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Fentanyl

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What is Fentanyl?

Fentanyl is a synthetic opioid analgesic drug that is often used to treat breakthrough pain in cancer patients and chronic pain patients. The drug is so strong that, according to the NLM, it should only be used to treat those "who are tolerant (used to the effects of the medication) to narcotic pain medications" already. It is available by prescription only and is a Schedule II substance.

Fentanyl Can Be Prescribed As:

  • A Patch (Duragesic)
  • A Lozenge (Actiq)
  • A Film (Onsolis)
  • An Injection (Sublimaze)
  • A Buccal Tablet That Goes Between the Gum and Cheek (Fentora)
  • A Sublingual Tablet That Goes Underneath the Tongue (Abstral)

Many people need fentanyl for its pain relieving abilities. However, there are side effects of the drug and its use can be dangerous. Some individuals even abuse it recreationally which can lead to addiction, overdose, and other issues.

Side Effects of Fentanyl

Fentanyl has many side effects that are commonly experienced by those who use the drug. Some of these side effects can be handled with a lower dose of fentanyl or by using over-the-counter medications to curb them. Discuss the side effects you may experience from fentanyl with your doctor, including:

  • Drowsiness
  • Nausea
  • Vomiting
  • Diarrhea
  • Gas
  • Weakness
  • Headache
  • Vision Problems
  • Weight Loss
  • Problems Urinating
  • Depression
  • Anxiety
  • Hallucinations
  • Insomnia and Problems Sleeping
  • Dry Mouth
  • Sweating
  • Shaking of a Part of the Body
  • Back and Chest Pain

Any of these side effects should be remediable, but they can also be particularly severe. Depending on what you experience and how much it is interfering with your life, you should absolutely seek your doctor's help. For someone abusing fentanyl, these symptoms will likely be even stronger.

There are also other side effects of fentanyl use which could be a sign of a much more serious condition. These side effects are:

  • Heart Beating Slower or Faster Than Normal
  • Seizures
  • Hives, Itching, or Rash
  • Slow Breathing
  • Shallow Breathing
  • Problems Swallowing
  • Confusion
  • Fainting

Someone who experiences some of these symptoms could be allergic to fentanyl and may need to discontinue use of the drug or be switched to a different medication. Others still may be experiencing a reaction to the strength of the medication where bodily functions like breathing are slowed down to a dangerous degree. Stop using the drug and call your doctor immediately if your use of fentanyl begins to cause symptoms like these.

Fentanyl and Other Opioids
According to the DOJ, "Fentanyl is 100 times more potent than morphine as an analgesic." This means that it can be very strong in relieving pain in an individual who needs it, thus being the choice medication for chronic pain patients who are suffering extreme pain at a certain time. However, its effects are very similar to the effects of other opioid drugs; it is just much stronger. The DOJ also states that "fentanyl appears to produce muscle rigidity with greater frequency than other opioids" which can be difficult for individuals who are prescribed it.
Fentanyl is even more potent than heroin, a highly abused illicit opioid. Heroin addicts sometimes abuse fentanyl when unable to take more heroin, often causing overdose and other issues as the drug is so much stronger even than heroin.
Fentanyl Withdrawal and Dependence
opioid fentanylFentanyl comes in a few different forms, including a patch and an injection.

Like other opioids, fentanyl causes dependence and can cause withdrawal in those who use or abuse it for a long period of time. The withdrawal syndrome from fentanyl is like those of other opioid analgesics.

The only major difference is that patients do not normally experience it as a result of treatment because they are already likely on some other type of opioid medication.

Individuals who experience fentanyl withdrawal are usually those who are abusing the drug. If they do experience this when they stop taking fentanyl, it will likely be milder due to the presence of other opioids.

Some of the fentanyl withdrawal symptoms, according to the NLM, are:

  • Agitation
  • Tearing of the Eyes
  • Yawning
  • Sweating
  • Runny Nose
  • Insomnia
  • Muscle Aches and Pains
  • Bone Aches and Pains
  • Anxiety
  • Chills
  • Goose Bumps
  • Nausea and Vomiting
  • Diarrhea
  • Dilated Pupils
  • Cramping of the Abdomen

You Are Dependent on Fentanyl if You Experience:

  • The withdrawal symptoms listed above
  • Not feeling normal unless you are taking fentanyl
  • Not being able to get out of bed/fall asleep without fentanyl
  • Needing to take fentanyl every day without a prescription
Fentanyl Abuse

According to the NIDA, fentanyl is one of the most commonly abused prescription opioids. The drug is very potent, and many users do not care how dangerous it is. It is usually either "injected, smoked, or snorted" when used illicitly.

Some of the street names for fentanyl and drugs which contain fentanyl are:

  • Apache
  • China girl
  • China white
  • Friend
  • Tango and Cash
  • TNT
  • Murder 8
  • Dance fever
  • Goodfella
  • Jackpot

The patches are commonly abused by recreational users, but lozenges and injectables are also abused as well. Some people remove the gel from the patches and inject it or freeze the patches and place pieces of them under their tongues or in their cheeks to make the drug get into their system as quickly as possible. The DOJ states that even "used patches are attractive to abusers as a large percentage of fentanyl remains in these patches even after a 3-day use."

Fentanyl abuse is still common today, but an outbreak of deaths and overdoses caused by the drug occurred from 2005 to 2007. Also, "according to the Drug Abuse Warning Network (DAWN), emergency department visits associated with nonmedical use of fentanyl increased from an estimated 15,947 in 2007 to an estimated 20,034 in 2011." While fentanyl seems attractive to many opioid abusers, the drug can be very dangerous and lethal.

Fentanyl Overdose

Fentanyl overdose has the same general symptoms caused by other opioid overdose syndromes, but the drug is absolutely more likely to cause death from overdose than many other types of opioids. Common fentanyl overdose symptoms are:

  • Drowsiness
  • Dizziness
  • Shallow Breathing
  • No Breathing
  • Pinpoint Pupils (Or very small pupils like head of a pin)
  • Confusion
If someone you know is suffering from these symptoms and has been abusing fentanyl, call 911 immediately and do not leave the individual's side until help arrives.
Fentanyl Addiction

There is a definite possibility of becoming addicted to fentanyl, but it is just as dangerous and perhaps more so than being addicted to heroin. Someone who has become addicted to fentanyl will:

  • Experience severe problems in work, school, home life, and health as a result of fentanyl use
  • Ignore these problems in order to continue using fentanyl
  • Only want to be around others who abuse fentanyl or other drugs
  • Become angry or aggressive when asked about their fentanyl use
  • Hide fentanyl use from others and even hide the drug around the house
  • Abuse fentanyl when alone
  • Stop taking care of themselves and their responsibilities
  • Become apathetic toward life in general when abusing fentanyl is not involved

Overdose often occurs in addicted individuals and especially in those who become addicted to opioids. Because fentanyl overdose can easily be fatal, seeking treatment for the individual as soon as possible is necessary.

Treatment for Fentanyl Addiction
Many opioid abusers need formal addiction treatment, and fentanyl addiction is no exception. In fact, as much as possible should be done to help those who abuse fentanyl stop doing so and work toward a recovery that guards against relapse as much as possible. Because fentanyl is so strong, a person definitely should be careful of going into treatment and then relapsing afterward. According to the NLM, "Most opiate overdose deaths occur in people who have just withdrawn or detoxed" (NLM 2).
Fentanyl treatment will usually start with detox. The individual must be helped through the inevitable withdrawal process which will likely be intense. Afterward, the patient can begin addiction treatment.
According to Harvard Medical School, "Since the 1970s, professionals who care for opiate addicts have reluctantly recognized that many of them will not or cannot stop taking the drug." This is is especially true for those who have abused intense opioids like heroin or fentanyl for a long time. In this case, methadone maintenance treatment could be beneficial. Methadone:
  • Can be taken once a day
  • Blocks the opioid receptors in the brain
  • Prevents the individual from taking more illicit opioid drugs
  • Helps to prevent relapse and overdose
  • Treats opioid addiction while the patient is able to continue on with their life
Methadone maintenance can go on for a year or longer and patients are encouraged to slowly try and taper off their use of methadone at their own speed, with the help of medical professionals. This method is great for long-term addicts who have tried treatment before.

Other Possibilities for Fentanyl Addiction Treatment Include:

  • Buprenorphine
  • Naltrexone
  • Support Groups
  • Family Therapy
  • Cognitive-Behavioral Therapy
  • Contingency Management

According to the NIDA, "Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies." The best treatment for fentanyl addiction is usually a combination of both medication and therapy.

Fentanyl is a dangerous drug and a person who abuses it can quickly become dependent and addicted. Making sure to protect yourself from these issues is important, and seeking treatment for someone who is exhibiting the warning signs above is necessary.


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