Fentanyl is the most powerful narcotic opioid available for pain management in the United States, and it comes in a variety of forms, and in both immediate and controlled release formulations. Fentanyl is about 100 times more potent than morphine, and has been praised for its efficacy in relieving pain in those individuals whose pain cannot be managed by other opioid painkillers. Fentanyl is expressly unintended for those who are opioid-naive, or do not have an established tolerance to other potent painkillers, such as OxyContin or Dilaudid. Although it is available through prescriptions, on the black market is where Fentanyl does the most damage.
Forms of Fentanyl and Abuse
Like any other opioid, Fentanyl attaches to the opioid receptor in the brain, and causes a flood of dopamine to stimulate the reward center, which results in a euphoric feeling. Although Fentanyl is strictly regulated in how it can be prescribed by doctors and physicians, a great deal of this drug finds its way to the streets, and in the hands of people who will ultimately use it non-medically.
There are a number of different forms of Fentanyl, which include:
- Duragesic Skin Patch
- This patch is for around-the-clock pain management, up to 72 hours, and it contains a large amount of Fentanyl. It is commonly abused by individuals who chew the patch to get a full dose of the gel-like form of Fentanyl inside. The patch also releases more medication with high body temperature, so many individuals will sit in a sauna or hot tub, sunbathe, or do whatever they can to raise body temperature and get larger doses of Fentanyl at a time.
- Acted Lozenge
- The lozenge form of Fentanyl is intended to treat breakthrough pain (sudden periods of pain despite around-the-clock pain management). Fentanyl lollipops (a common name since they come in berry flavor) are most effective when held in the mouth, on the inside of the cheek, and allowed to dissolve there. Aside from non-medical use, this formulation of Fentanyl is most effective when consumed as directed, and has less bio-availability when chewed and swallowed.
- Lazanda Fentanyl Nasal Spray
- This form of Fentanyl is expressly intended only for breakthrough pain in opioid-tolerant cancer patients aged 18 and over, and has a very high bio-availability, as it is ingested through the nasal cavity. Any drug that is snorted gets to the brain very quickly, and this is the purpose of Lazanda nasal spray. Lazanda nasal spray is considered to be extremely dangerous if not used exactly as directed, but it is generally very difficult to obtain, as every prescription written for this drug is very closely monitored to ensure the safest medical practices.
- Fentanyl Film, Sublingual, and Buccal Tablets
- Fentanyl film, sublingual, and buccal tablets are all intended to dissolve on the inside of the mouth, and have immediate action to treat breakthrough pain. All three of these formulations of Fentanyl are most effective when dissolved in the mouth, and are more commonly prescribed than Lazanda nasal spray. Abuse of these forms of Fentanyl is common among those for whom they are prescribed and those who get them on the black market and from friends and family members.
- Duragesic Skin Patch
Either the individual for whom they were prescribed or someone taking them without a prescription can abuse any one of these forms of Fentanyl. Regardless of how Fentanyl is obtained, its potency has been the cause for several fatal overdoses in individuals who may have thought it to be just like any other opioid. Although far more potent than any other opioid, Fentanyl does have the same effects, such as:
- Shallow breathing
- Lowered heart rate
- Dry mouth
- Extreme euphoria
- Constricted (pinpoint) pupils
- Muscle weakness
- Nausea and vomiting
- Loss of appetite
When Fentanyl is abused, its effects can become deadly very quickly because of its potency. Individuals who use Fentanyl that has not be prescribed to them are at an increased risk of overdose, and many who attempt to use Fentanyl in this way end up in emergency rooms. According to the Drug Enforcement Administration (DEA), the number of ER admissions from non-medical use of Fentanyl increased from 11,211 in 2005 to 20,945 in 2009.
Fentanyl is also commonly used to cut heroin for a more potent product. While many heroin addicts may be aware of the possibility of Fentanyl being present in heroin they buy, there is no way to know how much, and countless addicts suffer from fatal overdoses for this reason. Fentanyl used in this manner is typically obtained through theft from pharmacies, nursing homes, and fraudulent prescriptions. Additionally, clandestine laboratories have emerged, mostly in Mexico, which produce large quantities of this potent drug, and export it primarily to the United States, where painkiller addiction has been a growing and profitable epidemic.
Fentanyl Addiction and Withdrawal
When an individual becomes addicted to Fentanyl, the experience is identical to that of individuals who are addicted to any other drug. Although Fentanyl is more powerful than any other painkiller, it is also more potent than heroin, making it extremely dangerous when it is used non-medically. As with any other painkiller and heroin, Fentanyl produces a physical and psychological dependence in addicts that causes severe withdrawal symptoms when it is not being used. Accordingly, addicts will do anything to ensure they have enough Fentanyl to last them through the day and night in order to avoid the uncomfortable and painful withdrawal symptoms. Since it is difficult to get Fentanyl products without doctors and physicians who are willing to risk their medical license to prescribe it fraudulently, most addicts who use it non-medically do so through the risky and illegal means of drug dealers. Once addicted, an individual will do unthinkable things to maintain his or her habit, and risking safety and freedom is part of the everyday hustle for many.
The dangers of obtaining Fentanyl or any drug through dealers are that an individual never knows what he or she may really be getting. When using dealers to get Fentanyl, which can come from a clandestine lab with various additives that may be deadly, addicts may be getting far more than they bargained for, and suffer deadly consequences as a result.
Because Fentanyl is a fast and short-acting opioid, withdrawal symptoms from this drug tend to come on quickly, in a few hours after the last dose. Fentanyl withdrawal symptoms are the same as any other opioid or opiate, and include:
- Nausea and vomiting
- High fever
- High blood pressure
- Dilated pupils
- Abdominal pain
- Muscle pain and spasms
- Intense cravings
- Cold sweats
In a medical setting when an individual is ready to come off of Fentanyl, a doctor will typically taper down his or her dose of the drug in gradients, in order to avoid severe withdrawal symptoms. While none of these symptoms is life-threatening, they can be excruciating and deter an addict from completing the withdrawal process to become sober. For this reason, it is always recommended that Fentanyl detoxification is done under medical supervision. There are other reasons that can be just as important for having a medically supervised Fentanyl detox, and they include:
- Medical staff can administer medication to ease severe withdrawal symptoms and facilitate sleep throughout the process.
- Staff is available to offer support and encouragement to complete the detoxification.
- If and when an addict becomes intolerable of the detoxification process, medicine can be administered to take the edge off.
- There is no access to drugs of any kind by the individual undergoing detox, and this drastically minimizes the occurrence of relapse prior to complete detox.
After Fentanyl Detox
Once Fentanyl detoxification has been completed, it is highly recommended for any individual to participate in some kind of rehabilitation program to adjust to life without the use of Fentanyl or other mood-altering and addictive drugs. Even for individuals who have taken Fentanyl as directed per their prescription, long-term use of any drug requires a routine of taking the drug, feeling the effects, and doing so at certain times throughout the day, for an extended period of time. The sudden change from using Fentanyl every day (or several times a day), to not using it at all, can take some getting used to, and rehabilitation programs and counseling can be an invaluable tool in assisting with that transition.
For individuals who used Fentanyl non-medically, and became addicted to it, addiction treatment is necessary, as Fentanyl detox does nothing to address the vital issues that contribute to the continuation of addictive behaviors. Some of these issues addressed in addiction treatment include:
- Addressing underlying issues, trauma, and pain that may have contributed to the addiction.
- Understanding unconscious triggers (such as people, places, and things), that may jeopardize sobriety from Fentanyl.
- Understanding of how addiction works, and how to recognize dangerous situations that may trigger a relapse.
- Development of friendships and support groups which are conducive to helping in maintaining sobriety and recovery from addiction.
- Learning survival and coping skills to avoid relapse in stressful or painful situations in life.
The process of an effective addiction treatment program should be one in which an individual can heal at his or her own pace, and in an environment where he/she feels comfortable and is accompanied by people with similar struggles and goals. Individualized healing is the most effective form of treatment since it has been proven that one approach will not work for every addict. Based on the needs, preferences, and belief system of each individual, addiction treatment should be unique to each person, for a personalized approach to healing.
At A Forever Recovery, we understand the individual challenges, strengths, and goals of each person who walks through our doors, and we implement a results-based program that has no time constraints to ensure that each person has whatever time he or she needs to accomplish the vital goals necessary for sustained sobriety and recovery.
Addiction is progressive, and will not let up until treatment is received. Please don’t wait for more devastation. Addiction treatment works when it is designed around you. Call now.