The goal of this fentanyl guide is to provide crucial information to those struggling with fentanyl abuse. Dealers now manufacture fentanyl for illicit purposes. It is the leading cause of overdose deaths in the country because dealers lace it in other street drugs. Information in this guide may help you or your loved ones stay safe when it comes to fentanyl use.
What is Fentanyl?
Fentanyl is a synthetic opioid similar to methadone. However, unlike methadone, fentanyl is at least 50 to 100 times more potent than morphine1. It is dangerous and highly addictive. It works by binding to the body’s opioid receptors in the brain, which control pain and emotions.
What Does It Treat?
Researchers created this substance to treat severe pain, often post-surgery, and pain associated with chronic or terminal illnesses such as cancer. Physicians may give it to an individual with high tolerance to morphine and codeine.
What Does It Look Like?
Fentanyl, particularly the illicit kind, is designed to look like other drugs. The powder may be off-white or light brown but may be unnoticeable when mixed with heroin. Even the pill form of fentanyl looks similar to the legitimate medication.
Once a helpful pain killer, fentanyl is now known primarily as a killer. Doctors are still using it in medical settings; however, they prescribe the medication more cautiously than in the past.
Fentanyl Details
Knowing what class and schedule a drug is in tells you how dangerous the Drug Enforcement Agency (DEA) considers it, both for its medical uses and illicit purposes.
Drug Class
The Drug Enforcement Agency classifies fentanyl as a narcotic.
Brand Names
Fentanyl goes by several brand names, including Sublimaze®, Duragesic®, and Actiq®.
Street Names
Fentanyl has several street names, including Friend, TNT, China Girl, Dance Fever, Apache, Tango and Cash, Murder 8, Jackpot, Goodfella, and China White.
Drug Schedule
In 2018, the Drug Enforcement Agency (DEA) decided to classify fentanyl and fentanyl-related substances as Schedule I under the Controlled Substances Act2. This act designated fentanyl as an illicit drug with no medical use but with a high potential for abuse. As of May 6, 2021, only the fentanyl-related substances remain in the Schedule I category. Fentanyl is a Schedule II drug because it is highly addictive with psychological and physical dependence.
These historical changes in fentanyl and fentanyl-related substances demonstrate just how dangerous the drugs are in our communities.
How is Fentanyl Used?
There are several ways to use this medication. People use fentanyl for various reasons, some legal, others illegal. Whatever the use, the potential for dependence and fentanyl overdose remains high.
Legally
When permitted by the Federal government, fentanyl has legal uses. It is one of the most potent pain management medications available. There are several ways you can use fentanyl to treat pain:
Fentanyl Patch
The patch allows patients to self-medicate as they would with a morphine drip. Typically, physicians place fentanyl patches on an arm where users can reach it easily.
Fentanyl Drip
Doctors use fentanyl in a liquid or drip form in medical settings. It is the best way to manage the dosage. Physicians and nurses are careful to avoid accidental fentanyl overdose as that can lead to addiction.
Fentanyl Lozenges
This medication also is available as lozenges that patients can suck or lick like cough drops. Lozenges are a great way to manage dosage to patients.
Illegally
Unfortunately, not everyone uses fentanyl as recommended. It has become a powerful and often fatal filler for street drugs. Dealers use it to distribute more of their products (drugs) on the streets. Users illegally misuse fentanyl in several ways:
Snorting
When mixed with drugs like heroin and cocaine powder, individuals end up snorting the substance. People are rarely aware when they are snorting fentanyl directly, but its potency is likely to kill them outright.
Injecting
Some individuals prefer to melt the powder and inject it into their veins. They believe this method gets the drug into their system faster.
Patches
Other people may steal fentanyl patches from people they know. The benefit of the patches is that an individual can manage how much fentanyl gets in his/her/their system.
Carfentanil vs Fentanyl
Both drugs are synthetic opioids. However, they differ because one is for humans (fentanyl), and the other is for animals (Carfentanil). Veterinarians use the latter on large animals like elephants to tranquilize them before treatment.
Fentanyl addiction is serious. It does not take much to overdose when you consider it can be 100 times stronger than morphine. Everyone should take this drug with extreme caution.
Signs and Symptoms of Fentanyl Addiction
If you are concerned you may be addicted to fentanyl or someone you know may be addicted, consider the following signs and symptoms3 of addiction. Signs of addictions are things you can see while others are changes in one’s behavior.
Physical Changes
You may experience the following more often if you are addicted to fentanyl:
- Dry mouth
- Nausea
- Vomiting
- Dizziness
- Difficulty breathing
- Itching
- Sweating
- Severe constipation
- Loss of appetite
- Headaches
Mental/Behavioral Changes
Addiction affects mental functions as well and can change someone’s behavior. The following are examples of how fentanyl addiction can result in cognitive and behavioral changes:
- Problems sleeping
- Depression
- Irritability
- Anxiety
- Agitation
- Suicidal ideation
- Hallucinations
If you notice any of these changes in yourself, you may be addicted to fentanyl. It is recommended you seek immediate treatment as fentanyl addiction is life-threatening.
Fentanyl Side Effects
There are various side effects4 associated with fentanyl use. These include those associated with the legal use of the drug and the illicit use of it. The following are common fentanyl side effects to know:
Short-Term Effects
There may be side effects when you first take this medication. These are short-term fentanyl side effects that are expected to subside. They include:
- Sweating
- Rapid heartbeat
- Shallow breathing
- Dry mouth
- Itching
Long-Term Effects
Some side effects last longer and may or may not go away once fentanyl use ends. Typical long-term fentanyl side effects include:
- Slowed heartbeat
- Poor balance
- Breathing problems
- Euphoria
- Sedation
- Drowsiness
- Fatigue
- Throat tightness
Overdose
There are fentanyl overdose side effects, including:
- Confusion
- Difficulty walking
- Inability to talk
- Faintness
- Blue-tinted skin from lack of oxygen
- Sedation
- Drowsiness
Withdrawal
Specific withdrawal symptoms exist for fentanyl as well. Withdrawal symptoms occur when someone is dependent or addicted to the drug and abruptly stops taking it because they no longer have access for whatever reason. The following are typical fentanyl withdrawal symptoms:
- Nausea
- Vomiting
- Insomnia
- Muscle pain
- Joint pain
- Fast breathing
- Increased heart rate
Knowing the different side effects of fentanyl can help you determine if you are experiencing symptoms for which you need to seek medical attention.
The Dangers of Fentanyl
Experts say that just about everyone knows someone affected by the opioid crisis. Specifically, the crisis caused by fentanyl has resulted in an unprecedented number of overdoses in our lifetime. The drug is so dangerous that one can die just by touching it. It puts first responders at risk when they are trying to assist fentanyl overdose victims.
Why is Fentanyl So Dangerous?
Fentanyl is dangerous because of its strength. It is at least 50 to 100 times stronger than morphine. Additionally, fentanyl is mixed with other drugs, so people are unaware when they are ingesting it. A lethal dose of fentanyl can show up in any street drug today. You might even get fentanyl-laced weed.
How Many People Does Fentanyl Kill?
The number of fentanyl deaths has increased significantly annually since 2013. Fentanyl deaths increased again between 2018 and 2019 by 16%. Synthetic opioid overdose deaths were 12 times higher in 2019 compared to 2013. In 2019, more than 36,000 fentanyl deaths occurred. By May 2020, the death count had accelerated. Researchers expect to see a significant increase in fentanyl deaths during the Covid-19 pandemic. Experts do not see the opioid epidemic or fentanyl deaths ending any time soon5.
Fentanyl-Laced Drugs
If you are not aware that you have fentanyl-laced drugs and ingest the substances, it can instantly kill you. It is not possible to build a tolerance for fentanyl because of its strength, but no drug is safe. In many communities, those who use weed are now at risk as fentanyl-laced weed finds its way into the hands of people.
Fentanyl is a dangerous drug whether used as directed or misused illegally. It needs to be used with caution and only under the care and supervision of a physician.
Fentanyl Addiction Treatment
Like other addictions, physicians and other professionals can treat fentanyl addiction. Individuals addicted to this drug seek treatment as soon as possible. If you are concerned about fentanyl withdrawal symptoms, treatment is available to you.
Detox
Facility-based detox allows you to face withdrawal with medical assistance in a safe environment. For individuals experiencing fentanyl withdrawal, this method is particularly critical. Detox without medical supervision can result in coma or death.
Medication-Assisted Treatment
Certain medications can help treat fentanyl addiction. Specifically, the following medications6 have shown success in assisting individuals in beating addiction to this drug:
- Methadone and buprenorphine reduce withdrawal symptoms and cravings by connecting to the same opioid receptors in the brain as fentanyl.
- Naltrexone blocks opioid receptors to prevent fentanyl from having any effect on the individual with the addiction.
In consultation with you, your physician will determine which option may be the best route to take to help you if medication-assisted treatment is part of your plan.
Inpatient and Outpatient Care
If you are seeking treatment for fentanyl addiction, you will find it available in both inpatient and outpatient settings. Inpatient treatment provides around-the-clock facility-based care that includes one-on-one and group treatment as well as art therapy, 12-step groups, and other interventions. Outpatient treatment is less restrictive, permitting you to maintain a job and attend treatment at hours established between you and the treatment facility.
Therapies
Therapy is another aspect of fentanyl addiction treatment. While there are several types of therapy available, the following are the two most used with fentanyl treatment:
Cognitive-Behavioral Therapy (CBT)
CBT works by helping you change your way of thinking. When you do this therapy, you can change your behavior. Combined, you can change addictive thinking and behaviors and be on your way to recovery.
Dialectical Behavioral Therapy (DBT)
DBT often supports CBT by helping you understand your emotions. Individuals often become misusing or abusing drugs to meet an emotional need. Getting in touch with your feelings is a critical part of therapy and recovery.
Treating fentanyl addiction requires a comprehensive treatment plan to prevent relapse. Recovery is possible with your full participation and commitment. With treatment, you no longer need to worry about receiving a lethal dose of fentanyl.
The information in this guide provides the information you need to make informed decisions about using this medication. Your physician offers adequate oversight in a medical setting to ensure you have as few side effects as possible while managing your pain. However, in a private setting, the risk for misuse and abuse increases. It does not take much for drug use to become habit-forming. Utilize this guide to learn about addiction signs and treatment options so you can get back to a healthy life.
Resources
- https://www.drugabuse.gov/drug-topics/fentanyl
- https://www.deadiversion.usdoj.gov/schedules/
- https://www.ncbi.nlm.nih.gov/books/NBK459275/
- https://www.drugabuse.gov/publications/drugfacts/fentanyl
- https://www.cdc.gov/opioids/basics/fentanyl.html
- https://www.drugabuse.gov/publications/drugfacts/fentanyl
