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Article Summary

A Guide To Fentanyl Addiction

Fentanyl is now ranked among the most powerful of all narcotic opioids. Used in the management of pain, the drug comes in many different forms, as well as in both controlled and immediate release formulations.

However, since Fentanyl is estimated to be 50 - 100 times more potent than morphine, it has been hailed as a great drug especially in terms of its ability to relieve pain for people whose pain has proved unmanageable by the other opioid painkillers.

As such, this commonly prescribed to people who are opioid-tolerant, which means they have established tolerance to another potent painkiller, like Dilaudid or OxyContin.

However, even though Fentanyl is mostly available as a prescription painkiller, it is also sold on the black market - which has increased the instances of addiction, withdrawal, and overdose, as well as death.

Previously unheard of by most people, Fentanyl has now become quite notorious on account of the rising numbers of overdose deaths caused by heroin laced with this potent narcotic. This was especially the case after the death of Prince, an iconic singer whose death was attributed to an overdose on the drug.

Since Fentanyl is such a strong painkiller, it produces effects that are quite similar to those of heroin. However, this has also meant that the drug has now made its way to the streets, leading to consequences that are usually deadly.

The DEA (Drug Enforcement Administration) further reports that more than 1000 people in the United States lost their lives from 2005 to 2007 as a result of abusing Fentanyl. AANA (the American Association of Nurse Anesthetists) also reports that anesthesiologists and nurses have a high probability of abusing this drug - certainly higher than members of the general public.

Today, the DEA also reports that there are more than 12 varieties of intoxicating substances produced illegally in laboratories to resemble Fentanyl before being trafficked and sold on the street.

Read on to learn more about Fentanyl, its addictive qualities, effects, signs of abuse, and more:

Understanding Fentanyl

A synthetic opiate, Fentanyl is medically used for pain relief. As such, doctors will typically prescribe it for patients suffering severe injuries or pain, as well as those who have just undergone surgery. The drug works quickly and eliminates any pain you might be feeling in your body. Even so, Fentanyl can prove to be quite addictive. This is especially so because it is more potent than both morphine and heroin.

Originally synthesized in 1960 by Janssen Pharmaceuticals (and credited to Paul Janssen), Fentanyl works as one of the fastest pain relief medications. Additionally, its effects are short lived. However, many users may experience intense relaxation and euphoria after using the drug, which is why some of them start abusing Fentanyl seeking these desirable effects.

Today, Fentanyl is available in the following forms:

  • Dissolvable tongue film
  • Lollipops
  • Patches
  • Pills that can dissolve inside the cheek.

Since Fentanyl is often administered in the hospital setting, individuals with easy access to it - including those who work around and in the health care industry - are at high risk of becoming addicted to it. However, others will start taking it as a prescription medications before becoming dependent on it.

On the street, the drug is also highly sought out for its famed powerful pain relief and relaxing effects. At times, it might be mixed with cocaine or heroin to heighten these effects. However, these combinations are extremely dangerous because the heightened effects are also accompanied by heightened dangers.

Others manipulate Fentanyl to try and release its effects faster - such as by heating up Fentanyl patches. This mode of use is quite dangerous because it often sabotages the drug's slow-release mechanism and may lead to a sudden overdose.

That said, Fentanyl is an opiate. This means that it is derived from the poppy opium plant. As such, it is similar to the other tens of opiate alkaloids derived from this plant, including but not limited to codeine, morphine, and heroin.

The human body also produces opioid peptides, such as endorphins, dynorphins, and enkephalins. Endorphins work by binding to the body's opiate receptors to block pain, which is how your body naturally provides pain relief when you get hurt.

When opioids and opiates like Fentanyl bind to the opioid receptor areas of the spinal cord and brain, they will influence how your brain perceives pain. As such, they will effectively diminish the signals of pain sent to the brain by the body. Therefore, these drugs will not dissipate your pain immediately. Instead, they will change how your body and brain perceive pain.

Today, the US is experiencing a public health crisis involving Fentanyl abuse. This could be because the drug is now more available than it has ever been in previous years - apart from its year of discovery.

For instance, the DEA seized more than 239 kilos of the drug between 2013 and 2015. Although this might seem like a small amount especially in comparison to the amounts of other illicit intoxicating substances that the authorities have seized in the past, it is worth keeping in mind that Fentanyl causes effects that are more lethal than most of the other substances. This is because even a small dose of the drug - about 2 mg - can prove fatal.

NPF, which refers to illegal and non-pharmaceutical Fentanyl (also referred to as IMF, or illicitly manufactured Fentanyl) is usually produced in clandestine laboratories. This form of the drug is also sold illegally. Since it produces effects that are quite similar to heroin, it is not surprising that this form of the drug is so widely sought after. That said, it is usually sold under a variety of names, including but not limited to Dance Fever and China Girl.

In some cases, NPF might be laced with cocaine or heroin without your knowledge. What most people don't know is that adding chemical adulterants to a street drug might cause death because you might be unaware of the potency of the batch you are abusing.

The CDC (Centers for Disease Control and Prevention) reports that 55% of all the people who died in 2015 following a Fentanyl overdose also tested positive for cocaine or heroin. This is a stark increase from the 42% who displayed the same results from 2013 to 2014.

Fentanyl Uses

As mentioned above, Fentanyl is a pain killing synthetic opioid. Given that it is one of the most powerful of all intoxicating substances, it is not surprising that Fentanyl is more potent than both morphine and heroin.

However, this has not stopped the FDA (Food and Drug Administration) from approving the rather powerful painkiller for:

  • Managing the pain from advanced cancer
  • Treating acute or chronic pain, particularly in individuals who are tolerant to opioids and those who have already developed tolerance to their narcotics meaning that they need the strongest analgesic available
  • Use as an effective adjunct to anesthesia prior to surgery and also during post-operative recovery

Fentanyl Effects

If you have a long term problem with Fentanyl, you are highly likely to experience several severe effects when you decide to stop using it. In fact, there are several serious physical and mental effects arising from abusing the drug for a prolonged period of time.

Therefore, if you do not seek treatment for your Fentanyl abuse and addiction - or if you have been abusing synthetic derivatives of this drug, you might be at risk of the following negative outcomes and effects:

a) Physical Effects

  • Difficulty breathing
  • Seizures
  • Severe gastrointestinal problems, which may include bowel perforation and obstruction
  • Weakened immune system

b) Mental Effects

On the other hand, using Fentanyl might elicit the following mental effects:

  • Delusions
  • Lack of motivation
  • Paranoia
  • Personality changes.
  • Social withdrawal

c) Lethal Combinations

At times, you may end up taking Fentanyl that has been combined with another street drug such as heroin. This combination may depress your CNS (central nervous system) and increase your risk of developing the following:

  • Coma
  • Death
  • Respiratory distress

d) Others

In other instances, you may suffer the following problems with your psychological and physical health:

  • An overwhelming sense of intense hopelessness
  • Arrest followed by incarceration
  • Diminished performance at work or in school
  • Failed interpersonal relationships
  • Financial problems
  • Homelessness
  • Inability to seek, secure, and keep a job
  • Physical harm as a result of making poor decisions and impaired motor functioning
  • Suicidal attempts and ideation
  • Withdrawal, which is also known as ostracization

Fentanyl Side Effects

Fentanyl is similar to other potent OPRs in the sense that it comes with a high risk of abuse, tolerance, dependence regardless of the form of prescription you got. In fact, NIDA (the National Institute on Drug Abuse) now warns that it is highly likely that an epidemic involving Fentanyl might develop - particularly as a result of the addictive potential and immense potency of Fentanyl.

That said, when you ingest the drug at un-prescribed levels, you may experience a sense of relaxation and intense euphoria in the same way you would if you had taken heroin.

Consider the following outward signs of Fentanyl abuse:

  • Blurred vision
  • Constipation
  • Dizziness
  • Headaches
  • Itching
  • Nausea
  • Seizures
  • Slowed breathing
  • Vomiting

Fentanyl abuse, in particular, is extremely dangerous for people who have are not already tolerant to opioids. Since Fentanyl comes with an elevated risk of suffering an overdose, this risk is intensified when you try the drug with no prior knowledge about your own levels of tolerance.

Apart from the above, abusing this drug can depress your respiratory to such a point that you will eventually overdose on it. Additionally, if you mix it with other illicit narcotics such as heroin and cocaine, its dangerous and damaging side effects will be amplified. Therefore, whether you choose to take Fentanyl recreationally or as prescribed, you should always remember that it is a potentially lethal and highly volatile substance.

Fentanyl Addictive Qualities

If you become addicted to this drug, the experience might be similar to anyone who is addicted to another intoxicating opiate substance. Even though Fentanyl is the most powerful painkiller, it is also quite potent - more so than heroin. This means that the drug is quite dangerous especially when you use it non-medically.

Fentanyl is also similar to heroin and other painkillers because it can produce both psychological and physical dependence among users. Additionally, when you are not abusing this drug, you may experience severe withdrawal symptoms.

Accordingly, most of the addicts will have to do just about anything to ensure that they have a large enough supply to last them all through the night and day. By so doing, they try to avoid the often painful and uncomfortable withdrawal symptoms.

On the other hand, it can be difficult for you to get your hands on this drug unless you have physicians and doctors willing and ready to risk their license to prescribe Fentanyl to you fraudulently. As a direct result, those who take it recreationally will have to go through the illegal and risky means of a drug dealer.

After you become addicted to Fentanyl, you may do things that are unthinkable and out of the norm for you to ensure that you can continue maintaining your habit. In the process, you will effectively be risking your freedom and safety.

One of the dangers of getting Fentanyl through a drug dealer is that you may never know what you are getting. If you use dealers to get your supply of the drug, you should keep in mind that most of it comes from clandestine laboratories. It might also contain other additives, some of which can prove quite deadly.

Additionally, Fentanyl abuse and addiction may compel you to do something illegal or immoral to ensure that you are able to maintain your addiction. This means that you could start stealing pills and money from people you know who hare taking the drug.

While Fentanyl, you might also become so preoccupied with it that you have to strive to ensure that you always have a large enough supply. This could compel you to start withdrawing from your family and friends and instead form new social groups. Your work or school performance may decline further than you thought possible.

When you are on this drug, it will often start out as a prescription medication. However, with time, regular use may cause you to become dependence on Fentanyl. However, since everyone is different, it follows that not all the patients who receive a prescription for this substance will become addicted.

In the same way, Fentanyl is quite dangerous as an addictive substance. This is because it might eventually act as a gateway drug - particularly to heroin, which is often cheaper. Luckily, there are rehab and medical treatment options available today for Fentanyl addiction.

Fentanyl Overdose

If you abuse Fentanyl, you should be majorly concerned about suffering an overdose. While there are antidote treatments that can deal with such an overdose, the treatments should be administered extremely quickly to ensure that the overdose does not cause death. In most cases, however, fatal respiratory depression might occur even before medical help is administered.

According to the DEA, Fentanyl has been responsible for several thousands of deaths in every year. However, since not every coroner's office will test for this drug, the actual number might actually be higher.

When you ingest Fentanyl - or any synthetic derivative of this drug - you may suffer several severe and dire outcomes. Therefore, if anyone you know starts exhibiting the following signs and symptoms, you should call 911 to ensure that they receive immediate attention from qualified experts and medics. These symptoms include, but are not limited to:

  • Confusion
  • Disorientation
  • Faint pulse
  • Hallucinations
  • Irregular, shallow, or otherwise labored respiration
  • Loss of basic motor functions
  • Loss of consciousness
  • Loss of coordination
  • Muscle spasms
  • Pinpoint pupils
  • Seizure
  • Slowed heart rate

As a result of the ever rising incidences of overdoses caused by Fentanyl - as well as other opioids - the CDC now recommends that first responders and law enforcement officers carry naloxone with them.

From the Narcan brand name, naloxone works as an opioid antagonist. This means that it will temporarily block the opioid receptor sites within the CNS (central nervous system). As such, it can reverse the sometimes fatal effects of abusing this drug.

Although naloxone will not always reverse opioid overdoses immediately, it might help you to regain your consciousness. After that you should be able to start breathing on your own with no external assistance.

If naloxone is administered to you and you slip right back to a state of unconsciousness, the medical personnel present might continue administering the dose to ensure that you are able to breathe again. As such, when you overdose as a result of a high dose or multiple doses of Fentanyl, then it follows that you will need multiple naloxone doses for reversing these effects.

Today, naloxone is administered in the following ways:

a) IM or Intramuscular Route

If the medics administer naloxone through IM, it will take effect within 2 to 3 minutes.

b) IV or Intravenous Route

This is usually the fastest mode of administering naloxone. Here, the effects tend to take place in a matter of 1 to 2 minutes

c) SQ or Subcutaneous Route

In case there is lack of IV, then the naloxone might be administered subcutaneously.

d) ET or Endotracheal Tube Route

The drug can also be administered through an ET but only after the airway has cleared and you are breathing normally or stabilizing.

Fentanyl Withdrawal

Since Fentanyl is both psychologically and physically addictive, you may often experience mental, emotional, and physical withdrawal symptoms when you stop using this drug.

Some of these symptoms include:

  • A rapid heartbeat
  • Abnormal thoughts
  • Chest tightness
  • Chills
  • Confusion
  • Diarrhea
  • General weakness
  • Hallucinations
  • Irritability
  • Joint pain
  • Loss of appetite
  • Mood changes
  • Muscle pain
  • Poor balance
  • Poor coordination
  • Pounding in your ears
  • Restlessness
  • Shaking
  • Stomach pain
  • Tremors
  • Insomnia

These withdrawal symptoms are quite severe. As such, it is highly recommended that you work with qualified medical professionals and addiction experts to ensure that you detox safely and comfortably.

When you detox and receive supervision and care from a qualified professional, you can easily decrease the risk that you will stop the process and eventually sabotage your own recovery while trying to alleviate these withdrawal symptoms.

Fentanyl Dangers

Although some people seek Fentanyl out knowing that it causes an extremely potent high, others use the drug unwittingly because it is sometimes disguised as another opioid narcotic or as heroin. This means that those who believe that they are actually buying their usual drug of choice, such as heroin, might actually end up with a substance that is so strong their bodies won't be able to handle it. That said, Fentanyl may heighten heroin's potency, thereby leading to respiratory depression that could prove fatal. It also compounds the toxic effects of cocaine.

On the other hand, some buyers might hear about a certain strain of heroin that provides a strong high or is quite potent and start using it without realizing that it has been laced with Fentanyl. This also results in an immediate overdose, particularly if you use your normal amount expecting to feel the same effects.

It is also important to know that Fentanyl is an opioid that directly works on the brainstem's respiratory center. This means that it can depress your ability to breathe normally. It can also paralyze the muscles in your chest that help you breath, leading to sudden death. This effect is often referred to as the sudden onset of wooden chest or chest wall rigidity.

Signs And Symptoms Of Fentanyl Abuse

There are many different signs and symptoms of Fentanyl abuse. The 11 symptoms that are commonly associated with opioid use disorders, which also encompass this drug include:

  • Being unable to adequately meet your responsibilities at school, work, or home
  • Continuing to use the narcotic despite the various problems it is causing in your life
  • Continuing to use this drug even when you know that it leads to dangerous situations, such as driving under the influence
  • Developing tolerance to this drug, meaning that you need more of it to experience the desired effects
  • Experiencing withdrawal symptoms when you stop taking Fentanyl or after decreasing your normal dosage
  • Having an ongoing desire to stop using Fentanyl (or cut it down) but being unable to do so
  • Having cravings and urges to use this drug
  • Spending a significant portion of your money, time, energy, and day looking for, abusing, or recovering from using Fentanyl
  • Taking more Fentanyl or for a longer period than you initially intended, which is often the slippery slope that leads from the use of recreational narcotics to full addiction
  • Using Fentanyl continuously even though it is exacerbating or causing a physical or psychological problem
  • Withdrawing from or reducing your participation in recreation, society, and work, as well as other opportunities in favor of abusing Fentanyl

When you have been abusing Fentanyl or you have become addicted to it - or to its synthetic derivative, you may display additional symptoms that are typical of opioid use disorder. These symptoms include, but are not limited to:

1. Mood Symptoms

  • Depressed or elevated mood
  • Anxiety
  • Paranoia
  • Mood swings
  • Euphoria
  • Dysphoria
  • Confusion
  • Depression

2. Behavioral Symptoms

  • Acting lethargic
  • Being secretive
  • Being unable to fulfil most major life responsibilities
  • Continuing to abuse Fentanyl despite the problems it causes for you socially, occupationally, or academically
  • Continuing to use the drug despite your awareness that it is worsening or leading to psychological/physical problems
  • Desiring to cut down on the drug or on the amount you use
  • Engaging in deception
  • Engaging in reckless, risky, and dangerous behaviors
  • Giving up activities and events that you once considered important in your life
  • Spending a great deal of money or time looking for, using, and recovering from abusing the drug
  • Taking the drug longer or in larger amounts than you intended
  • Using Fentanyl even in dangerous situations and conditions
  • Withdrawing from friends and family

3. Physical Symptoms

  • Coma
  • Constipation
  • Cravings
  • Death
  • Depressed respiration
  • Difficulty walking
  • Diminished effects when you take the same dose you are used to; also referred to as tolerance
  • Dizziness
  • Drowsiness
  • Fainting
  • Fatigue
  • Gastrointestinal distress
  • Increased heart rate
  • Itching
  • Labored breathing
  • Shallow breathing
  • Lightheadedness
  • Muscle stiffness
  • Nausea
  • Needing more of the drug to obtain the effects that you desire
  • Pinpoint pupils
  • Scratching
  • Shaking
  • Sleepiness
  • Slowed heart rate
  • Altered heart rate
  • Slurred speech
  • Stomach ailments, including nausea, constipation, and vomiting
  • Swollen feet and hands
  • Unconsciousness
  • Visual hallucinations
  • Vomiting
  • Weakness
  • Weight loss
  • Withdrawal, where you experience negative symptoms whenever you attempt to stop using the drug or having to use it to avoid the negative symptoms

4. Psychological Symptoms:

  • Trouble concentrating
  • Confusion
  • Disorientation
  • Inability to focus
  • Impaired judgment

Treatment For Fentanyl Addiction

Even though cutting Fentanyl out is rarely life threatening, quitting cold turkey can prove to be quite miserable and distressing. If you are addicted to this drug, you might already be physically dependent on it. This means that the ensuing withdrawal will certainly take a painful toll on your health and wellness.

Luckily, you can now go to a specialized treatment center where you will be able to benefit from the help provided using outpatient and inpatient resources. In most cases, withdrawing from Fentanyl will vary in terms of severity. This will depend on the form of the drug as well as on your level of use. It is often accompanied by restlessness, sweating, chills, and marked irritability.

In spite of the typical non-lethal nature of withdrawing from Fentanyl, however, you will still be vulnerable to a potential relapse. This is why it is highly recommended that you undergo medical detoxification, where you will have the added benefit of professional medical supervision. This option may ease the process of cleansing your body, thereby curbing the odds that you will relapse.

When you start using a drug like Fentanyl even if you are not experiencing any pain, you may derive euphoric effects from it. If you continue seeking out this euphoric state, you may eventually become addicted to the drug.

After some time, you will start fearing the onset of what is commonly referred to as acute opioid withdrawal - which inevitably occurs if you try quitting the drug. This condition may cause extremely uncomfortable symptoms.

Today, you can get treated on an outpatient or inpatient basis until you overcome your addiction to Fentanyl. Through these options, you should be able to safely wean yourself off the drug.

Additionally, as you undergo detox, you may require medical supervision to help manage your symptoms and reduce your cravings for Fentanyl, which could lead to a relapse when you are out of treatment.

Most inpatient treatment programs for Fentanyl addiction will last anywhere from 30 to 90 days. These are the best and most appropriate programs if your Fentanyl addiction is quite severe and/or if you come from an environment rife with triggers that could compel you to start using again.

On the other hand, outpatient treatment works for people with a less severe addiction to this drug, as well as those who are able to live at home and continue working even as they get treated. These programs will, however, still require to attend clinic periodically to receive therapy and treatment. At the crux of the treatment will be group therapy, which can help you through the support network so created.

Overall, Fentanyl detox and treatment are essential components of the full recovery process. Without them, you will have a hard time beating your addiction. Of course, you should learn more about your options so that you know which is best for your particular needs, preferences, wants, and desires.

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