Fentanyl Addiction Treatment

Learn more about fentanyl addiction symptoms, treatment, and recovery

What is fentanyl?

Fentanyl is a powerful synthetic opioid, originally produced for pain relief. In comparison to morphine, fentanyl is around 50-100 times more potent. Just a 100mcg dose of this drug can provide the relieving benefits of 10mg of morphine. In prescription form, fentanyl is known as Actiq, Abstral, Sublimaze, Duragesic, and more.

But while this opioid does have legitimate, medical uses, it is often illegally produced for recreational abuse. This misuse often results in dangerous outcomes—in 2020, fentanyl ranked first in overdose deaths caused by non-methadone, synthetic opioids.

Even those who use fentanyl as prescribed by their doctor need to be cautious. Around 21-29% of patients prescribed opioids misuse them. A large percentage of people with opioid dependence or addiction began by using medications prescribed by their healthcare providers.

Symptoms of fentanyl abuse

Like other opioids, fentanyl is available in tablet form. It is also sold as a lozenge, skin patch, nasal spray, or in dissolvable film strips. Illicit fentanyl is produced in powder form, or pressed into a pill that resembles real prescription medication.

When a person is addicted to fentanyl, they will:

  • Require higher amounts to produce the desired fentanyl high
  • Continue drug use to avoid withdrawal symptoms
  • Become preoccupied with using or acquiring fentanyl
  • Find it difficult to stop using even when they desire to
  • Avoid professional and social affairs to use drugs.

Effects of this opioid include extreme happiness, drowsiness, nausea, confusion, constipation, sedation, difficulty breathing, and unconsciousness. This drug produces short-term feelings of euphoria which can lead to dependency.

Symptoms of fentanyl overdose

Like other opioids, fentanyl users are at high risk for an overdose. This risk is heightened when they’re taking illegally produced fentanyl. The illicit drug is frequently mixed with other substances like heroin, methamphetamine, and cocaine—this can lead to dangerous consequences. Overdose deaths involving multiple drugs are on the rise, and fentanyl is often involved. In 2019, nearly half of drug overdose deaths involved multiple drugs.

When a person suffers an overdose from clandestinely produced fentanyl, the following effects may be observed:

  • Altered consciousness or stupor
  • Constriction of pupil size
  • Clammy skin
  • Blue skin caused by decreased oxygen supply
  • Coma
  • Respiratory failure

The DEA reports that 42% of pills tested for fentanyl contained at least 2 mg of the opioid—a likely fatal dose. Between January 31st, 2020, and January 31st, 2021, the agency reports that synthetic opioid-related deaths rose by 55.6%. This rise was primarily led by cases from illicitly produced drugs.

Treatment for fentanyl overdose

When a person is suspected of having an opioid-related overdose, it’s vital that they receive urgent medical attention. Because dealers and suppliers often cut drugs with other substances, it may be difficult to pinpoint the direct cause of the overdose. Naloxone (brand name Narcan) is an opioid-overdose reversal medication that can and should be administered immediately to treat the symptoms. This rescue medication rapidly binds to opioid receptors in the body, blocking the effects of an opioid drug.

Because fentanyl is very potent, it may still be active in the body after the naloxone wears off, so multiple doses of naloxone may be required. The most common form of naloxone is an easy-to-administer nasal spray. It’s important that a person who experiences an overdose receives medical care even if naloxone is given, so call 911. Most states have Good Samaritan laws protecting people who call emergency services in case of overdose.

Fentanyl addiction treatment

Fentanyl is an opioid, and the gold-standard treatment for opioid addiction is medication-assisted treatment (MAT). The Substance Abuse and Mental Health Services Administration defines MAT as “the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.” 

Medication
The core of MAT is medication that has been FDA-approved to treat opioid use disorder. Buprenorphine and methadone are medications that reduce cravings by stimulating the opioid receptors in the brain. These medications help to stabilize long-term recovery and lower the risk of relapse. Naltrexone is another medication approved by the FDA to treat opioid addiction that operates by binding to and blocking opioid receptors in the brain. Workit Health prescribes buprenorphine in formulations that combine it with naloxone to prevent diversion and misuse (like Suboxone), and also prescribes naltrexone. Workit does not prescribe methadone, which is subject to more stringent regulations and monitoring requirements.

Many people who use opioids want to stop but are afraid of going through withdrawal. To be fair, opioid withdrawal can be a miserable experience. Your healthcare provider can suggest options—prescriptions, over-the-counter medications, and self-care—to help with the discomfort.

Behavioral Therapy
Behavioral health support is an important component of MAT. Counseling techniques like cognitive behavioral therapy can help to navigate addiction. Talk therapy, group counseling, and therapeutic courses can help people in recovery identify and navigate their triggers, set goals, and learn to modify negative attitudes and behaviors. 

Some treatment centers and rehab centers provide both options, but many do not support MAT. 

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Citations

1. C.F. Ramos-Matos, K.G. Bistas, & W.Lopez-Ojeda W. Fentanyl. [Updated 2022 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

2. National Institute on Drug Abuse. Fentanyl DrugFacts. June 2021.

3. National Institute on Drug Abuse. Opioid overdose crisis. March 11, 2021.

4. United States Drug Enforcement Agency. Facts about fentanyl.

5. Department of Justice/Drug Enforcement Administration. Drug Fact Sheet. April 2020.

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