Fentanyl is a highly potent synthetic opioid used to treat severe and chronic pain. It’s also used for anesthesia and sedation prior to surgeries and other invasive procedures. Its high potency makes it particularly dangerous, especially in terms of addiction and overdose. The drug is estimated to be 50 times stronger than pure, pharmacy grade heroin.

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How addictive is fentanyl?

The high potency of fentanyl does not necessarily make it more addictive than similar drugs. Users often report that this particular opioid creates a less intense euphoria and more of a sedative effect compared to heroin. This may mean that it’s less addictive than heroin due to the fact that it doesn’t produce as strong of a connection between the behavior (taking the drug) and the reward for that behavior (the high).

Regardless, fentanyl is still considered to be highly addictive, especially after long-term use. Addiction is also more likely to lead to overdose death with this drug. According to the Drug Enforcement Administration, it was responsible for over 1,000 deaths in 2007 alone.

What are the signs of addiction?

The abuse of any opioid can be spotted through a number of distinct signs, including:

  • Severe drowsiness
  • Frequent nodding off
  • Chronic constipation
  • Poor memory and concentration
  • Slowed reaction time
  • Anxiety or depression
  • Slowed breathing
  • Altered sleeping patterns
  • Mood swings

Drug abuse does not always lead to addiction, although opioids tend to be particularly addictive. Signs of abuse combined with behaviors that indicate addiction should be cause for serious concern. Addiction behaviors can include:

  • Spending all of one’s spare money on the drug
  • Secretive behavior
  • Social withdrawal or isolation
  • Changes in social circles
  • Neglecting work, school, and/or family responsibilities
  • Neglecting grooming and/or personal hygiene
  • Constant preoccupation with the drug

What is fentanyl withdrawal like?

Withdrawal from fentanyl can be particularly intense due to its high potency. Most of the time, people abuse fentanyl after already developing a tolerance to weaker opioids to the point that they need something stronger in order to feel high at all.

Fentanyl withdrawal symptoms include:

  • Yawning
  • Sweating
  • Runny nose
  • Joint or muscle pain
  • Chills
  • Stomach cramps
  • Nausea or vomiting
  • Diarrhea
  • Anxiety
  • Insomnia
  • Hypertension
  • Increase heart rate
  • Muscle weakness

These symptoms tend to kick in around 24 hours after the last dose of fentanyl wears off and fade after about a week. Insomnia and psychological symptoms may linger in some individuals.

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What treatment options work best to treat fentanyl addiction?

Due to the severity and dangers associated with opioid addiction, medications have been developed to directly treat addiction disorders related to drugs like fentanyl. These medications are designed to replace the substance that a person is addicted to by producing the same reactions in the brain without causing a high. The individual can then be weaned off the replacement medication.

For several decades, methadone has been used in this way, particularly to treat heroin addiction; however, it can be applied to any type of opioid. More recently, buprenorphine has been developed, which operates in much the same fashion as methadone but has a decreased potential to trigger an overdose. Both of these drugs are opioids themselves but are considered to be less addictive, though users can become addicted to them in some circumstances.

Treatment with medication works best in conjunction with standard addiction rehabilitation programs, support group participation, therapy, and ongoing aftercare. Addiction specialists can create an individualized program for any person addicted to fentanyl to best address that person’s needs and to best ensure a sustained recovery.

Frequently Asked Questions

Fentanyl is a powerful prescription painkiller synthesized from morphine. It is used in the treatment of severe pain immediately after surgery, pain due to long-term chronic illness, or end-of-life pain associated with illnesses like cancer. This synthetic opioid is a Schedule II drug because it has an important medical use, but it is highly addictive.

Because fentanyl is an opioid painkiller, like other opioid painkillers, it has become a target for substance abuse and addiction. In fact, several states have seen an outbreak of narcotic overdoses due to mixing fentanyl and heroin.

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What are the street names for this drug?

There are several brand names of the prescription version of fentanyl, but as this intoxicating substance becomes more prevalent for illicit use, more street names are appearing. Some of these include:

  • China Girl
  • China white
  • Apache
  • Friend
  • Dance fever
  • Goodfella
  • TNT
  • Tango and cash
  • Murder 8
  • Jackpot
  • Drop dead
  • Percopop

When sold for illicit or nonmedical purposes, fentanyl is typically a white powder, which has recently been sold as heroin or mixed with heroin. It is also sometimes sold on blotter paper, in medical form as transdermal patches, or as tablets or pills.

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What are the health risks of use?

When a person struggles with addiction to narcotics, including fentanyl, there are many potential health risks. Side effects can be dangerous or reduce the person’s quality of life. Long-term abuse can cause damage to major organ systems, including the liver and kidneys. Addiction can also change brain chemistry to the point that mood disorders or other psychiatric conditions develop, although this is more likely in people who are at risk of developing these conditions anyway.

Addiction can also cause physical dependence on the drug, leading the person to ingest the substance compulsively in order to feel “normal.” The individual could also develop a tolerance to the substance, so they ingest more fentanyl in order to achieve a euphoric effect. Tolerance and dependence put the person at great risk of overdosing on the drug and can also cause intense withdrawal symptoms when the person attempts to stop taking the drug.

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What are the side effects of use?

Because fentanyl is such a potent medication, it can cause side effects, whether it is used for nonmedical reasons or it is used as prescribed. However, people who ingest larger doses of this drug, or abuse it for a long time, are more likely to suffer side effects than people who take the medication with a doctor’s supervision.

Side effects include:

  • Constipation
  • Nausea or vomiting
  • Abdominal cramps
  • Insomnia
  • Sweating
  • Fatigue or increased need for sleep
  • Feeling cold
  • Headache
  • Changes in appetite or weight
  • Mood swings
  • Depression
  • Fluid retention, especially in the lower limbs
  • Tingling sensation, especially in extremities
  • Anxiety
  • Confusion
  • Hallucinations
  • Muscle spasms
  • Tremors
  • Slowed heart action
  • Respiratory changes, especially shallow or depressed breathing

Some of these symptoms are more physically dangerous than others; if they occur while a person is taking the medication as directed by their doctor, they should alert their doctor immediately. If a person abuses fentanyl and experiences these side effects, it is an indication that professional help is needed immediately.

People who struggle with addiction to fentanyl, or who abuse fentanyl with other drugs like heroin or alcohol, are more likely to suffer tolerance, dependence, overdose, and withdrawal.

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What is the risk of overdose?

Fentanyl is between 50 and 100 times more potent than morphine, so even a small dose taken for nonmedical reasons can lead to overdose. Recently, illicit drug sellers have mixed fentanyl with heroin, sold fentanyl as heroin, or pushed fentanyl instead of heroin, which has led to a dramatic rise in overdoses and related deaths across the United States, starting in 2013. Because heroin and fentanyl are both narcotics, they can enhance each other’s effects, making the risk of overdose much higher.

People who ingest fentanyl instead of heroin, or another drug like OxyContin or Xanax, are also at a greater risk of overdose because they do not know what they are taking. When a person struggles with heroin addiction, they are more likely to suffer an overdose in general because they increase the amount of heroin they ingest over time, as their body becomes more tolerant to the drug; however, if they take fentanyl instead of heroin, they do not know how much of the substance to prepare and will mistakenly take more fentanyl than their body can tolerate.

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What are the dangers of mixing fentanyl with other drugs?

Mixing fentanyl with any other central nervous system (CNS) depressant is dangerous, especially other narcotics. CNS depressants like alcohol, benzodiazepines, opioids, and marijuana enhance the effects of other drugs, so the person is at a greater risk of overdose. Mixing opioids specifically increases the risk of respiratory depression, which reduces the amount of oxygen the brain receives; the person can also stop breathing and ultimately die. In Canada and some areas of the United States, fentanyl is also being sold as cocaine, or mixed with cocaine, which can cause intense side effects, overdose, and death.

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Are there support groups for this addiction?

People who struggle with addiction to fentanyl, or who abuse the drug as a pattern of polydrug abuse, need help overcoming this problem. Fortunately, medical professionals can help a person safely detox from fentanyl addiction and enter a rehabilitation program. Both inpatient and outpatient rehabilitation programs use therapeutic intervention, including individual and group therapy, to help the person understand their addiction and develop coping strategies.

Once the person leaves a rehabilitation program, however, they need ongoing support to maintain abstinence. There are many support groups across the United States that help people struggling with addictions to narcotics to stay sober and healthy. The two easiest ways to find help through an online search include:

Psych Central also offers an online message board support group. There are other organizations with online support groups and several organizations that offer in-person support groups. Social workers at hospitals, doctors’ offices, and rehabilitation treatment facilities typically have information on local support groups, including those focusing on specific addictions, like fentanyl or opioid addiction.

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What relapse prevention techniques exist?

Addiction is a disease of the brain that involves compulsive ingestion of intoxicating substances, so relapse is often part of the condition. Other diseases, including diabetes and cancer, often involve “relapses,” when the condition spontaneously reappears or gets worse. As with other health conditions, there are ways to reduce the potential for addiction relapse.

General relapse prevention techniques employed for any addiction include a healthier diet, exercise, and a support network that includes ongoing therapy and support group attendance. However, people who have struggled with addiction to narcotics, especially potent drugs like fentanyl, may need additional help overcoming withdrawal symptoms and staying off the drug. Maintenance drugs have been employed in the United States since the 1960s, and these can be crucial to ongoing recovery for some individuals. Maintenance drugs include:

  • Methadone
  • Buprenorphine, Subutex, and/or Suboxone
  • Naltrexone

These drugs are employed for different types of narcotics addiction and at different stages in the recovery process. Buprenorphine is becoming one of the more popular and effective maintenance therapies in the US, and many medical professionals have used this drug to taper clients off addiction to narcotics like heroin or fentanyl successfully.

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