Fentanyl

What Is Fentanyl?

Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. It is prescribed to treat severe pain but is also misused and a major contributor to the opioid crisis.

Some conditions fentanyl is prescribed to treat include:

• Cancer
• Complex regional pain syndrome
• Postherpetic neuralgia
• Chronic pancreatitis
• Severe forms of arthritis
• Ehlers-Danlos syndrome
• Arachnoiditis

As a synthetic opioid, fentanyl attaches to the body’s opioid receptors, which are found in areas of the brain that control pain and emotions. When fentanyl binds to these receptors, it can create intense feelings of euphoria and relaxation, but it also carries a high risk for addiction and overdose.

Illicit fentanyl use has increased sharply over the last decade and has significantly contributed to drug-related overdose and deaths. Illicit fentanyl is often mixed with other drugs like heroin, cocaine, counterfeit prescription pills, or legitimate prescriptions. Thus, consumers may unknowingly ingest fentanyl, increasing the risk of overdose and death.

Street Names For Fentanyl

Fentanyl and fentanyl-laced drugs often go by various street names, including:

As these are unofficial terms, they can rapidly change and vary from region to region. Healthcare providers, law enforcement, and the public should stay aware of these changes.

Common Forms Of Fentanyl

Fentanyl, an opioid, is available in various forms for both medical and illicit use. Understanding these different forms is essential to addressing fentanyl-related issues. These forms are:

• Transdermal patches, which come in several doses and last 72 hours. Fentanyl is embedded in the patch and adheres to the skin with an adhesive that can be placed on various parts of the body.
• Lozenges or lollipops
• Injectable solutions
• Tablets
• Powders
• Nasal sprays

How Is It Consumed?

Fentanyl can be consumed in various ways depending on its form. All forms will provide similar effects, and all are dangerous:

• Transdermal patches are applied to the skin
• Lozenges or lollipops are dissolved in the mouth
• Injectable solutions are administered intravenously or intramuscularly
• Tablets are taken orally
• Powders can be snorted, smoked, or injected
• Nasal sprays are inhaled through the nose

Due to the risk of the drug being mixed with other substances, it is now essential to obtain test strips, which can tell a person if fentanyl is present in the tested substance.

How Does Fentanyl Affect The Body?

The physical and mental effects of fentanyl vary depending on how it is used. This is true for either medical use or non-medical use.

Medical Use

The legitimate use of fentanyl is through a prescription from a licensed medical professional or administered in the hospital during procedures. Under these conditions, the patient can expect some or all of the following:

• Pain relief: This is the primary use of fentanyl in a medical setting.
• Drowsiness: Sedating the patient is often a desired secondary effect. For example, while setting a broken bone.
• Nausea and vomiting: These are common in medical use.
• Constipation: This is a common side effect of using all opioids in any setting.
• Confusion: This can occur but is monitored, and doses are adjusted depending on the situation.
• Muscle rigidity: This can occur in medical settings, especially with higher doses.
• Respiratory depression: Carefully monitored in medical settings.

If a patient is taking this drug on a prescription basis, they need to communicate immediately with their physician if they experience any adverse effects. Patients who are hospitalized will be monitored closely.

Non-Medical Use

If a person is taking fentanyl on their own, especially if it is not from a prescription, they risk serious harm and possibly death. The following are signs and symptoms of someone who is having trouble and should seek help immediately:

• Euphoria: This is the primary effect sought in non-medical use.
• Pain relief: This will occur but is rarely the primary goal of non-medical use.
• Drowsiness: Often more extreme and dangerous than in medical settings due to less controlled dosing.
• Respiratory depression: This is more dangerous in non-medical use due to lack of monitoring.
• Nausea and vomiting: Likely more severe due to less controlled dosing.
• Constipation: Likely more severe due to lack of medical management.
• Confusion: Often more pronounced due to higher, uncontrolled doses.
• Muscle rigidity: This can be more severe in non-medical use due to higher doses.

The drug’s effects vary in intensity and thresholds. Adverse effects occur based on dose, timing, and monitoring. The dose in a medical setting aims to use the least amount of the drug to achieve the desired effect of pain control. However, illicit use is usually aimed at using a dose that will maximize euphoria, therefore increasing the dangers.

Symptoms Of Fentanyl Addiction

It’s important to know and recognize signs of fentanyl misuse when caring for or being around anyone taking fentanyl so intervention can be started if necessary. Some common symptoms include:

• Increased tolerance, requiring larger doses to achieve the desired effect
• Experiencing withdrawal symptoms when not using fentanyl
• Neglecting responsibilities at work, school, or home due to drug use
• Continuing to use it despite negative consequences
• Spending significant time and resources obtaining, using, or recovering from fentanyl use
• Unsuccessful attempts to cut down or control use
• Strong cravings for fentanyl
• Engaging in risky behaviors while under the influence
• Social isolation or changes in social circles
• Neglecting personal hygiene and appearance

If you or someone you know is showing these symptoms, it is important to seek professional help immediately. Users and family members should have immediate access to naloxone (Narcan), an opioid agonist medication that rapidly reverses opioid overdose.

How Addictive Is Fentanyl?

While the dangers of addiction to fentanyl cannot be understated, one should not focus on addiction but on the dangers of the drug itself, with or without addiction. Overdose rates have skyrocketed for nonmedical use, whether in those addicted or from accidental deaths.

It is often said that fentanyl is highly addictive due to its potency and rapid onset of action. It is more accurate to say it is a highly lethal substance due to its potency and rapid onset of action. Being susceptible to addiction consists of a complex combination of some or all of the following:

• Familial history and environment
• Genetic history
• Peer pressure
• Exposure

If a person has a susceptibility to addiction, then it is a situation where the person is more likely to develop a substance use disorder.

When used, fentanyl quickly binds to opioid receptors in the brain, producing intense feelings of euphoria and pain relief. This effect can lead to both physical and psychological dependence, even with short-term use.

There is also the category of medical dependence. People taking a daily prescribed dose will become dependent on the drug and will have withdrawal symptoms if they stop it. This is not an addiction but instead a physiological response.

One should always weigh the risks vs the benefits of a drug. Many may be worried about stopping prescription fentanyl due to fear of withdrawal symptoms. There is a high probability a person will have withdrawal symptoms after two weeks of use. You are likely to start feeling these within 24 hours of stopping the medication. The best way to prevent this is to work with your prescriber to slowly taper the drug (decrease the dose gradually), along with seeking symptomatic relief through activity, nonopioid pain relievers, massage, and rest.

What Are The Signs Of A Fentanyl Overdose?

Fentanyl overdose is a medical emergency requiring immediate attention. Signs of a fentanyl overdose include:

• Slow, shallow, or stopped breathing
• Unresponsiveness or loss of consciousness
• Pinpoint pupils
• Blue or grayish lips and fingernails
• Cold, clammy skin
• Gurgling or choking sounds
• Extreme drowsiness or inability to wake up
• Slow or stopped heartbeat

If you suspect someone is overdosing on fentanyl, call emergency services immediately. If available, administer naloxone, a medication that can rapidly reverse opioid overdose.

Long-Term Health Risks Of Fentanyl Addiction

Prolonged fentanyl use can lead to severe health complications. This is true whether it is used under medical supervision or not:

• Chronic respiratory issues: Long-term use can permanently damage the respiratory system.
• Gastrointestinal problems: Chronic constipation can lead to bowel obstruction and other digestive issues.
• Liver damage: The liver can be affected by long-term opioid use.
• Increased risk of infectious diseases: Intravenous use increases the risk of HIV, hepatitis C, and other blood-borne infections.
• Hormonal imbalances: Fentanyl can alter the endocrine system, leading to issues like reduced libido and fertility problems.
• Cognitive impairment: Long-term use can affect memory, decision-making abilities, and overall cognitive function.
• Mental health disorders: Chronic use is associated with an increased risk of depression, anxiety, and other mental health issues.
• Increased risk of overdose: As tolerance builds, the risk of accidental overdose increases significantly.
• Physical dependence: The body becomes reliant on fentanyl to function normally. This is a sign of addiction, but it does not mean there is addiction.

If using fentanyl under a doctor’s care, communicate openly with them about any concerns. If using fentanyl on your own, understand the dangers and seek professional treatment to help you quit.

Understanding The Fentanyl Crisis

The fentanyl crisis has become a significant public health issue in recent years. Its potency and widespread availability have contributed to a dramatic increase in opioid-related deaths. Specifically, at least 80% of overdoses are due to non-prescription substances. This percentage may be even higher as fentanyl can easily be mixed with other drugs, often without the user’s knowledge, which has made it particularly dangerous.

Education about the risks of fentanyl use, increased access to naloxone, and comprehensive addiction treatment programs are crucial in addressing this crisis. If you or someone you know is struggling with fentanyl use, it is essential to seek professional help. Recovery is possible with the proper support and treatment.

Looking To Quit?

Fentanyl is a potent and dangerous drug, and the use of drugs without medical supervision carries significant risks.

Always prioritize your health and safety, and do not hesitate to reach out for help if you are dealing with fentanyl addiction or other substance use issues. Contact a treatment provider today to learn more about your treatment options.