Is Fentanyl Addictive?

Opioid addiction has become a national health crisis, causing more than 80,000 overdose deaths per year. Fentanyl, an increasingly used opioid, was responsible for a large number of those deaths.

It’s important to understand what fentanyl is and the dangers of fentanyl, including dependence and addiction.

What Is Fentanyl?

Fentanyl is a synthetic opioid similar to morphine, but significantly more potent. It is often used in a medical context for pain by prescription, but it’s also made illegally and sold on the street.

Street forms are sold as a powder, blotter paper, pills, or in eye droppers and nasal sprays. Drug dealers also mix it with heroin, meth, or cocaine because it’s cheap, and the people who take the other drugs are usually not aware that they’re also taking fentanyl.

Fentanyl’s effects include:

• Drowsiness or sedation
• An extreme feeling of happiness
• Nausea or constipation
• Confusion
• Difficulty breathing
• Unconsciousness

Fentanyl Addiction

Fentanyl works by binding to opioid receptors in the brain, which are located in the areas of the brain that control emotions and pain. After taking fentanyl for a period of time, the brain gets used to having the drug, which can make it difficult to feel pleasure without it. This leads to dependence on the drug, and stopping its use will lead to withdrawal symptoms.

This dependence can lead to addiction, which is characterized by compulsively seeking the drug and using it regardless of the negative effects on the user’s health or life.

Dependence can occur even if the fentanyl is legally prescribed for pain, so patients need to be aware of the possibility and continue to use fentanyl only as prescribed.

Fentanyl Overdose

Fentanyl overdoses have increased, in large part because of illegal manufacturing and mixing of fentanyl with other drugs. People don’t know they’re taking fentanyl and can easily overdose because fentanyl can be lethal in even very small amounts.

Additionally, manufacturers of illegal fentanyl are making the drugs into pills which look like other prescription opioids, leading to even more unintentional fentanyl use and sometimes overdose. A lethal dose of fentanyl can be as low as 2 milligrams depending on the person’s size, but the DEA reports that they have found counterfeit opioids containing up to 5.1 milligrams. This means that even if the person knows they are taking fentanyl, they don’t necessarily know how much.

Signs of overdose include:

• Small, constricted pupils
• Loss of consciousness
• Weak breathing or no breathing
• Gurgling or choking sounds
• Limpness
• Cold, clammy skin
• Gray or blue lips, nails, or skin

Narcan is a drug that can save a person experiencing fentanyl or other opioid overdose and is available in most states without a prescription. It works by blocking the opioids effects and restoring breathing. It’s intended for people, particularly those close to someone with an opioid addiction, to have on hand in case of an overdose emergency.

It’s important to note that the person who overdosed still needs to be taken to an emergency room even after Narcan administration. The Narcan will wear off before the opioids do, so the person could stop breathing again.

Fentanyl Withdrawal

When the body has become dependent on fentanyl, stopping its use can lead to very unpleasant withdrawal symptoms. These usually start between 8 and 24 hours after the last use and can last for up to two weeks.

Withdrawal symptoms include:

• Diarrhea, nausea, vomiting
• Increased heart rate
• Pain in the muscles or bones
• High blood pressure
• Anxiety
• Increased body temperature
• Chills and sweating
• Severe drug cravings

The severity of the withdrawal symptoms varies based on the length and amount of fentanyl usage and any underlying health conditions.

Because withdrawal is so uncomfortable, people who try to detox on their own often use again to relieve the withdrawal symptoms. Withdrawal without supervision can also lead to severe dehydration which increases sodium levels in the blood and can cause heart failure.

Fentanyl Addiction Treatment

The first phase of fentanyl addiction treatment is a period of inpatient supervised detox. The goal is to keep the addicted person safe and comfortable, and to alleviate withdrawal symptoms, sometimes with medications such as methadone, buprenorphine, or naltrexone. These medications may also be used long term to alleviate fentanyl cravings and prevent relapse.

But treating any addiction must also include therapy, both in an inpatient setting and after leaving inpatient treatment.

Cognitive behavioral therapy is a common therapy used in fentanyl addiction treatment and has shown good results. It involves teaching the patient how to recognize their “addict thinking” and to rethink it reasonably.

For example, if the patient thinks “I can control my fentanyl use and just do it on the weekends,” they will learn to stop and rethink that thought to come to a realistic conclusion based on what they’ve learned in therapy.

Cognitive behavioral therapy also teaches problem solving and coping skills so that the patient can better deal with life and its challenges.

Positive reinforcement, which involves giving the patient a reward for good behavior such as passing a drug test, is another type of therapy that may be used.

Group therapy is also critical in a fentanyl addiction treatment program. It’s an opportunity for education, and for patients to share their stories, emotions, and strategies for preventing relapse. Patients also provide each other with support and develop relationships that may last even after treatment.

Group therapy also makes patients feel less isolated, knowing that they are not alone in their addiction struggles and the recovery process.

All of these therapies can be used during inpatient treatment and during ongoing treatment. The next step in ongoing treatment may be a partial hospitalization program (PHP) followed by an intensive outpatient program (IOP).

Individual therapy is also helpful on an ongoing basis to reinforce coping strategies and relapse prevention strategies. Many also find it useful to attend addiction support groups to maintain peer support. Additionally, peer support programs are available which give the addict an opportunity to interact individually with someone else who has successfully gone through the addiction treatment process.

Help Is Available

If you are addicted to fentanyl or any substance, treatment can seem frightening and overwhelming. It’s important to understand that you are not alone, and that help is available. Many people navigate treatment successfully and move on to live healthy, productive lives. You can be one of those people, starting with the first step—reaching out to ask for help. It will take many more steps and some time, but life on the other side will be better.