelings of restlessness
  • Chills and sweating
  • Yawning
  • Anxiety
  • Irritability
  • Watery eyes and nose
  • Muscle pain
  • Stomach cramps
  • Enlarged pupils
  • Back pain
  • Rapid breathing
  • Hypertension
  • Elevated heart rate
  • Nausea
  • Vomiting

Beating Fentanyl Addiction

While fentanyl detoxification and withdrawal are not life-threatening, they can be so uncomfortable that it drives the addict to begin using again. This is why medication-assisted therapy is frequently used to treat this type of addiction.

There is a variety of medications that can be used to decrease withdrawal symptoms. Some medications will also prevent the individual from attempting to abuse the drug during the withdrawal period. These medications, called substitution drugs, can be gradually withdrawn with a marked reduction in withdrawal symptoms.

Medication-assisted therapy can be used for months or years before the addict is able to fully sustain a life of recovery without the help of medication-assisted treatment drugs.

Author:Kent Hoffman
Kent Hoffman

Kent Hoffman, D.O. has been practicing medicine for nearly 30 years. He is board-certified to practice addiction medicine and family medicine. Dr. Hoffman gets to know his patients on a first-name basis to provide compassionate and professional health care.

Last modified: 01/24/2019