Fentanyl is one of the strongest opioids available. Because it is fast-acting rather than long-lasting, doctors typically prescribe it following surgery. It can also be used to treat breakthrough pain, which is temporary but severe pain that occurs after a patient has already taken opiates. Fentanyl comes in the form of skin patches, lozenges, pills, shots, nasal sprays, IV fluids, and films that dissolve under the tongue.
According to the National Institute on Drug Abuse (NIDA), fentanyl is a powerful synthetic opioid analgesic that affects specific pain receptors in the central nervous system in order to minimize feelings of pain. It is critical that people only take it as directed by a doctor because the difference between a therapeutic dose and a potentially fatal one is very small. The Drug Enforcement Administration (DEA) reports that fentanyl is approximately 100 times more potent than morphine, making it far more dangerous. When people develop an addiction to fentanyl and are no longer taking it as directed by a doctor, they run the risk of overdosing every time they use.
When Abuse Turns to Addiction
Anyone can abuse fentanyl, but there are some factors that may make someone more susceptible to developing an addiction than others. According to NIDA, no single factor can predict if someone will develop an addiction, but those that increase the risk of doing so are:
- Biological: The National Council on Alcoholism and Drug Dependence, Inc. reports that genes account for 50 percent of an individual’s risk of drug and alcohol dependence. Some people are genetically predisposed to developing an addiction, but that does not mean doing so is inevitable for them at some point during their lives.
- Environmental: Everyone has external influences that affect them, and some people socialize in circles that may pressure them or stress them out enough to abuse fentanyl.
- Developmental: Taking drugs at any age can result in an addiction, but the earlier someone starts, the more likely they are to develop a serious problem. The areas of the brain that control decision-making, foresight, and judgment do not fully develop for most people until they are in their early 20s. Adolescents who abuse drugs have less self-control in general and thus are more likely to develop an addiction.
- Psychological: Fentanyl might be prescribed to treat physical pain, but individuals who have undergone serious psychological stress at some point in their lives may turn to it to ease emotional pain as well.
The initial side effects of fentanyl are euphoria, lethargy, drowsiness, and mellowness. Many people crave the euphoria and relaxation that it promotes, but the body quickly builds a tolerance to fentanyl, which means users need to take it in larger doses in order to feel the same desired effects. Tolerance to fentanyl builds up so quickly that a dose that is adequate one week may not be adequate the next.
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If people take fentanyl in increasingly higher doses frequently enough, they will eventually develop a dependence on it, which means they will experience withdrawal symptoms if they stop taking it. According to the US National Library of Medicine, withdrawal symptoms of fentanyl include:
- Loss of appetite
- Muscle pain
- Joint pain
- Rapid heart rate
Dependence is different from addiction because it is a physiological state, not a compulsive behavioral syndrome; however, dependence often leads to addiction. Addiction is characterized by compulsive drug-seeking behaviors regardless of the negative consequences that might result.
The DEA reports that illicit use of fentanyl first appeared in the 1970s and began in the medical community. Today, more than 12 analogues of fentanyl have been identified in US drug trafficking, and there has been an increase in recent years of fentanyl abuse. Some recent examples from the DEA of this surge are four fatal overdoses within a two-month period in New Hampshire; 80 fentanyl-related deaths in the first six months of 2014 in New Jersey; and 200 fentanyl-related deaths in Pennsylvania in a 15-month period.
- Signs of Fentanyl Addiction
- A friend or loved one may be abusing fentanyl if they exhibit a combination of these signs or symptoms:
- Muscle stiffness and difficulty walking
- Labored breathing
- Slurred speech
- Nausea and vomiting
- Weight loss
- Itching and scratching
If it turns out a loved one is addicted to fentanyl, it is important to seek help as soon as possible. According to the American Society of Addiction Medicine, 1.9 million people had a substance abuse disorder that involved prescription pain relievers in 2014. Fentanyl addiction can feel scary, but it is entirely treatable. The sooner someone checks into treatment for addiction, the better, because individuals run the risk of overdosing on fentanyl whenever they use.
- Long-term Effects of Fentanyl Abuse
- In addition to the potential of overdosing, there are other risks of abusing fentanyl, especially for individuals who do so for an extended period of time. For example, continued use of fentanyl can result in liver and kidney damage. As the body filters fentanyl out of its system, the liver and kidneys deteriorate over time, and liver or kidney failure can eventually occur.
Abusing fentanyl can also worsen current health conditions. Because fentanyl depresses respiration, doctors do not prescribe it to people with significant respiratory problems. People who suffer from asthma or chronic pulmonary disease can experience permanent respiratory system damage if they abuse fentanyl.
Abusing fentanyl can also affect an individual’s relationships with others. People who are suffering from an addiction to fentanyl may neglect their spouse or children. They might even commit physical or emotional abuse, and it’s not uncommon for them to pawn off valuables or family heirlooms to pay for their next hit.
Treating Fentanyl Addiction
There are a variety of ways to treat fentanyl addiction, but not every treatment option works for every person. Luckily, many people find success with a combination of treatments. One particularly effective option is residential treatment. Clients enter residential treatment once they have undergone medical detox. In this program, they remain at the facility and are monitored 24/7 while staff ensures that they remain safe, sober, and actively engaged in the program. While in residential treatment, clients will attend individual and group therapy sessions in order to work through their addiction and gain the tools they need to combat cravings in the future.
During residential treatment, clients will also be able to get treatment for any co-occurring disorders that they are battling alongside their addiction.
Some common co-occurring disorders that addiction treatment can manage are bipolar disorder, anxiety, depression, and post-traumatic stress disorder.
In a partial hospitalization program, clients receive structured care at least five days a week for no less than six hours per day. PHPs give clients the freedom to carry on with their everyday lives while attending treatment, and they can be effective for clients who have family and career obligations that cannot be put aside. Like residential treatment, individuals attend various kinds of therapy in a PHP, but they also have greater access to outside support groups and meetings.
The treatment program with the most flexible schedule is intensive outpatient treatment. In IOP, clients attend treatment for three days a week for a minimum of three hours per day. In this program, clients focus on reintegrating back into society and developing a solid aftercare plan that will help them maintain a life of sobriety.
- Regardless of the program or combination of programs that clients enroll in, treatment always starts with undergoing medical detox for an opiate addiction. Medical detox is the highest level of care when it comes to treating a fentanyl addiction because it consists of close medical monitoring as the individual goes through withdrawal. During medical detox, healthcare staff can make clients more comfortable and prevent life-threatening complications from occurring. When people try to quit fentanyl at home, they do not have access to certain medications that can make it easier and might turn instead to using fentanyl again, which is a dangerous cycle.Undergoing treatment for a fentanyl addiction may not be easy, but recovery is entirely possible, and with the right approach, it’s manageable. At the end of the day, addiction is a disease, and individuals suffering from it can benefit from the support and encouragement of their family and friends as well as professional treatment.