Understanding Fentanyl Addiction

The United States contains only five percent of the world’s population, but Americans consume 80 percent of all pain pills taken worldwide.¹ Both short-term pain and chronic pain are often managed by prescription opioids, which are derived from the opium poppy plant.

Fentanyl is an opioid narcotic (painkiller) that acts on regions of the brain responsible for pain sensations, mood, and emotional regulation. Like other opioid drugs, fentanyl attaches to opioid receptors throughout the brain and body, blocking feelings of pain. They also lead to a sense of sleepiness, because opioids also act as central nervous system depressants, suppressing respiration, heart rate and blood pressure. Opioids also often produce a euphoric effect that users are keen to experience again. This can quickly lead to addiction. Fentanyl stands out, because it is stronger than most painkillers, and can lead to overdose very quickly.

Substance use occurs anytime a prescription drug is used outside of its prescribed purpose. This includes taking more than the prescribed amount at one time, taking the drug for longer than prescribed, or taking a prescription medication when it is not considered medically necessary.

Approximately 52 million Americans over the age of 12 have abused a prescription medication at least once in their lifetimes.² Right now, more than 3.3 percent of the American population aged 12 and older are currently abusing drugs other than marijuana. Of that 3.3 percent, 1.7 percent misuse pain relievers.³

How Fentanyl is Misused

Fentanyl is a powerful and potent opioid analgesic with a high potential for abuse and dependency. It is often mixed with other drugs, including heroin, and manufactured in home laboratories. It is often abused without medical supervision, which increases the risks for potential side effects, including drug dependence, addiction, and overdose death.

Fentanyl is misused in a variety of ways. Gel from fentanyl patches may be scraped off and ingested or injected. Patches are also sometimes frozen, cut up to be chewed, sucked, or dissolved in drinks. These patches are typically designed to be worn for up to three days, but trace amounts of fentanyl still remain in used patches that are often abused in an attempt to get high. Fentanyl lozenges and tablets are abused as well, through crushing and snorting, smoking, swallowing, or injecting the drugs. Fentanyl lozenges are also made into lollipops and sold for recreational use.

Fentanyl may be obtained from a friend or relative with a legitimate prescription, stolen out of someone’s medicine cabinet, or bought off the street. Medical professionals may be at a high risk to misuse fentanyl, possibly due to their easy access to the drug or potentially because of their exposure to it. Up to 75 percent of physicians that abuse fentanyl are anesthesiologists, who are consistently exposed to fentanyl in the operating room.

Fentanyl is often abused as an alternative to heroin, although it is actually more potent than heroin. Misuse of heroin or fentanyl may lead to life-threatening complications or an overdose. Further, fentanyl that is found on the street may be manufactured in illegal laboratories, and you may never be entirely sure what drugs were used to cut it, therefore increasing the potential for unintended drug reactions or death.

Side Effects of Fentanyl Abuse

Over time, even legitimate users of opioid analgesics can become tolerant to their effects, meaning that the brain and body become used to the drug, and the individual will have to take more in order to effectively block pain and obtain the same results as before. Fentanyl is often prescribed to patients with severe illness (like cancer) who have become tolerant to other opioids and require medication to manage persistent or chronic pain. The DEA states that fentanyl is 100 times more potent than morphine, as published, and using it in any way other than intended can have severe consequences.⁴

Fentanyl can cause drowsiness, nausea, constipation, mental confusion, respiratory depression, headache, loss of appetite, hallucinations, irregular heart rate, dizziness, and impaired motor functions. Fentanyl abuse or misuse led to 20,034 emergency department (ED) visits in 2011 alone.⁶

Mixing fentanyl with other drugs or alcohol increases all of the potential risk factors. About one in five hospital emergency department visits for the nonmedical, or recreational, use of pharmaceuticals also involved alcohol.⁶

The Centers for Disease Control and Prevention, or CDC, and DEA surveillance system implicated fentanyl abuse in 1,013 deaths between 2005 and 2007.⁴ Fentanyl overdose fatalities happen when breathing slows and lessens to dangerously low levels. An overdose is a medical emergency, and if you recognize any of the following symptoms, seek immediate medical attention:

An overdose occurs when levels of fentanyl reach toxic amounts that the body can no longer break down safely. Accidental overdoses may occur just by coming into contact with the fentanyl patch, and the U.S. Food and Drug Administration, FDA, has released several warnings about the potential dangers of fentanyl exposure. Snorting, smoking, or injecting fentanyl can increase the risks for an overdose, and the potency of the drug may increase the potential for hazardous consequences as well.⁷

Ongoing use of fentanyl increases one’s physical tolerance to the opioid, which in turn can interfere with the brain’s natural reward system, creating an emotional and physical dependence to the drug. The more and longer a person abuses fentanyl, the more he or she begins to rely on and crave the drug and its effects.

Fentanyl and other opioids stimulate the production of dopamine in the brain, which is responsible for pleasure and over time, the brain may expect the artificial stimulation provided by fentanyl, therefore producing fewer “happy” neurotransmitters naturally. The individual will then crave the euphoria produced by fentanyl abuse and suffer from withdrawal symptoms when it is removed. Addiction begins shortly after.

“While I was in the hospital, my roommate asked me how a person could get hooked on painkillers. I remember telling her that the pain of living with no heart and a broken spirit had gotten so unbearable that morphine and fentanyl were the only things that could take the edge off. …I don’t live with that pain anymore. I wake up in the morning grateful. I cry, I laugh, I scream, and I get through the ups and downs of living in a world that is not also working a 12-Step program. When things get overwhelming,I return to a meeting. I unload my burdens into the arms of my recovery family and I help carry theirs.” —Emoni J., HeroesInRecovery.com

Seeking Help for Fentanyl Abuse and Addiction

It is not recommended to stop taking or using fentanyl suddenly without medical supervision or direction, due to the uncomfortable withdrawal symptoms that may occur. Fentanyl detox is easier and more successful with the help of a treatment team. Often, fentanyl doses can be tapered off slowly in a controlled and scheduled manner, reducing the dosage over time until you are drug-free.

Medications may be used during detox to manage the flu-like physical symptoms as well as the drug cravings, mood swings, depression, anxiety, agitation, irritability and insomnia that go along with fentanyl withdrawal. Therapy and counseling sessions are also important during recovery as they help you better understand addiction and learn new life skills. You may never be able to completely avoid stress in daily life, but learning how to manage it in a healthy manner can help you avoid a relapse.

Signs of addiction that indicate it is time to seek help for Fentanyl use, include:

• Alteration of fentanyl medications, taking more than the prescribed amount or for longer than needed
• Shopping different doctors to obtain prescriptions
• Using fentanyl when it is not medically necessary
• Repeated failed attempts to quit using substances
• Inordinate amount of time spent figuring out how to obtain the drug
• Withdrawal from social situations and enjoyable activities
• Mood swings and/or shift in personality
• Unhealthy fluctuations in weight
• Inability to fulfill work, school, or family obligations
• Change in sleep and/or eating patterns

The Oaks at La Paloma provides a comprehensive assessment to ensure that each individualized recovery plan offers the best rate of success possible. Our comfortable amenities and engaging activities, as well as highly trained, professional, and compassionate therapists, counselors, and staff at The Oaks at La Paloma ensure that you or your loved one can recover from fentanyl abuse, dependency, or addiction with confidence. Call today to learn more.

¹ Gupta, S., M.D. Unintended consequences: Why painkiller addicts turn to heroin. CNN. 2 Jun 2016. Accessed 10 Aug 2017.

² National Institute on Drug Abuse. Prescription and Over-the-Counter Medications. NIDA. Nov 2015. Accessed 10 Aug 2017.

³ SAMHSA. National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. 2013. Accessed 10 Aug 2017.

⁴ DEA. Fentanyl. Drug Enforcement Administration. Dec 2016. Accessed 10 Aug 2017.

⁵ Gold M., Melker R., Dennis D., Morey T., Bajpai L., Pomm R., Frost-Pineda, K.Fentanyl abuse and dependence: further evidence for second hand exposure hypothesis.Journal Addiction Disease. 2006;25(1):15-21. Accessed 10 Aug 2017.

⁶ SAMHSA. Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. Accessed 10 Aug 2017.

⁷ FDA. FDA Drug Safety Communication: FDA requiring color changes to Duragesic (fentanyl) pain patches to aid safety―emphasizing that accidental exposure to used patches can cause death. U.S. Food and Drug Administration. Sept 2013. Accessed 10 Aug 2017.