Fentanyl withdrawal & detox

This Page was last reviewed and changed on June 6th, 2022

Content Overview

Quitting fentanyl is an important part of the addiction recovery process. However, doing so can be complicated due to the presence of withdrawal symptoms. Fentanyl detox is safest when carried out under medical supervision in a special detox facility. Within such a facility various pharmacological interventions can be used to make the process safer and easier.

Breaking free from fentanyl addiction entails stopping using the drug, which of course is easier said than done. Just as with any other substance addiction, fentanyl addiction is a complicated illness of the brain and so getting clean will be a challenge.

Having said that, with the right programme of care and support, you can get clean and sober and go on to live a much healthier and happier life than the one you are living right now. So treatment for a fentanyl addiction starts with a detox.

Fentanyl Withdrawal

The first step on the road to recovery from fentanyl addiction is quitting the drug. But it is not just a case of stopping it and hoping for the best. The reality is that trying to quit a substance that your brain and body have learned to rely on is not going to be easy.

Withdrawing from any drug that you have become physically or psychologically dependent on is going to be a challenging, complicated process. The good news is that in the right place, and with plenty of support, fentanyl withdrawal need not be too difficult.

You should be aware that withdrawing from an opioid drug such as fentanyl is likely to cause a range of withdrawal symptoms. Because your body has been depending on the drug for normal functioning, it will need some time to get back to normal. As it adjusts to the removal of the substance from the system, you will experience a variety of symptoms, some of which could make you feel quite unwell.

In a dedicated detox facility though many of the worst symptoms can be headed off with medication, if appropriate to the situation and circumstances. Staff will also have the knowledge and experience to ease any discomfort experienced as a result of those symptoms that do occur.

Fentanyl Withdrawal Symptoms

The symptoms that you do experience during fentanyl withdrawal could make you feel unwell. The symptoms have been likened to those experienced during a bout of the flu and usually last for several days. Some examples of the symptoms associated with fentanyl withdrawal are:

Causes of Fentanyl Withdrawal

Over time, the brain and body learn to rely on fentanyl for normal functioning. In fact, you may find that you are unable to feel any pleasure at all unless you are taking the drug. This is due to the way in which fentanyl affects certain receptors in the brain.

The longer you are taking fentanyl, the more the brain and body depend on it; when it is stopped, both will react as they try to get back to normal. They must learn how to adjust so as to restore normal functioning, which is that which causes a range of withdrawal symptoms to occur.

If you are no longer supplying regular doses of fentanyl to your body, your brain will have to learn how to produce certain neurotransmitters and other hormone chemicals without help. It can take a while before the body and brain get back to normal and in the meantime, you might feel quite unwell. The good news is that these feelings will pass with time.

Treatment for Fentanyl Withdrawal

In a detox facility, the discomfort can be eased using appropriate medications, administered by a medical professional. If you are experiencing symptoms such as nausea or vomiting, for example, you may be prescribed medication to relieve these symptoms.

It is important to stay hydrated during withdrawal too, so whoever is taking care of you is likely to be monitoring your fluid levels to ensure you are safe and comfortable.

It may also be the case that a substitute opioid drug is administered to help lessen the impact of the withdrawal process. Using a drug similar to the one you are trying to break free from can help your brain and body to adjust slowly rather than a sudden cessation where they are shocked into a rapid response.

Does Fentanyl Withdrawal Work?

When fentanyl withdrawal is handled correctly, it can be extremely effective. Although not considered especially dangerous, the presence of withdrawal symptoms can often cause some people to return to fentanyl, just to make them subside.

What most individuals do not realise is that their tolerance for fentanyl can reduce significantly in just a few days. So a return to the drug at the same dose as before the detox began could result in an overdose with fatal consequences.

If you are willing to work with staff at a detox facility, however, you can overcome your addiction to fentanyl. You already know that you are likely to feel unwell and you may experience strong cravings for the drug as well. But working with the staff at the facility and taking their advice will help you to make it through.

If you remember that the symptoms you are experiencing will pass and that when they do you will feel much better, you should be able to make it through to the end.

Medications for Fentanyl Withdrawal

During fentanyl withdrawal, substitute drugs are often prescribed. Taking another opioid drug such as methadone or buprenorphine can prevent the worst symptoms from occurring and may make it easier for you to stick with the detox.

As methadone and buprenorphine also act on the brain’s opioid receptors, it helps make it easier to withdraw from fentanyl. You are unlikely to experience severe symptoms, and those you do get should be mild. The idea behind using a substitute opioid is that it allows your brain and body time to adjust to the removal of fentanyl. Once you are no longer using it, the other opioid drug can be slowly withdrawn.

Naltrexone or suboxone can also be prescribed during a fentanyl withdrawal. These medications stop opiates from binding to the receptors in the brain and are known as opiate agonists.

The type of medications that you are given during fentanyl withdrawal will depend on your individual set of circumstances as well as the type of symptoms you experience. Your mental and physical health will also be considered before any medication is administered.

If appropriate, you may be prescribed anti-depressants or beta-blockers to relieve any mental health symptoms or medications to deal with nausea, vomiting and diarrhoea should you experience any of these physical symptoms. In addition, rehydration salts can be given if there is a risk of becoming dehydrated during the process.

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Fentanyl Withdrawal Psychosis

Sometimes during opioid detox and withdrawal, a form of psychosis can occur. This results in certain symptoms manifesting including paranoia, intense anxiety or fear, delusional thinking, and a temporary loss of touch with reality. Those going through fentanyl withdrawal can also experience feelings of hopelessness, which can obviously affect their wellbeing. These feelings can even cause some sufferers to experience depression or even suicidal thoughts.

Due to the scrambled thoughts and delusional thinking, it is not uncommon for those with fentanyl withdrawal psychosis to want to harm themselves or those around them. Therefore, this condition needs to be effectively managed by those with experience of opiate withdrawal.

Medical Detox from Fentanyl as Part of a Whole Treatment Plan

Medical detox is the best way to break the cycle of abuse and should be included as part of a comprehensive programme of treatment that deals with all aspects of the addiction.

Quitting fentanyl is rarely severe enough to be life-threatening, but it can be a very unpleasant experience that could cause some individuals to return to the drug out of desperation. A medical detox can prevent this from happening by making you more comfortable throughout the process.

It is possible to quit fentanyl ‘cold turkey’, which is another term for stopping suddenly. Although this is the quickest way to break free, it is also the most unpleasant and the one that is likely to result in the worst withdrawal symptoms. During a medical detox, you will be prescribed medications that help to not only ease any symptoms you experience but also help prevent the worst from occurring.

While medical detox is a particularly important part of fentanyl recovery, it is just the first part of the process and is not the same as treatment. Quitting the drug is important but perhaps more important is learning how to live without it. You need to know how to avoid a return to fentanyl in the future, and for this, you will require rehabilitation.

Rehab usually comes after detox and while the latter will tackle the physical element of the illness, rehab programmes are specifically designed to help you overcome the emotional and psychological issues associated with addiction. Both are essential in terms of helping you to achieve a full recovery.

Fentanyl Addiction Detox

How you detox from fentanyl will depend on your circumstances and situation. In a dedicated facility, for example, you might be weaned off the drug over the course of a couple of weeks, you may go cold turkey, or you could be given a substitute opioid drug to help lessen the severity of the process.

Detox is a natural process that will begin after the last dose of fentanyl has been taken. When you stop taking the drug, or at the very least cut down the dosage significantly, your body will react by trying to heal itself. It will start the process of getting back to normal, and it is this that can result in the many types of symptoms that can occur, which can range from mild to severe in intensity.

You could feel very unwell for the first few days before symptoms reach a peak and then subside. It is for this reason and more that detox is best completed under the watchful eye of medical professionals within a dedicated detox clinic.

Detox clinics are always considered the safest environments in which to withdraw from drugs. As you will stay in the clinic for the duration of the process, there is less chance of returning to the drug when strong cravings do occur. While detox is possible at home for those who do not yet have a full-on addiction or those who have a less severe addiction, the risk of relapse tends to be higher.

In a dedicated detox facility, staff not only make the process more comfortable, but they can also ensure your safety at all times. As with any withdrawal from a chemical substance, fentanyl detox does carry the risk of severe complications, particularly in those with more complex needs. If you have any underlying medical conditions or a history of mental health disorders, it is best to withdraw from fentanyl in a dedicated facility where your progress can be monitored, and staff can react appropriately in the event of a medical emergency.

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Fentanyl Detox Protocol

When detoxing in a dedicated facility, a fentanyl detox protocol will be put in place before your medication is withdrawn. This is a very important part of the process as it ensures that everyone involved in your care is on the same page in terms of how the detox should proceed and the methods to be used to ensure your comfort and safety.

The detox protocol will be created with your needs and circumstances in mind. It will include details of your medical history that are appropriate to the detox as well as the way in which the drug is to be withdrawn.

If you are to be provided with a substitute opioid drug such as methadone or buprenorphine, the detox protocol will contain dosage information. Other medications that may be needed as well as their recommended dosage will also be included.

The benefit of a detox protocol is that whoever is looking after you will be fully aware of the process to be followed. This is vital considering that you are likely to be taken care of by a number of different people throughout the one-to-two-week detox.

As well as information about the procedures to follow and medications that may be required, the detox protocol should also contain information about any vitamins and nutritional supplements that should be given, if appropriate.

Physical Dependence vs. Addiction

Many people believe that if you are physically dependent on a drug such as fentanyl then you automatically have an addiction to it, but this is not necessarily the case. Yes, it is true that most of those with an addiction are also physically dependent, but you can be dependent without being addicted.

A physical dependence occurs when the body gets used to the presence of a substance and learns to rely on it for normal functioning. It commonly occurs among those who use opioid drugs such as fentanyl and it is for this reason that caution should be taken when taking such medications. When a physical dependence occurs, you are likely to experience withdrawal symptoms when you try to quit the drug or cut down dramatically on the amount that you are using. This is because your body must learn to function without it again. It will take some time for it to be able to do this.

Nevertheless, addiction is not the same as a physical dependence. When a person becomes addicted to fentanyl, the substance begins to take over their life. Their use of the drug interferes with their ability to perform daily tasks and they will develop a compulsive need for it. They are likely to be unable to quit the drug, even if it is causing obvious harm to themselves and to those around them.

When an addiction does occur, a complete loss of control over the use of the drug is present. Even those who want to quit will find themselves unable to resist the pull of the substance. Fentanyl addicts are likely to also have a physical dependence on it, which means that should they try to stop using it, a range of withdrawal symptoms will arise.

Fentanyl Overdose

Fentanyl is an extremely powerful drug. In fact, it is around fifty to one hundred times more powerful than morphine and because of this users risk an overdose every time they take it. When provided by a doctor for pain relief or as an anaesthetic, fentanyl doses are considered safe as they are controlled. Nonetheless, if the drug is combined with other sedative substances or taken without a prescription, the risk of overdose is high.

Fentanyl purchased on the streets may be more potent than that provided by a doctor, and there is just no way to tell how strong it actually is. High doses of fentanyl severely depress the central nervous system, causing respiratory distress and heart problems. Some individuals will suffer respiratory failure and cardiac arrest. Know that without treatment, a fentanyl overdose can be fatal.

It is important to seek medical help immediately if you have taken fentanyl with another substance or a dose that you have purchased on the street, and experience the following symptoms:

  • Severely constricted pupils
  • Dizziness
  • Extreme muscle weakness
  • Extreme fatigue
  • Slow heartbeat
  • Shallow breathing
  • Breathing difficulties
  • Confusion
  • Low blood pressure
  • Blueish tinge to nails and lips
  • Loss of consciousness

Fentanyl overdose is becoming a massive problem in many parts of the world, particularly in the US, where researchers say it is the most common drug involved in fatal overdoses. In a report published in the Journal of the American Medical Association, researchers found that there was a jump from 14 per cent in 2010 to 46 per cent in 2016 in the number of fatal overdoses that involved synthetic opioids.

They also found that in cases where synthetic opioids such as fentanyl were not the primary cause of death, they were prevalent in almost eight per cent of deaths that involved other drugs or alcohol in 2016.

While the problem is nowhere near as severe here in the UK, there is a fear that fentanyl overdose deaths will begin to rise dramatically as the drug is becoming more prevalent in street drugs such as heroin. According to a report in The Guardian, the National Crime Agency said that there were 60 fentanyl deaths in 2016/2017, most of which had occurred in Yorkshire and the Humber.

Reports from Bristol, South London, Birmingham, the Scottish Borders, and Hertfordshire have also mentioned the growing presence of fentanyl in the illicit drugs industry.

Fentanyl Addiction Treatment and Rehab

Overcoming fentanyl addiction requires a comprehensive recovery programme. It is important to tackle the physical side of the illness first but once you are free from the drug, you can get started on tackling the other issues that have led you to this point in your life.

Treatment for fentanyl addiction typically includes both traditional and holistic therapies and programmes tend to take place in either inpatient or outpatient facilities. During treatment, you will learn the reasons for your addictive behaviour and how to develop strategies that will enable you to avoid them going forward.

Fentanyl Addiction Withdrawal and Detox Statistics

  • Fentanyl is fifty to one hundred times more powerful than morphine.
  • It can be fatal even in tiny doses.
  • NHS figures released in 2017 showed that there had been a 100 per cent increase in the number of opioids prescribed in the previous ten years.
  • In 2006, 12 million opioid prescriptions were issued; that number doubled to 24 million in 2016.
  • Included in these figures was a 143 per cent rise in fentanyl prescriptions.
  • It is estimated that up to 200,000 people in the UK are dependent on opioid medications such as fentanyl.
  • In Sacramento, California, 53 people overdosed on a powerful fentanyl pill obtained without a prescription in March and April 2016. Of those, twelve died.
  • Fentanyl was one of the drugs that caused the accidental overdose death of pop legend Prince in April 2016. The fentanyl was found in pills that had been labelled as hydrocodone – suggesting that the singer did not even know he was taking the much more powerful drug.
  • Opioid addiction has claimed hundreds of thousands of lives in America.
  • A report by Public Health England found that evidence shows opioid substitution treatment is an important driver of crime reduction; reoffending rates were proportionate to the amount of time that opioid addicts spent in treatment.
  • The report also stated that analysis estimates that four out of every five heroin users in the USA began abusing an opioid analgesic medication prior to abusing heroin.
  • Opioid substitute treatment is the frontline NICE recommended pharmacological therapy for those with heroin or other opioid addictions.

Frequently Asked Questions

How does fentanyl withdrawal affect my health?

When you withdraw from a drug such as fentanyl you are likely to experience various withdrawal symptoms that could make you feel unwell. Symptoms such as nausea, vomiting, and diarrhoea can make you feel uncomfortable, but they are unlikely to affect your overall health.

You might also suffer symptoms of depression and anxiety, but the good news is that most of the symptoms you experience will subside over the course of one to two weeks. As you continue on your journey to permanent sobriety, your health should improve.

Will my information be kept confidential?

Your information will be kept confidential and secure at all times and nobody will know you are in treatment for addiction unless you want them to know. Staff at CQC-regulated clinics follow strict confidentiality policies and never share patient details with third parties without permission.

Am I addicted?

It is difficult to know if your use of a drug such as fentanyl has progressed from abuse to addiction, but there are certain things that can indicate when your use constitutes a problem. For example, if you have increased the amount of fentanyl that you are using in order to achieve a certain level of satisfaction, it is likely that this is because of an increased tolerance to the drug.

Being tolerant to fentanyl, or even having a physical dependence, does not necessarily mean you have an addiction. However, if your use of the drug is having a negative impact on your life as well as the lives of those around you and you continue using it anyway, it is likely that you are addicted. If you have tried to quit but found that you could not, and if you have a compulsive need for the drug even though it causes harm, you need professional help to get better. It is important to speak to someone about your options for treatment.

How serious is fentanyl detox?

Fentanyl detox is rarely life-threatening in and of itself. However, strong cravings for the drug could cause you to return to it. What you should be aware of is that returning to previous levels of fentanyl after a period of abstinence can cause a fatal overdose.

This is because tolerance to opioid drugs drops dramatically even with short periods of abstinence. If you take the same amount of the drug that you were taking before you quit, you will have a high risk of overdose.

Can medications help me detox from fentanyl?

The use of medications during fentanyl detox can help to make the process more comfortable. Opioid replacement therapy is regularly used during detox as it can help to maintain your tolerance for opioids and prevent the worst symptoms from occurring. This gives your body a chance to get used to the withdrawal of fentanyl without you feeling too uncomfortable.

Can I die from fentanyl withdrawal?

While fatal complications rarely occur during withdrawal from fentanyl, a fatal overdose is possible if you return to the drug shortly after a period of abstinence. As fentanyl detox can be unpleasant and uncomfortable, and because cravings for the drug commonly occur, many people will return to the drug at the same dosage as they were taking previously. This can cause a severe overdose with fatal consequences as tolerance for the drug will have decreased dramatically.

How do I detox from fentanyl?

The best way to detox from fentanyl is in a secure and managed facility with medical staff in attendance. How the process proceeds will be a matter for you and your care team to discuss. It may be the case that you withdraw from fentanyl suddenly, or alternatively, you might be weaned off the drug slowly.

< p>Your detox provider could put you on an opioid replacement programme where you will take fentanyl or buprenorphine for a period while you withdraw from fentanyl. When you have successfully withdrawn from fentanyl, your dose of the replacement opioid can be tapered off until you are completely clean.

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