Fentanyl is a highly potent narcotic medication that belongs to the opioid class of drugs. It is prescribed for the treatment of severe pain following surgery, a major injury, nerve damage, or pain associated with cancer treatment.
The drug works by interfering with opioid receptors that are responsible for sending pain messages throughout the brain and body. By inhibiting these messages from being sent, opioids reduce the amount of pain people experience.
Fentanyl comes in many different forms, including as a transdermal patch, tablet, spray, lozenge, and intravenous injection. The intravenous injection will produce the most immediate pain-relieving effects. Tablets and lozenges, also sometimes given as lollipops, will take slightly longer to take effect. The transdermal patches are designed for extended-release of fentanyl only, which means low doses of fentanyl are released over time to provide a constant level of pain relief.
How Does Fentanyl Compare to Other Opioids?
Fentanyl is one of the strongest opioids available on the market today. As it is 80 to 100 times stronger than morphine, fentanyl must be used with extreme caution and only in very specific conditions. Its use is reserved for the treatment of severe pain that has not responded well to other pain medications.
All opioids are addictive, but due to the potency of fentanyl, the risk of misuse and overdose is higher. Like all opioids, tolerance to fentanyl can develop quickly, within just a few days. Dependence is likely to develop with extended use of fentanyl, which can happen within just a few weeks for some people. Fatal overdose, however, can happen with just one unintentionally high dose of fentanyl.
How Is It Abused?
Fentanyl is abused by people who wish to use it for recreational purposes as well as for medical reasons. Even when used through a doctor’s prescription, people can develop substance use disorders. If you take your fentanyl medication other than how your doctor prescribed it, such as taking it in greater doses or using it more frequently than you were told, you are misusing the prescription.
Fentanyl is also frequently abused recreationally. Some people extract fentanyl from the transdermal patch and then inject it intravenously. This is a particularly risky way to use fentanyl, as exact doses are very hard to determine, and your risk of overdose is high.
People who use fentanyl to get high are also more likely to be using multiple substances at once. They sometimes mix fentanyl with other drugs to increase the potency and experience of euphoric effects. Mixing fentanyl with other drugs is very dangerous, however, as it can cause very adverse side effects, including life-threatening ones.
Mixing fentanyl with alcohol, for example, greatly increases your risk of respiratory depression. Mixing fentanyl with benzodiazepines can increase the sedative effects of benzodiazepines and cause dangerously suppressed breathing. Additionally, mixing fentanyl with MAOI antidepressants causes severe and unpredictable side effects in many people.
Why Is It Dangerous?
Fentanyl is so dangerous because it can lead to addiction in a short time. Just one use of fentanyl puts people at risk of overdose, which is often fatal.
Fentanyl, like all opioids, is habit-forming. Fentanyl may be even more addictive than other forms of opioids because of its high potency.
Fentanyl that is used for recreational reasons is particularly dangerous. The potency and quality of drugs being bought on the street cannot be guaranteed. The National Institute on Drug Abuses (NIDA) warns that fentanyl sold on the street is often laced with other substances, such as heroin or cocaine.
This combination increases the potency as well as the risks associated with fentanyl use significantly. Likewise, many people who buy other drugs experience adverse side effects because the products they purchase are laced with fentanyl, unbeknownst to them.
When fentanyl is combined with other drugs like heroin, the chances of overdose increase. It’s difficult to dose these combinations, and people often take doses that their bodies simply can’t handle. This can quickly lead to significantly suppressed life functions and even death. Medical treatment is needed immediately for the best chances of survival.
How Widespread is Fentanyl Abuse?
While exact numbers on fentanyl use can be difficult to find, fentanyl was involved in 46 percent of opioid deaths in 2016. This claim comes from a 2018 study of that time period. The study found there were 42,249 opioid-related deaths that year, 19,413 of which were from synthetic opioids.
In 2010, only 14.3 percent of opioid overdose deaths were related to fentanyl. This means there has been a massive leap in the popularity of fentanyl among those who abuse drugs.
As disturbing as this trend may be, it makes sense. Fentanyl is a hyper-potent opioid. Many people who abuse drugs may see it as the “ultimate” high. As awareness of fentanyl grew, so did interest in abusing it.
Meanwhile, its effect is intense. It is likely many who choose to abuse the drug underestimate it. The incredibly potent high quickly pulls them into addiction. It is this intensity that also makes it so dangerous. When mixed with other drugs, it is easily underestimated, and overdose can rapidly occur.
Fentanyl is often laced into other drugs of abuse, often without the user’s knowledge. People may buy a batch of cocaine or heroin, not realizing that it has been cut with fentanyl. They take their normal dose and quickly experience an overdose.
Fentanyl is so potent that naloxone, a drug used to reverse opioid overdoses, may need to be administered multiple times to save a person.
If you have given naloxone to a fentanyl user, monitor them until professional emergency help arrives. You may likely have to administer a second dose of naloxone.
What Are Street Names For Fentanyl?
There are many different street names for fentanyl, some of which vary depending on which drugs fentanyl has been mixed with, such as heroin.
According to NIDA, common street names for fentanyl include:
- China Girl
- China White
- Dance Fever
- Murder 8
- Tango and Cash
What Are Its Side Effects?
Because fentanyl is such a potent drug, it is important to be aware of its side effects before you start taking it. Likewise, you should pay attention to how your body responds to fentanyl before performing tasks such as driving or operating heavy machinery.
Specifics can vary from person to person, but common side effects of fentanyl include:
- Nausea and vomiting
- Tiredness or drowsiness
- Trouble sleeping
- Sweating and chills
- Loss of appetite
Less common but more severe side effects can be very dangerous.
- Respiratory depression
- Dangerously low or increased blood pressure
- Restlessness and anxiousness
- Increased breathing and heart rate
- Dilated pupils
Common side effects of fentanyl are usually expected to resolve within a few days. Your doctor may recommend at-home remedies that can alleviate some discomfort the side effects cause.
You should not attempt to manage the more severe side effects, however, by yourself. They indicate the need to seek medical attention right away so that they don’t progress to complicated health problems or an accidental overdose.
What Are The Signs of Addiction?
One of the most serious side effects of taking fentanyl is addiction. Addiction occurs following the extended use of a substance that the brain and body have become dependent on. It is a disease that impacts a person’s brain as well as behavior. People who battle with addiction lose all control over their drug use and can’t stop using, even if they want to.
Drug addiction presents itself differently in every individual, but there are many common signs to look out for.
Symptoms of opioid drug addiction include:
- Reduced sensation of pain
- Drowsiness and sedation
- Agitation and irritability
- Problems with focusing and remembering things
- Constricted pupils
- General lack of awareness to surroundings
- Impaired physical coordination
- Runny nose
In addition to the above symptoms of addiction, people who struggle with a substance use disorder will not seem like themselves. They will be failing to fulfill responsibilities, skipping out on family and social events, be consumed by obtaining the drug, and continue to use it despite suffering adverse consequences.
What Does a Fentanyl Overdose Look Like?
One of the greatest risks of fentanyl misuse is overdose. The high potency of fentanyl means an overdose is a very real risk. When used under a doctor’s supervision and as directed, the risk of overdose is considered to be relatively low. The U.S. Centers for Disease Control and Prevention (CDC) explains, however, that most cases of fentanyl overdose are caused by illegally manufactured and sold fentanyl.
Signs of a fentanyl overdose include:
- Pinpoint pupils
- Extreme drowsiness
- Loss of consciousness
- Extremely slowed heart rate
- Particularly low blood pressure
- Dangerously slow breathing or no breathing at all
- Bluish color to lips and fingernails
Although the rates of prescriptions for fentanyl are decreasing, the number of overdoses related to fentanyl use continues to rise. Synthetic opioid-related deaths increased 264 percent from 2012 to 2014.
People have started to add this drug to other substances to enhance their effects. As illicit drug makers continue to find new ways to incorporate fentanyl into their products, more common drugs of abuse are being tainted. In many cases, the people using the drugs are unaware that they contain fentanyl.
People are combining fentanyl with marijuana, cocaine, amphetamines, and heroin. There are also cases of people manufacturing fake “Oxys” that are fentanyl, but they contain the imprint marking of oxycodone pills.
In some cases, the pills have no oxycodone at all, but only fentanyl at varying doses, according to a report released by the Gulfport Police Department. When people take these pills, they are expecting oxycodone, so they may take too much, which can result in a fentanyl overdose.
Much of the fentanyl being added to illicit drugs is homemade. This is due to it being difficult to obtain legitimate fentanyl on the street.
When people use fentanyl-laced drugs, and they do not know fentanyl is in these drugs, they often take their usual dose, which can equate to too much fentanyl. According to Dr. Jeanmarie Perrone, people come to the hospital and wake up after getting Narcan (naloxone), but they say they had no idea the drug they took had fentanyl in it.
If you are using synthetic opioids for medical or recreational purposes, stay informed about signs of a potential overdose so that you can get help before it is too late.
How Can You Treat A Fentanyl Overdose?
If you recognize the signs of an overdose in yourself or someone around you, call for emergency medical attention right away. An overdose leading to severe respiratory depression can be fatal. Emergency medical responders can administer a dose of naloxone, an antidote approved by the U.S. Food and Drug Administration (FDA), that can reverse the effects of an opioid overdose, such as fentanyl.
“Naloxone works by interfering with the depressive effects of fentanyl. It can be administered by emergency responders, law enforcement personnel, or even friends or family members of the drug user. People who are considered to be at high risk for an overdose due to patterns of fentanyl use are encouraged to have doses of naloxone on hand, should an accidental overdose occur.”
The CDC encourages expanding the use of naloxone to fight the currently high rate of fatal opioid-related overdoses.
Why Are People Lacing Drugs With Fentanyl?
People cut drugs with fentanyl because it makes it easier to smuggle the drugs, and the drugs are cheaper than heroin, according to an NBC News report. There are different fentanyl-like synthetic drugs that people are adding to street drugs, too. These include 3-methylfentanyl, acrylfentanyl, and furanylfentanyl.
“There is also carfentanil, which is even more dangerous than fentanyl. It is 100 times more potent, according to the U.S. Drug Enforcement Administration. The DEA says that carfentanil is being seen more often on the streets. People are disguising it as heroin. It can also be mixed with other drugs like fentanyl.”
– U.S. Drug Enforcement Administration
How Do You Treat Opioid Addiction?
Proper treatment of a fentanyl addiction is likely to include medically assisted detox followed by participation in behavioral therapy. If you enroll in a rounded treatment program, you will benefit from medically assisted detox as well as psychological support to get you through this difficult period.
Medical detox can help to mitigate withdrawal symptoms that are likely to be very unpleasant and prevent many people from getting sober. In the case of a fentanyl addiction, alternative and less addictive opioids, like methadone, may be used as a replacement for fentanyl.
Methadone, for example, produces similar physiological effects on the body as fentanyl does without causing sensations of euphoria and cravings. People are then gradually tapered off methadone as the body adjusts. This gradual taper prevents withdrawal symptoms from being nearly as severe and uncomfortable as those that occur if fentanyl was quit cold turkey.
Detox is only the first stage of addiction treatment, explains NIDA. Detox alone does little to gain an understanding of your patterns of substance abuse and instill lifelong healthy coping skills that will prevent you from returning to drug use once treatment ends. For people who require a longer tapering period, behavioral therapy can begin before all of the methadone is cleared from the system.
What Are Common Fentanyl Withdrawal Symptoms?
If you have decided to quit using fentanyl, but you have already developed a dependence on the drug, you are likely to encounter withdrawal symptoms as it metabolizes out of your system.
Common symptoms of fentanyl withdrawal include:
- Teary eyes
- Runny nose
- Muscle and joint aches and pains
- Enlarged pupils
- General weakness
- Abdominal cramps and pains
- Nausea and vomiting
- Increased heartbeat
- Rapid breathing
The severity of the above withdrawal symptoms will vary greatly depending on many personal factors. The duration and intensity of your fentanyl use as well as general health condition will impact how easily your body adjusts to fentanyl being removed from it. Fortunately, for people who are faced with severe withdrawal symptoms, there are medical interventions to ease the discomfort and get you on the path to recovery.
Can Fentanyl Be Used Safely?
It is possible to use fentanyl safely, and it can play a very important role in the medical world. It provides powerful pain relief to people who can’t get it through other medications. Even when used medically, however, the risk for misuse is high because it is such a potent and addictive substance. To reduce your chances of having a negative experience with fentanyl, use it minimally and with extreme caution.