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Fentanyl is a narcotic opiate analgesic by classification. It is also much stronger than both heroin and morphine combined. This is why it is used in the treatment of chronic, severe, and moderate pain.
However, Fentanyl is also quite addictive. It works by interrupting the signal of pain that is sent from the CNS (central nervous system) to the brain by effectively binding itself to the receptors of the brain that take up these signals.
Shortly after your doctor has put you on this drug, you may become addicted to it - albeit unintentionally. At this point, the best thing you can do is find a detoxification and rehabilitation facility so that the addiction does not develop to a level where you will have a hard time dealing with it.
Fentanyl is a powerful opioid drug used both as a prescription and recreationally. It is manufactured in the form of Duragesic (transdermal patches), Aqtic (lollipop or lozenges), and Sublimaze (the injectable form of the drug).
However, it is quite addictive and works in the same way that heroin does - but it is about 100 times as potent. As a direct result, the abuse of this drug has been rising over the past few years going by recent reports by the DEA (Drug Enforcement Administration). This is clear from the increasing numbers of overdose deaths, drug seizures, and visits to emergency departments related to Fentanyl.
Fentanyl patches, in particular, are manufactured for use by people who are found to already be tolerant to the other less-potent opioid painkillers but who are also in need of pain management around the clock. These include cancer patients.
Tolerance to opioids occurs when you take these types of drugs for a long time period and they stop working in the same way they used to when you first started using them. At this point, your pain symptoms might start breaking through, meaning that you will have to take more of the painkillers to relieve your pain. After tolerance forms and you start taking higher doses, you may become dependent on opioids.
When you take opioids like Fentanyl, they may change the chemistry of your brain. They work by filling the opioid receptors found on the CNS, thereby changing the way some of the neurotransmitters (or brain messengers) move around.
After dependence sets in, your brain won't be able to make neurotransmitters at the required levels by itself. Instead, it will start relying on the interference of the drug. Therefore, when you remove the drug or stop taking it, you may develop opioid withdrawal syndrome and your brain will struggle to restore balance.
The physical symptoms of this syndrome are flu-like in nature while the psychological symptoms are also just as intense. In most cases, Fentanyl dependence will set in even after you have been taking it legally following a medically necessary and valid prescription, although most people develop it as a result of abusing the drug recreationally.
Since Fentanyl is an opioid, it tends to lead to tolerance, dependence, and addiction much in the same way as any other opioid would. First, you will start taking the drug - either according to the instructions from your doctor or as a fun way to feel euphoric.
When you do this, the drug will flood your brain with dopamine by binding to its opioid receptors. In the process, it will activate the reward centers of the brain and create an intensely euphoric and comforting rush.
After that point, your brain will start wanting to continue looking for the substance that created this substantially enjoyable feeling. This means that you will be positively reinforced to continue abusing and using Fentanyl.
In the course of your abuse, you may become tolerant to the drug. As a direct result, you will have to take higher doses of Fentanyl to achieve the same effects - including euphoria and pleasure.
Tolerance is dangerous with most drugs. However, in the case of Fentanyl, it is more than dangerous given the fact that it can be 50 to 100 times as potent as morphine, and similarly more powerful than heroin.
With time and continued Fentanyl abuse, your body will start getting used to it. This will lead to physical dependence. However, you do not even have to display any signs of addiction or to have psychological cravings for it to be physically dependent. This is why people often develop this type of dependence even when they are using Fentanyl according to a doctor's prescription.
If you decide to stop taking Fentanyl, you may develop opioid withdrawal syndrome. This syndrome will normally start within 12 to 30 hours of the last drug dose you took - according to reports by the NLM (National Library of Medicine).
In patch form, Fentanyl is an extended release medication. Its effects may continue increasing for the first 12 to 24 hours of wearing this patch and last for a total of around 72 hours.
The half-life of the patch is about 17 hours after you remove it. However, withdrawal may begin a day or so after you take the patch off. At this point, you will be said to be suffering from opioid withdrawal syndrome, which is characterized by the following potential side effects:
The syndrome may peak over the first few days after your last dose of Fentanyl before leveling off within 7 or so days. However, difficulty feeling pleasure and depression may persist longer than that because of the disruption of the pleasure inducing transmitters in the brain (including dopamine). You may also experience intense cravings for the drug for more than 7 days, which could lead to a relapse.
The duration of the above withdrawal symptoms will vary depending on the user. However, there are some general things that you should expect when you stop using and/or abusing Fentanyl:
The withdrawal symptoms for most opioids - including Fentanyl - will typically begin between 12 and 30 hours after you the point when you took your last dose of the drug. The Fentanyl patch, however, comes in the form of an extended release formulation. This means that the duration might be longer - sometimes within a day after you remove your patch.
The early signs and symptoms of opioid withdrawal syndrome might include runny nose, muscle aches, insomnia, and anxiety - among many others.
2 to 4 days after your last Fentanyl dose, the peak effects of the opioid withdrawal syndrome may finally start revealing themselves. Most of these signs and symptoms involve the gastrointestinal system - and might include vomiting and nausea.
About a week after your last dose, most of the Fentanyl withdrawal symptoms will have waned. However, you can still continue experiencing emotional issues for a bit longer. These are often referred to as post-acute withdrawal symptoms, and tend to persist for several months after you stop taking the drug.
Discontinuing Fentanyl suddenly may induce intense and severe opioid withdrawal. As such, many people tend to prefer tapering off the drug. This refers to the slow but sure removal of the drug over a given period of time. Tapering is also referred to as weaning off a drug.
Although you might try to go through this process alone, it is highly recommended that you get outside medical assistance. This means that you should only try to wean yourself off Fentanyl under the watchful eye and direction of a team of medical professionals.
When this happens, the doctors involved with set a tapering schedule for you. This way, you can easily ensure that some of the withdrawal symptoms do not manifest themselves - mostly because you will still have some Fentanyl in your system.
Removing the drug slowly is the best way to manage opioid withdrawal syndrome. It certainly works much better than undertaking the cold turkey approach to quitting Fentanyl.
As you start tapering off the drug, the medical team might first try switching you to another opiate or opioid drug - such as the longer acting methadone or morphine. After the switch is made, the new opioid will be reduced by anywhere from 20 to 50% every day until the daily dosage gets to about 30 mg (for methadone) or 45 mg (for morphine).
Once you get the this point, the doctors can reduce the dosage by 15 mg (morphine) every 2 to 5 days or by 5 mg every 3 to 5 days until you get to 10 mg per day. For methadone, the dosage might be reduced by 2.5 mg after every 3 to 5 days until you get to a dosage of 0 mg.
As you can well imagine, tapering does not work in exactly the same way for everyone. As such, the doctors might have to adopt a different tapering schedule for you. Some of the factors that might require your tapering schedule to get modified include, but are not limited to:
If you abuse other drugs/alcohol at the same time that you abuse Fentanyl, all these mind altering substances might interact. In the process, they might increase your level of dependence on all substances and create cross-tolerance. This condition will have to be managed in a different way.
If you have been using Fentanyl for anything other than its medical purpose - or if you also suffer from a compulsive drug use disorder, you may be better placed to attend an inpatient detoxification program. Checking into one of these centers will ensure that your addiction and substance abuse is addressed at the same time as your withdrawal syndrome.
If you are addicted to Fentanyl and suffering from mental health and medical disorders at the same time, you might be required to take certain medications to deal with these disorders. This means that you will have to be managed properly while on a tapering schedule.
The total period of time you have been using Fentanyl will also affect your tapering schedule. In general, the longer you have been taking opioids like Fentanyl, the slower your taper might have to be for withdrawal to be effectively managed.
Additionally, if your dependence on Fentanyl is quite significant, the taper might have to be slower than normal.
Medical professionals like substance abuse professionals and doctors can help you create your own individualized tapering schedule. Using this schedule, you can effectively and safely wean yourself off the drug while also minimizing your withdrawal symptoms at the same time.
As you can well imagine, there are many benefits that come with tapering or weaning off Fentanyl. It might, for instance, extend the overall withdrawal period. However, it will also reduce the severity and intensity of any withdrawal symptoms you experience. This means that it could make quitting the drug much easier.
As always, you should ensure that tapering off is done in a safe environment where you have medical supervision and instruction. Your physician will create the plan to help you overcome your addiction to Fentanyl by providing you with lower doses of the drug until you are able to live without it.
Apart from tapering off or quitting cold turkey, you can also go for medical detox. This refers to the process of removing toxic substances like Fentanyl from your body's bloodstream.
As far as possible, the best option here would be to undergo medical detox in a specialized drug treatment and rehabilitation center. Whether you go the residential or the outpatient route, you can be sure that it is possible for you to overcome your addiction to Fentanyl, and start living a life free of the drug and its various adverse effects and accompanying problems.
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