Fentanyl is a drug prescribed for the treatment of pain. However, as an opioid drug, it is highly addictive and should be used with caution. Fentanyl can induce feelings of warmth, relaxation, and euphoria while also providing relief from pain. This makes it attractive to those looking for an easy way for recreational use. Unfortunately, with such a high potential for abuse though, fentanyl addiction is fairly common. Moreover, because this drug is much more potent than other opioids such as heroin or morphine, overdose is also common.
What is Fentanyl?
Fentanyl is an opioid drug that is used for pain treatment. It is also used as an anaesthetic in combination with other substances to produce sedation during various medical procedures such as cardiac catheterisation and endoscopy. It can also be used before oral surgery. It is also often used for pain management in those with cancer.
As an opioid drug, fentanyl has the potential for abuse. A tolerance to it can quickly occur, causing some people to increase their dose. This can then lead to physical dependence on the drug, which can, in turn, result in an addiction developing.
Unfortunately, fentanyl addiction is a growing problem, with some individuals choosing to abuse the drug deliberately because of its sedative properties. However, what most people do not realise is that fentanyl is an extremely addictive and powerful substance that can negatively affect the life of the user in so many ways.
As a prescription-only medication, fentanyl is around fifty to one hundred times more powerful than morphine. Unfortunately, most of those taking fentanyl, irrespective of whether this is for a legitimate medical condition or for recreational purposes, fail to appreciate how powerful the substance actually is. And because of this, deaths from fentanyl abuse are both on the increase and are increasingly common. In fact, the death of pop superstar Prince in April 2016 was caused by an accidental fentanyl overdose, with the singer taking fake Vicodin pills that had been laced with the more powerful opioid.
Fentanyl works very quickly, which is one of the reasons it is used as an anaesthetic. The effects tend to last for between one and two hours, although skin patch versions of the drug work much more slowly. When used in a skin patch, the drug is released slowly over the course of two to three days. This version of the drug is typically utilised in the management of chronic pain.
Due to the addictive nature of fentanyl, it can become a problem in those prescribed the drug for the treatment of a medical condition. Tolerance can develop rather quickly and with it comes the temptation to take a higher dose. Doing this though can significantly increase the risk of dependence and subsequent addiction.
The unfortunate truth nowadays is that fentanyl is a commonly abused drug, with many individuals seeking it out for illicit purposes. Its powerful sedative effects make it attractive, particularly for those who have already developed a heroin addiction. Fentanyl is much more potent than heroin and so is consequently often abused alongside it to enhance the effects.
How Can Fentanyl Be Addictive?
As mentioned above, tolerance to fentanyl tends to develop very quickly. What this means is that the dose of fentanyl you are taking will become less effective. You may find that you are not getting the same amount of respite from the drug or that it is not giving the same pleasurable feelings.
For many, the answer to this problem is to increase the amount of the drug being taking. So while the higher dose may indeed provide the desired relief, after a while the higher dose will also become less effective. And so the cycle of abuse ensues.
Know though that taking fentanyl at higher than recommended doses is classed as abuse and can lead to a physical dependence. Conversely, even taking it at the specified dose could also lead to a physical dependence if taken for a prolonged period. Like other opioid drugs, fentanyl is designed for short-term use only unless part of a pain management programme for patients with conditions such as cancer.
When a physical dependence does occur, you will notice withdrawal symptoms when the effects of the drug wear off or if you try to quit or cut down on your use. You might then have realised that taking more fentanyl helps relieve the withdrawal symptoms, but this can lead you down the path of addiction without you even noticing what has happened.
Fentanyl: Key Statistics
- Fentanyl is available as a patch, lollipop, lozenge, or injectable liquid.
- Fentanyl is hundreds of times stronger than morphine.
- Fentanyl was first developed in 1959 but was not approved for use in the US until 1968.
- In 2015, 1600kg of fentanyl was used around the world.
- It became the most widely medically used synthetic opioid in the world in 2017.
- The World Health Organisation’s List of Essential Medicines contains fentanyl patches.
- The most common side effects of fentanyl include abdominal pain, constipation, diarrhoea, nausea, dry mouth, weakness, confusion, and sweating.
- It is illegal to possess fentanyl without a prescription. If you are found in possession of the drug without a prescription, you could face criminal prosecution.
- When abused, fentanyl can be snorted, sniffed, injected, taken orally, or spiked onto blotting paper. Some people remove the gel from patches and inject the solution.
- Fentanyl causes effects such as dizziness, sedation, relaxation, euphoria, and pain relief. It is these effects that make the drug attractive to illicit drug users.
Why are Opiates Prescribed?
Opiates drugs are regularly prescribed for pain treatment and management. Fentanyl, as we touched upon briefly above, is often used for anaesthetic purposes. However, for terminal cancer, fentanyl might be appropriate for ongoing pain treatment. When used for chronic pain, fentanyl is usually prescribed in patch form, allowing the dose to be administered slowly over the course of a few days.
Opiates like fentanyl work by depressing the central nervous system. They can relieve both physical and psychological pain while inducing a sense of relaxation and euphoria. While these drugs do carry risks, when taken as prescribed by a doctor they are highly effective. Unfortunately, when opiates are abused, there is a risk of addiction and even death due to overdose.
Understanding Fentanyl Abuse
Most people who take fentanyl for a medical reason will have no intention of abusing their medication. The trouble is that most just do not comprehend what fentanyl abuse actually is or entails. Some see all medications prescribed by a doctor as completely safe, and the very idea that they could be harmful is something they do not even consider.
As it is common for a tolerance to fentanyl to develop quite quickly, there is often a temptation on the part of the user to increase his or her dosage, all the while being unaware that doing so without a doctor’s recommendation is classified as prescription drug abuse.
Using another one's medication
For example, many individuals do not realise that taking medication prescribed for another person is abuse. Some just assume that if a pill is okay for one person, it is bound to be okay for another, especially if the two have the same condition and/or symptoms.
The dangers of abuse
Drugs available on prescription only can be extremely hazardous to health if abused. There is a very good reason these drugs are not available over-the-counter; in the case of fentanyl, it is because it is an extremely potent drug that can cause devastating consequences when abused.
While many people abuse fentanyl without even realising, others do so deliberately. Some are attracted to the sedative and euphoric effects of the drug and take it for recreational purposes. Others will mix fentanyl with other drugs or alcohol to enhance the effects of each substance.
Understanding Fentanyl Dependency and Tolerance
As you now know, fentanyl tolerance occurs very rapidly and when it does, the drug becomes less effective. This happens because the body gets used to the substance and thus alters its response to it. Developing an increased tolerance to fentanyl means not getting the level of relief desired.
So to achieve the desired feelings, you have to increase the dose. Increasing the dose though means increasing the risk for dependency.
When you become dependent on fentanyl, you will almost certainly experience a range of symptoms if or when you try to quit. Even when trying to cut back, you may find that a range of unpleasant symptoms occurs; the presence of such symptoms might cause you to continue abusing the drug just to get some relief from the withdrawal symptoms.
While being tolerant to fentanyl, or even having a physical dependence, does not necessarily mean you have an addiction, continuing to abuse the drug means that the chances of developing one will increase dramatically.
Since fentanyl is such a powerful drug, a sudden discontinuation can result in severe withdrawal symptoms. It is therefore often recommended that a substitute opioid drug is administered in its place.
A slower-acting opioid such as morphine or methadone may help with the withdrawal from fentanyl. The idea of substituting one opioid for another is that it gives the brain and body time to get used to the removal of fentanyl.
A substitute opioid drug will act on the same brain receptors as fentanyl, having the effect of lessening the impact of withdrawal. This idea of this type of treatment is to help prevent the worst symptoms from occurring while reducing the severity of those that do.
With fentanyl substitution, the replacement drug will be reduced gradually until you are completely drug-free.
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The Dangers of Fentanyl Addiction
Just as with any other addiction, fentanyl addiction can have profound consequences for the user. Moreover, because this drug is so potent, the risk of death from overdose is exceedingly high. There is also a severe risk to health from chronic use of the drug.
Abuse of fentanyl often occurs without the user realising what has happened. He or she might have started taking the drug for pain relief but before long felt compelled to use it, even when knowing that to do so would affect daily life.
As fentanyl is a drug that depresses the central nervous system, those under its influence could suffer symptoms such as:
- slurred speech
- impaired judgement
- slower reactions
- obstructed decision-making
- high change of mental health issues
- high chance of worsening of pre-existing mental health issues
- organ exhaustion and damage
By now, you have probably realised that fentanyl addiction can severely damage health but know that it can also have a negative impact on your overall wellbeing, particularly in terms of your relationships with those around you. Family members and friends will struggle to cope with your changing behaviour as the addiction grows. This can put a lot of pressure on relationships, with some even being pushed to breaking point.
It can be difficult watching a loved one struggle with addiction, especially knowing that there is nothing that one could do about it. Family members and friends may be at risk of developing what is known as co-dependency, where their own behaviour changes in response to the addict’s. Co-dependency is basically the term given to those who develop their own dependency on an addict. Many put their own happiness behind their overwhelming need to help their addicted loved one.
Perhaps one of the biggest dangers associated with fentanyl use is an overdose. Unfortunately, this is becoming a massive problem on both sides of the Atlantic, but particularly in the US, where the situation has been described as ‘an opioid epidemic’.
In May 2018, The Atlantic reported that more people in the US are dying because of synthetic opioids such as fentanyl than of heroin or prescription painkillers. It was also reported that other drugs such as Xanax and cocaine are increasingly being laced with fentanyl and are hence causing more overdose cases.
Dr Wilson Compton, who co-authored a report on the ‘Changes in Synthetic Opioid Involvement in Drug Overdose Deaths in the United States, 2010-2016’, stated that almost half of the 42,000 overdose deaths in the US in 2016 were in some way related to fentanyl.
Fentanyl overdose is extremely dangerous, and it can lead to severe depression of the central nervous system. When too much of the drug is taken, or if it is combined with other substances, it can result in overdose. It is important to be alert to the signs of overdose so that you can seek help immediately, whether this is in yourself or in a loved one. These signs include:
- extreme sedation
- breathing problems
- low blood pressure
- limp muscles
- constricted pupils
- cold clammy skin
- pale face
- bluish tinge to nails and lips
Failure to get treatment for a fentanyl overdose can potentially result in respiratory distress, cardiac arrest, and eventual death. If you or someone you are with displays any of the above signs after taking too much fentanyl or mixing it with another substance, call for medical help immediately.
Fentanyl Overdose Risks
Due to the powerful nature of fentanyl, you know that the risk of overdose is extremely high. Nevertheless, this is particularly so among those taking variations of the drug procured on the streets. Fentanyl is unregulated when sold on the streets, making it impossible to know how pure it is. As well as this, it is often combined with other substances, which can increase the risk of death from overdose.
Did you know that fentanyl is more powerful than both heroin and morphine and when combined with other substances? This makes the risk of overdose exponentially higher.
When to Seek Medical Care?
If you have been using fentanyl and start to experience the signs of overdose, it is vital that you seek help immediately. With treatment, the risk of severe overdose effects as mentioned above will reduce but failing to get help potentially means suffering often serious complications.
Medical help will also be required if you think that you have developed an addiction to fentanyl. If you have noticed that you are becoming tolerance to the effects of your medication and have been tempted to take a higher dose, seeking medical advice at this point could prevent you from developing a full-blown addiction.
However, if your use of fentanyl is already having a negative impact on your ability to live a normal life, it may be that you are already addicted and will need help to regain control of your life. Your doctor should be able to provide advice on the next steps you can take.
Fentanyl Brand and Street Names
Fentanyl is sold under the following brand names:
It is also known under the following street names:
- Murder 8
- Dance Fever
- China white
- China girl
Causes and Risk Factors for Fentanyl Abuse
Those who have been prescribed fentanyl for medical reasons might begin abusing the drug unwittingly. Once a tolerance develops, it can be difficult to resist the temptation to increase the dose to achieve the relief or satisfaction desired.
If you have been getting respite from fentanyl for a painful condition, it can be upsetting and frustrating when that level of pain relief diminishes. You might not see the harm in increasing the dose because you believe that it must be completely safe or else the doctor would not have prescribed it. You know from the above paragraphs that increasing the dose of fentanyl without a recommendation from a medical professional is classed as abuse. But there are still countless individuals that do not realise this.
You also know by now that not everyone abuses fentanyl unintentionally; there are some who take the drug for recreational reasons. There are various reasons people abuse fentanyl but not everyone will go on to develop an addiction to it. There is no single cause of addiction, but there are some risk factors that make it more likely. These include:
Family history of addiction
Those with a family history of addiction have a higher chance of becoming addicted themselves.
History of mental health disorders
Mental health problems and substance abuse are intricately linked, with many people choosing to relieve symptoms of their mental health condition with mood-altering substances.
Traumatic experiences can lead to some individuals seeking solace in mood-altering substances. Those who have suffered abuse, neglect, the loss of a loved one, or have been bullied have an increased risk of developing an addiction. The risk is higher with more incidences of emotional trauma.
Fentanyl Abuse Statistics
- The National Crime Agency (NCA) has found that fentanyl has recently appeared in the UK heroin street market in the North East of England.
- Fentanyl first began appearing in the heroin market in late 2016.
- It is suggested that the drug could be a contributing factor in growing numbers of heroin deaths.
- Fentanyl was implicated in the accidental overdose deaths of top stars including Michael Jackson, Prince, and Tom Petty.
- A kilo of fentanyl costs around £3,000 to produce compared with £4,500 for heroin. However, while this amount of heroin will sell for a few hundred thousand pounds, the same amount of fentanyl could take in as much as £1.2 million.
- In 2017, fentanyl was cited in sixty UK deaths, according to the NCA. Most of these deaths had occurred in Yorkshire and the Humber.
- From 2012 to 2016, US deaths attributed to synthetic opioids rose sevenfold to 20,145.
- In 2016, synthetic opioids were responsible for the majority of the 64,080 recorded drug deaths in the states.
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Co-Occurring Disorders of Fentanyl Abuse
There is a strong link between substance abuse and mental health problems. Many people struggling with mental health conditions such as depression or anxiety will turn to mood-altering chemicals to help relieve their symptoms.
As fentanyl can induce feelings of warmth and relaxation, it can help to stop affected individuals from feeling depressed or anxious – at least temporarily. Statistics show that those with mental health problems are more likely to abuse mood-altering chemicals such as fentanyl.
What can often happen though is that substance abuse can be the catalyst for the development of mental health conditions. Due to the way in which chemical substances affect the brain, they can trigger conditions such as anxiety and depression. For care providers, co-occurring disorders can make treatment much more complicated.
It can be difficult to know where one condition begins and the other ends as they tend to have similar symptoms. What treatment providers do know is that both substance abuse and mental health problems need to be treated simultaneously. There is no point in treating one condition and not the other, as was the case for many years.
Fortunately, these days co-occurring disorders are treated together, and it is important that the clinic providing the care has staff fully trained in dual diagnosis treatment. Treating one condition and not the other can result in both reoccurring at a later date.
Fentanyl and Other Substances
Fentanyl is a powerful opioid all on its own, but some people who abuse this drug will take even more risks by mixing it with other substances such as alcohol or other opioid drugs. Combining fentanyl with other sedative substances can end up having disastrous consequences.
Due to the way in which these drugs depress the central nervous system, there is a very real risk of fatal overdose as the respiratory or cardiac systems shut down completely.
What most people do not realise though is that fentanyl is increasingly being mixed with other street drugs by suppliers hoping to make bigger profits. As it is cheaper to produce fentanyl than it is heroin, it is often mixed with the latter to make it go further. Fentanyl-laced heroin is extremely potent, and users often do not realise that they are taking this much stronger product. Consequently, taking their normal dose could easily mean that they are putting their life in danger.
Unscrupulous dealers are also selling fake Xanax pills or other pain relievers that are actually fentanyl. Those using these drugs are risking death without even realising it. Irrespective of whether fentanyl is deliberately or unintentionally taken with another substance, the risks remain the same.
Fentanyl Addiction and Possible Treatments
Fentanyl addiction is a destructive illness, but it can be treated. Those who want to overcome it will need to complete a comprehensive programme of recovery that incorporates detox to deal with the physical side of the illness and rehabilitation to manage the psychological. This should then be followed up with aftercare.
In a rehab centre, you will learn how to say goodbye to fentanyl abuse once and for all. You will be helped to identify the reasons you developed the addiction via a series of counselling sessions. You can expect to be given a tailored treatment plan that will focus on your specific requirements. The plan will probably include elements of the following:
- Individual counselling
- Group therapy
- Dialectical behaviour therapy
- Cognitive behavioural therapy
- Motivational interviewing
- Family therapy
- Acceptance and commitment therapy
- Psychodynamic therapy
- Contingency management.
It is also likely that you will be treated with holistic therapies such as yoga, meditation, and art therapy. These treatments are designed to be used alongside traditional talking and behaviour therapies and aim to heal mind, body, and spirit rather than just the illness itself.
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When you decide to get help for a fentanyl addiction, you will need to complete a detox before starting a rehab. Detox (detoxification) is the process of cleaning your mind and body so that they can start healing and getting back to normal.
Detox begins after the last dose of fentanyl has been taken and the body realises that no more of the usual dose is forthcoming. At this point, it will begin eliminating any remaining traces of chemicals in an effort to restore normality.
What about Withdrawal?
During the detox process, you are likely to experience a range of withdrawal symptoms that will vary in intensity. Some may be mild while others might be more severe. As your body tries to heal itself and get used to functioning without fentanyl, both physical and mental symptoms can occur. The good news is that in a detox facility, the severity of the symptoms you experience can be lessened.
Do You Need to go onto Rehab?
Quitting fentanyl is just the first step on the road to recovery though. While it is a particularly important part of the process, it is not the only one. Once you learn to stop relying on fentanyl to be normal, you will need to learn how to live without it going forward.
This means learning those things that trigger your addictive behaviour and finding ways of avoiding these in the future. Basically, while detox tackles the physical element of your illness, it does nothing to deal with the emotional or psychological issues associated with it; for that, you will need rehab.
How can I spot fentanyl addiction?
If you have noticed physical symptoms whenever you try to quit or cut down on the amount of fentanyl you are taking, it might be because you have become physically dependent on it. Nevertheless, if you have developed an addiction to fentanyl, you are likely to continue using it even if you know that it is likely to result in negative consequences.
You will feel a compulsive need for the drug that will overtake everything else in your life, even affecting your ability to perform essential tasks. You might become preoccupied with fentanyl and you may lose interest in things that you used to enjoy. If this sounds familiar to you, it is important to seek help as soon as possible as you may need professional treatment to get better.
What is the goal of fentanyl addiction treatment?
When you enter a programme of detox and rehabilitation for a fentanyl addiction, the goal is to help you quit the drug completely and learn how to live without it going forward.
Addiction is made up of a physical and a psychological element and both must be addressed if you are to fully overcome the illness.
How bad is fentanyl addiction
Fentanyl addiction is a serious illness of the brain that requires comprehensive treatment. Without treatment, the addiction will progress and cause severe consequences for not only your life but also the lives of those around you.
Every time you take fentanyl, you are putting your life at risk. This is an immensely powerful drug that can easily result in overdose, particularly if you are buying fentanyl on the streets and are unaware of its potency. Fentanyl can also result in a fatal overdose if mixed with other substances. It is important to seek help immediately if you believe you have a fentanyl addiction.
How to cure fentanyl addiction?
Fentanyl addiction can be effectively treated via a programme of detox and rehabilitation. It should then be followed up with aftercare support and a commitment to ongoing maintenance. It is important to remember that while addiction can be effectively managed, it cannot be cured. Allowing yourself to become complacent after a period of sobriety could see you falling back down the slide to addiction.
How to help someone who is addicted to fentanyl?
If you believe that someone you know and care about has developed an addiction to fentanyl, it is important to speak out as soon as possible. Fear that you are mistaken might be holding you back, but if you have noticed signs of addiction, it is highly unlikely that you are wrong.
If you know for certain that this person is using fentanyl and you have perceived a change in his or her behaviour, early intervention could prevent this individual’s life from spiralling completely out of control.