Fentanyl Addiction: What Side Effects Should You Know About?

Medically Reviewed

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. 

In addition to medical pain relief, fentanyl is also used as a recreational drug, which can lead to consequences like addiction and overdose. What are the fentanyl addiction symptoms, and how can they be treated?

What Is Fentanyl?

Fentanyl is a prescription opioid medication that is a pain reliever. It’s similar to other opioid pain relievers in its effects and how it works in the brain, but it’s also unique as a fully synthetic drug. Fentanyl is one of a few synthetic opioids, which means it’s made in a lab without the use of a naturally occurring opioid like codeine or morphine. Fentanyl is also unique in its potency. It’s one of the strongest opioids that are regularly used for medical purposes. 

Its analogs, which are drugs made from variations on fentanyl, may be even stronger. Fentanyl is about 50 to 100 times more powerful than morphine. It’s effective in the microgram range, and a dose of 2 mg or 3 mg (milligrams) could kill the average person. Its analog carfentanil is estimated to be 100,000 times more powerful than morphine. In the U.S., it is used to sedate large animals, such as elephants and rhinoceroses. 

Fentanyl is used for its ability to facilitate fast-acting pain relief. It may be used in hospital settings to provide quick relief from severe pain associated with injuries and labor. However, over the past few years, fentanyl has been increasingly common in recreational drugs. Fentanyl is often mixed with other opioids like heroin to increase their perceived purity. However, fentanyl is so powerful that it can easily lead to a serious overdose. The increase in fentanyl availability has contributed to record overdose rates in the United States over the past few years. 

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.

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:

  • Apache
  • China Girl
  • China White
  • Dance Fever
  • Friend
  • Goodfella
  • Jackpot
  • Murder 8
  • TNT
  • 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
  • Dizziness
  • Trouble sleeping
  • Constipation
  • Sweating and chills
  • Headache 
  • Diarrhea
  • Loss of appetite 

Less common but more severe side effects can be very dangerous. They include:

  • Respiratory depression
  • Dangerously low or increased blood pressure
  • Lightheadedness 
  • Confusion
  • Fainting 
  • 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 
  • Depression
  • Anxiety
  • Confusion
  • Constipation
  • 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:

  • Dizziness
  • Confusion 
  • 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.

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.

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
  • Restlessness
  • Irritability
  • Insomnia 
  • Enlarged pupils
  • Anxiety
  • General weakness
  • Abdominal cramps and pains
  • Nausea and vomiting
  • Diarrhea 
  • 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.

FAQ About Fentanyl and Fentanyl Addiction

Fentanyl has been the subject of more media attention over the years because of its role in the recent surge in opioid overdose deaths. It’s also mixed into drugs without users knowing. There are many common questions about fentanyl. Here are some answers to a few of them:


What Does Fentanyl Look Like?

Fentanyl is usually distributed as a white powder. But an effective dose is so small that it would be smaller than a snowflake if you held one dose in your hand. Like cocaine and heroin, it may be trafficked into the country in large quantities. In law enforcement seizures, the drug appears as bricks and bags of white powder. It may also appear as small crystals or larger grains than a fine powder. When it’s mixed into other drugs, it may be indistinguishable from the surrounding material. Cocaine, heroin, and other drugs are also sold in white powders. When fentanyl is mixed in, you would not be able to tell until you take the drug. 


What Does Fentanyl Feel Like?

Fentanyl’s effects on the body are similar to heroin and prescription opioids. It can cause sedation, pain relief, a sense of warm comfort, and a general feeling of psychological well-being. Like other opioids, it can cause euphoric relaxation and an intense body high. Because fentanyl is so potent, misuse can cause extreme sedation, loss of consciousness, and difficulty staying awake. Other people may not be able to wake you up, and you may fall into a coma. During an overdose, your breathing and heart rate may slow down. During fatal overdoses, a common cause of death is oxygen deprivation from slowed or stopped breathing. 


Why Do People Lace Drugs with Fentanyl? 

Fentanyl is mixed into other drugs to increase the drug’s potency or create a unique high. Drugs like heroin may be cut with cheap substances to increase profits. Adding fentanyl can make the adulterated heroin feel closer to purity. Fentanyl may also be added to stimulants like cocaine to counteract some of its unpleasant effects. However, mixing opioids and stimulants can mask the intensity of each drug’s effects, leading to an overdose. 


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. 

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