An Overview of Fentanyl
Fentanyl is a powerful prescription opioid that’s usually reserved for very specific medical situations. For example, fentanyl may be prescribed to someone with breakthrough cancer pain already on around-the-clock opioid treatment. Fentanyl brand names include Subsys and Duragesic. Fentanyl is a schedule II controlled substance in the U.S. Schedule II substances do have currently accepted medical uses, but also have a high likelihood of addiction and dependence.
If someone is dependent on fentanyl, it’s very likely they will require a professional fentanyl detox to safely rid their system of the drug. Fentanyl is believed to be 50 to 100 times stronger than morphine and heroin. It’s currently the most potent prescription opioid available.
Along with being used in medical settings, fentanyl is increasingly produced in illicit lab settings. It’s fairly easy to produce analogs of fentanyl and then sell them on the black market.
Sometimes people know they’re getting fentanyl. At other times it’s in heroin or other pills they buy on the streets, and they don’t realize it. Because of the strength of fentanyl, it often leads to overdoses when people use it. Fentanyl is estimated to be involved with nearly half of all deaths related to opioids.
Fentanyl is the most potent prescription opioid available, and it’s one of the deadliest. Of the tens of thousands of opioid overdose deaths that occur each year, fentanyl is involved in the majority of them. Fentanyl is used in medicine to treat severe pain. Most often fentanyl is used for cancer breakthrough pain in patients who are already opioid-tolerant.
Fentanyl is also made illegally in laboratories and sold on the black market. Some people may seek fentanyl out because of how powerful it is and the high it creates. Many others don’t realize they’re using fentanyl and instead think they’re using a less potent opioid such as heroin or other prescription pain medications.
When someone is experiencing symptoms of fentanyl addiction or addiction to any opioid, they most likely need professional treatment. Fentanyl inpatient treatment is one option.
How Does Fentanyl Work?
Fentanyl works similarly to other prescription opioids, but it’s much stronger. Fentanyl is estimated to be as much as 100 times stronger than morphine. Fentanyl activates opioid receptors. These receptors are located throughout most of the body, including the entire central nervous system.
When opioid receptors are activated, it changes how the brain and body sense and responds to pain. At the same time, many people will experience a sense of euphoria when they use opioids. This euphoria can trigger the brain’s reward cycle.
Fentanyl is a central nervous system depressant as well. Central nervous system depressants slow thinking and all of the body’s major functions including breathing and heart rate.
The Reward Cycle
That’s what leads to the brain’s reward cycle. The brain is conditioned to want to continue seeking those things that bring a pleasurable feeling. In this case, this makes the brain want to continue using fentanyl.
Unfortunately, the pleasurable and euphoric response your brain has to fentanyl is likely going to be short-lived. People develop a tolerance to fentanyl relatively quickly. Once this happens, the user might not even feel euphoria or pleasurable feelings anymore. At this point, however, they have to continue using fentanyl to avoid withdrawal.
There are stringent regulations and laws guiding how fentanyl can be prescribed and used. Despite these guidelines and regulations, fentanyl abuse is a significant problem contributing to tens of thousands of deaths each year.
The reason for this is because fentanyl is illegally manufactured. Non-pharmaceutical fentanyl is sold as a powder, mixed with heroin, or mixed with certain opioid drugs that would ordinarily be less potent. Fentanyl is also sometimes sold on blotter paper.
Fentanyl abuse can occur when people swallow the drug, inject it, or snort it.
Fentanyl is a central nervous system depressant, as are other opioids. It’s just much stronger in its effects. Currently, fentanyl is the strongest opioid pain medication available legally. It’s not just the diversion from medical use that’s problematic with fentanyl either.
Fentanyl analogs, which are illicitly-manufactured replicas of fentanyl, are an even bigger problem than the drug being diverted from legitimate medical use.
When someone uses fentanyl, it binds to opioid receptors and floods the brain with dopamine. When the brain is flooded with dopamine, it then causes euphoria, a pleasant sense of well-being, a decreased sense of pain and suffering, and relaxation. Fentanyl and other opioids can also cause sedation in users. The effects of fentanyl are usually only felt for around 30 to 90 minutes.
Side effects of fentanyl include:
- Dry mouth
- Tiny pupils
- Slowed breathing and heart rate
- Flushed skin
- Concentration problems
According to research compiled by the American Medical Association, of the more than 42,000 overdose deaths that happened in 2016, almost 46 percent involved the use of fentanyl.
Some other facts about fentanyl include:
- The Centers for Disease Control estimates fentanyl is 50 to 100 times stronger than morphine
- Some people may seek out fentanyl for its strength, but more often people are unaware they’re taking it. For example, dealers may mix it with heroin or sell it as heroin.
- In 2017 there were around 72,000 overdose deaths in the U.S. which were a rise of around 10 percent from the already soaring numbers of 2016.
- Fentanyl is a synthetic opioid, and it can be made in illicit labs.
- Fentanyl is concentrated which makes it easy to transport.
- The CDC reports that the number of overdose deaths involving synthetic opioids has gone up significantly, but deaths from other opioids including heroin, methadone and prescription drugs have gone down.
- Certain areas have seen higher death rates than others. For example, in many states in the Midwest and the mid-Atlantic regions, death rates have gone up significantly.
- Some of the brand names of medical fentanyl include Duragesic, Sublimaze, Subsys, and Actiq.
There are differences between fentanyl abuse, addiction, and dependence. While all three conditions will usually occur together, they are distinct conditions.
Fentanyl abuse refers to a situation where a person is using fentanyl in any way outside of how it’s prescribed or intended to be used. If someone is abusing fentanyl it doesn’t necessarily mean they’re addicted, but the more someone abuses opioids, the more likely they are to become addicted.
Recognizing the Signs of Fentanyl Abuse and Addiction
If someone is in the early stages of opioid abuse, they may still be able, to begin with, an outpatient rehab program. If the signs of opioid abuse or addiction are identified, and intervention occurs early enough, outpatient treatment may be effective on its own.
However, as was noted, fentanyl is such a strong opioid that addiction and dependence occur quickly and also become severe rapidly so early intervention may not be possible.
Signs of opioid abuse can include:
- Taking higher doses than prescribed
- Using opioids without a prescription (for example, taking them from a family member)
- Taking opioids just for the effects (such as euphoria or relaxation)
- Continuing to use opioids for longer than prescribed
- Taking opioids with other substances like alcohol or benzodiazepines to intensify the effects
- Using opioids other than how they’re intended to be used (such as crushing up pills to snort or inject them)
While the signs of opioid abuse are different from addiction, abuse often leads to addiction.
Signs of opioid addiction can include:
- Compulsive, out-of-control use of opioids
- Using opioids even when there are negative consequences to health
- Engaging in dangerous activities while on opioids or to get opioids
- The inability to stop using opioids, even when trying
- Opioids become a top focus and priority above all else
Symptoms of Fentanyl Addiction
Along with overdose and death, two of the most serious possible effects of fentanyl use is addiction and dependence. Addiction is a diagnosable medical condition with certain specific symptoms. Addiction to fentanyl or any other substance can be characterized as mild, moderate or severe. This is primarily dependent on the number of symptoms a person experiences.
Detecting signs of opioid abuse and addiction early on can be key to a more successful opioid or fentanyl rehab process.
Some of the possible symptoms of fentanyl addiction that indicate a person might need fentanyl rehab can include:
- Feeling out of control when it comes to the use of fentanyl
- Wanting to stop using fentanyl but being unable to
- Having at least one failed attempt to cut down on or stop using fentanyl
- Becoming secretive or lying to cover up fentanyl use
- Declines in performance at school or work
- Cravings for fentanyl
- Continuing to use fentanyl despite negative consequences
- Losing interest in things that were previously priorities
- Financial or legal problems
- Changes in sleep or hygiene habits
- Relationship problems
Patient-Centered Fentanyl Treatment
Above all else, regardless of the specific treatment modality used, it needs to be centered on the needs of the individual patient.
For example, what are the patient’s ultimate wants and goals beyond the desire to stop using fentanyl? How willing is the patient to receive treatment, and what are their thoughts about addiction treatment in general?
For addiction treatment to be successful, the patient has to feel empowered, and that begins with treatment that is based on them individually and not a one-size-fits-all treatment model.
Finding a Fentanyl Treatment Program
If you would like to learn more about fentanyl addiction treatment programs and how to get help for yourself or your loved one, contact Amethyst Recovery. We can share more about our specific programs and how we create patient-centered treatment plans.