Fentanyl Use Disorder Treatment
Medically Reviewed by
Dr. Natalie Lindemann, Psy.D on 10/20/2022
Dr. Natalie Lindemann, Psy.D, holds a doctorate in Forensic Psychology and is a Licensed Clinical Psychologist.
By: Zinnia Healing Editorial Staff | Edited By: Rebecca Hill
Fentanyl Addiction Treatment and Recovery Options
Fentanyl is an extremely potent synthetic opioid. It is available as a pharmaceutical drug and is typically used as an anesthetic. However, it didn’t take long for the drug to find its way into the hands of illegal peddlers. Fentanyl is much stronger than other synthetic opioids, and many people began using it to get the euphoric high it is known for. Drug dealers also started to disguise fentanyl and sell it as heroin on the streets. The drug has been a big part of the national opioid epidemic in the United States over the last decade. Read on to learn more about the dangers of fentanyl abuse.
Fentanyl Abuse Overview
Fentanyl is a powerful synthetic opioid that produces effects like other drugs in the opioid class, such as Oxycontin, Percocet and morphine. However, it is 50 to 100 times more potent than morphine. Since 2013, it has been implicated in driving the dramatic rise in opioid overdoses. It and other synthetic opioids are the most common drugs involved in deaths from overdose in the United States. 59 percent of opioid-related deaths in the United States involved fentanyl in 2017, compared to just 14.3 percent in 2010. Most of these cases are linked to illegally made fentanyl that is sold through drug markets for its heroin-like high. The increase in overdose deaths indicates the need for more information and awareness around the dangers of this highly toxic drug.
Can You Get Addicted to Fentanyl?
Yes. Fentanyl is extremely addictive because it is so much more potent than other opioids. Even when a person takes fentanyl exactly as prescribed by a doctor, they can develop a dependence on it. It is possible to experience dependence on a drug without being addicted to it, but dependence is one of the primary factors that lead to addiction.
It is possible to get addicted to both legal and illegal opioids in just a few weeks of regular use. The primary sign of addiction is the appearance of withdrawal symptoms once a person stops using the drug. The withdrawal symptoms can be so uncomfortable that they often prompt a person to seek out the drug as quickly as possible and return to their original schedule of use.
This presents a danger even for people who are genuinely trying to stop taking fentanyl. Detoxing by stopping use altogether, i.e. going “cold turkey,” can often be deadly if a person then relapses and takes too strong of a dose. Also, some people have medical conditions that can make the detox process much more difficult on their bodies.
Addiction is characterized by the compulsive seeking and using of a drug. A person may feel that their drug use is under control, despite the negative consequences it continues to impose. A person addicted to fentanyl will continue to seek out and use it or other substances of the same caliber, even though they are experiencing trouble in their personal lives, issues with health, difficulty at work, and other complications related to their drug use.
What Is Fentanyl?
Fentanyl originated in the 1960s as a treatment for cancer patients who were experiencing chronic pain. It has been around since as a painkiller all over the world. A dose of 100 micrograms can produce the same analgesic effects as 10 milligrams of morphine. It is most often used as a sedative for intubated patients and for severe cases of pain in patients with acute renal failure.
Fentanyl is very similar to other opioid drugs and painkillers. It targets a subclass of opioid receptor systems. Many of these are located in the brain in areas that involve the control of emotions, pain and reward. It also activates other opioid receptors that produce analgesia or numbness. When taken, it increases the amount of dopamine in the reward areas of the brain, which causes the euphoria and relaxation associated with opiate use. This is also what causes addiction to the substance.
Fentanyl has become very popular as a street drug because it is much cheaper than cocaine, heroin and other drugs. It is potent and can be purchased both as a prescription drug and through black-market sources. New strains of fentanyl are increasingly potent and causing more overdose deaths than ever before.
How Is Fentanyl Consumed or Used?
Fentanyl can be used topically orally, nasally, or intravenously. A lot of the non-pharmaceutical fentanyl sold on the streets in the U.S. is smuggled in from Mexico. It is commonly found and sold in the form of a patch, which sticks to the skin and releases the drug. Sometimes people scrape the sticky substance off the patch to ingest or inject it.
What Are the Risks and Causes of Fentanyl Abuse?
Fentanyl’s side effects are much like those of heroin. It can cause euphoria as well as confusion, respiratory depression, sleepiness, nausea, visual disturbances, hallucinations, delirium, analgesia, constipation, muscle rigidity, loss of consciousness, low heart rate, low blood pressure, coma, and death.
When fentanyl is mixed with alcohol and other drugs, the dangerous side effects are heightened. This is problematic because people often use it in conjunction with other drugs, especially cocaine and heroin. Also, people can unknowingly take fentanyl combined with other drugs because many dealers sell it on the street as heroin or combine it with unknown substances. The mixing can be fatal. Receiving fentanyl in place of heroin or another drug can also be fatal because people are unaware of its potency and take the dose that they are accustomed to taking of the other drug. This can easily lead to overdose and death.
Many people are prescribed fentanyl by their doctors to treat severe pain. While the incidence of this is becoming much less common because it is so dangerous, it can still lead a person to develop a dependence on the drug. Once the prescription runs out, a person might be inclined to seek it out illegally just to ward off withdrawal. It is very important to only use fentanyl as prescribed by a doctor and to discuss a taper schedule to avoid withdrawal symptoms.
Other people use fentanyl thinking they are using a different drug and can become addicted that way.
What Are the Signs and Symptoms of Fentanyl Abuse?
If you suspect a loved one is struggling with fentanyl abuse, the best way to handle it is to address it with them directly and not enable their addiction. People can’t be coerced into stopping their use or seeking out treatment. They need to be ready to make their lives better themselves. But you can let them know that you are not judging them and you are there to help them when they are ready.
Drug addicts often exhibit manipulative and secretive behavior to hide their habits. You might notice that a person has started hanging out with totally different friends, constantly changes their friend groups or has given up on old connections. Someone abusing fentanyl might also spend a lot of time alone and isolated, avoiding friends and family. They might lose interest in activities they used to enjoy or suffer from erratic moods and emotional episodes. You might also notice that they have poor hygiene.
Many addicts experience financial trouble, need to borrow money, or have trouble at work or school. They might seem very flaky and unreliable, missing appointments, school, work, etc. In addition to these behaviors, signs that someone is struggling with fentanyl abuse might include:
- Weight loss
- Confused thoughts
- Hypersomnia or insomnia
- Low blood pressure
- Rigid muscles/lack of balance
What Are the Long-Term Effects of Fentanyl Abuse?
Prolonged use of fentanyl can experience a range of adverse effects, including:
- Chest pains
- Blurred vision
- Poor balance
- Muscle tremors/twitching
- Extreme fatigue
- Lack of coordination
- Irregular heartbeat
- Mood changes
The longer a person abuses fentanyl, the more severe the consequences will be. Over time, opioid abuse can cause structural brain changes that inhibit a person’s ability to feel good. The brain gets dependent on the synthetic substance to produce certain neurotransmitters, like dopamine and serotonin. This means that a person might permanently reduce the natural amount of these chemicals in the brain, which can leave one feeling more physical and emotional pain than they did before they started using the drug.
Fentanyl can also cause respiratory problems and slow a person’s breathing. This is very dangerous because it can cause a person to not get enough oxygen while they are sleeping, which can lead to coma or death. Long-term use can also start or exacerbate mental health conditions, including depression and anxiety. Using fentanyl also puts a person at risk of multiple organ system damages because of the havoc it wreaks on the body.
Other long-term effects of fentanyl abuse include:
- Heart disease
- Gastroesophageal reflux
- Fentanyl hypersensitivity
Fentanyl use carries an extremely high risk of overdose, which is often fatal. This is especially prone to occurring if a person doesn’t know that the drug that they are using contains fentanyl. Fentanyl can cause reduced breathing or can stop breathing altogether, leading to low levels of oxygen in the brain, heart and lungs. Without enough oxygen, the body’s vital organs are put under an extreme amount of duress. This can cause a heart attack and brain damage or death.
Critical signs of a fentanyl overdose to look for include:
- Pale, clammy skin
- Inability to speak
- Breathing difficulty
- Vomiting or making gurgling sounds if asleep/unconscious
- Slowed heart rate
- Purple/bluish hue to lips and/or fingernails and toenails
If you suspect that someone might be experiencing a fentanyl overdose, it is critical to call emergency services immediately. If naloxone is available, administer it immediately.
In addition to these physical and psychological changes, long-term fentanyl abuse can also cause a lot of damage to a person’s personal life and relationships. For users who regularly inject the drug, they are at increased risk of HIV/AIDS, hepatitis and more. Pregnant women who abuse fentanyl can put their babies at risk of low birth rate, miscarriage and neonatal abstinence syndrome.
What Are the Signs and Symptoms of Fentanyl Withdrawal?
When a person is dependent on or addicted to fentanyl, they can have severe withdrawal symptoms once they stop using the drug. The symptoms can range in severity and duration, depending on how much fentanyl a person was consuming, the length of time they have been taking it and many other factors.
Withdrawal symptoms can start as early as three to four hours after a person last used fentanyl. Symptoms can include:
- Insomnia or other sleep disturbances
- Diarrhea and vomiting
- Hot and cold flashes
- Pain in muscles and bones
- Restless leg syndrome or spastic leg movements
- Intense cravings
The symptoms of fentanyl withdrawal can be excruciatingly painful. For this reason, many people will continue to seek out and find the drug, just to temporarily get relief from the pain.
What Are Treatment Options for Fentanyl Abuse?
The FDA recently approved some treatments to help with opiate withdrawal, such as lofexidine, a non-opioid medicine designed to help reduce symptoms. Another device that might work is called the NSS-2 Bridge. It’s a small electrical nerve stimulator that tucks behind the ear and can help ease symptoms during acute withdrawal. The FDA also approved reSET, a mobile app designed to help treat opioid addiction. It offers cognitive behavioral therapy and should be paired with medical treatment when possible.
Another treatment that has shown a lot of promise for opioid addiction is Naloxone or Narcan. It is used to reverse the effects of opioids, including heroin, oxycodone, and fentanyl. Naloxone comes in pill form, which people can take every day. It also comes in the form of a 30-day shot, administered once a month. This has been shown to decrease the effects of opioids so that people are less inclined to use them. However, this drug can also have the opposite effect and encourage people to use more of the drug to experience some of the sensations they used to feel at lower doses. This increased dosage can lead to overdose and death.
Medication with behavioral therapies is the most recommended course of treatment for fentanyl addiction. Buprenorphine and methadone are two medications that work by attaching to the same opioid receptors in the brain as fentanyl does. This tricks the brain into replicating some of the processes that fentanyl causes, which helps cut down cravings and ease withdrawal symptoms.
In addition to medication, behavioral therapies for addiction to opioids are necessary to help people change their behaviors and develop new, healthier life skills. Therapy also helps people commit to taking the necessary medications. Some treatment options include:
Motivational therapy includes a type of interviewing that centers around an individual’s feelings about the drug and the mixed feelings they might have about wanting to stop and wanting to continue using.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) helps a person change their thinking around drug use and come up with more effective ways to manage any potential triggers and life stressors.
This type of therapy is based on a system that awards points to a patient based on behaviors and achievements related to stopping drug use. For instance, a person might get points or rewards each time they attend a therapy session, go to a 12-step meeting, etc. The rewards are given out in combination with negative drug tests.
Before treatment begins, however, it is critical to address the physical side of fentanyl abuse. At Zinnia Healing fentanyl abuse treatment center, we offer medically supervised detox to help ease any withdrawal symptoms. This allows a person to organically remove all the toxins from the body.
The combination of behavioral treatments and medication has been very effective for many people dealing with addiction. During drug rehabilitation, patients undergo a combination of behavioral therapy practices to address the underlying cause of addictions along with the option of medical treatment.
If you or a loved one are struggling with fentanyl abuse, contact us at (855) 430-9439. Our trained addiction experts can help you on your way to recovery.