Fentanyl Addiction

Fentanyl is a synthetic compound belonging to the opioid family. It’s related to medications like oxycodone and morphine, and functions the same way in the brain and body. However, depending on its formulation, fentanyl is 50 to 100 times more potent than morphine. This fact alone is usually enough to keep people from wanting to use fentanyl recreationally, but if someone is already addicted to opioids, the high potency may appear favorable.

Similarly to morphine, fentanyl is available as an approved medication for treatment of severe pain. Fentanyl is most commonly used to control pain during and following surgery, as well as in severely injured patients. It also has uses in cases of acute, chronic pain often associated with cancer or other end-of-life care. Prescription forms of fentanyl include:

• Duragesic®:A transdermal patch
• Fentora®:A tablet placed between the gum and the cheek
• Abstral®:A sublingual tablet
• Onsolis®:A soluble film that dissolves on the inside of the cheek
• Actique®:A lozenge placed between the cheek and the gum
• Sublimaze®:An injection given by a physician usually administered by a medication pump during surgery or in ventilator-maintained patients in the ICU

The majority of prescribed fentanyl forms are patches or lozenges, meant to release appropriate amounts of the drug over time.

Fentanyl Addiction Statistics

2018 data shows that every day, 128 people in the United States die after overdosing on opioids.1 The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare.

The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

• Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
• Between 8 and 12 percent develop an opioid use disorder.
• An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
• About 80 percent of people who use heroin first misused prescription opioids.
• Update: Among 38 states with prescription opioid overdose death data, 17 states saw a decline between 2017-2018; none experienced a significant increase.

Causes of Fentanyl Addiction

Fentanyl is much more potent than heroin, and only a tiny quantity is necessary to produce the same effect. Illegal drug producers and distributors save money on transport due to the reduced weight and volume, and the savings is passed on to buyers — the higher concentration makes fentanyl more affordable. The potentially deadly trade-off is that working with very small quantities magnifies the tiniest errors in measurement and leads to wildly unpredictable effects. Typically it’s the most severely dependent who are willing to accept this trade-off or inexperienced users who do not understand the risk.

Drug dealers also use fentanyl to cut heroin, thereby saving them money. This practice leads to people unknowingly purchasing a much more potent product than they realize, often leading to overdose.

Due to these deceptive practices on the part of distributors, fentanyl is the drug most frequently involved in overdose deaths. The number of overdoses involving fentanyl jumped by 113% per year from 2013 through 2016, and fentanyl was involved in almost 29% of all overdose deaths in 2016.

Drug dealers make illegal fentanyl in illicit labs that can reach commercial scale, and the drug usually comes in powdered form. That powdered form is then cut with other substances, and inhaled nasally or dissolved for injection use. Users can also drop it on blotter paper, incorporate it into nasal sprays, put it in eye droppers or swallow it in pill form. Street names for fentanyl include:

• Apache
• China Girl
• China White
• Dance Fever
• Friend
• Goodfellas
• Jackpot
• Murder 8
• Tango and Cash

When short-term fentanyl use starts turning to long-term abuse, the first thing to look out for is physiological dependence. Drug tolerance develops as someone receives diminishing effects from the same dosage of a drug over time. Some examples are benign, such as needing two cups of coffee in the morning instead of one after several years of enjoying the drink. Tolerance does not always lead to addiction, but is one component of it.

The brain is continually trying to preserve an equilibrium of its many compounds and components. When fentanyl use triggers massive surges of dopamine over and over, the brain compensates by reducing dopamine receptors and clearing the drug from its synapses more quickly. Every time someone uses fentanyl, the brain responds to it a little less.

As fentanyl becomes a more constant presence, the brain responds less and less to natural rewards, while becoming hard-wired to operate with the drug. These brain changes drive the drug-seeking behaviors and habits that characterize addiction.

Signs and Symptoms of Fentanyl Addiction

The emergence of fentanyl as a street drug is in response to the opioid crisis. About 21 to 29% of patients who receive an opioid medication for chronic pain misuse them, and those who end up addicted may turn to street drugs such as heroin. Long-term opioid use also has a wide-ranging pool of potential effects on other parts of the body. Studies have shown these systems can suffer damage from opioids:

• Gastrointestinal
• Musculoskeletal
• Cardiovascular
• Immune
• Endocrine
• Fentanyl can interfere with every system in the body. The most insidious long-term effects are often chronic depression, pain and “anhedonia” ⁠— the inability to experience pleasure from things that would normally cause happiness. Long-term users may feel under the weather for months or years during their fentanyl abuse, not knowing the drug is what’s damaging their body. Luckily, proper treatment and sustained sobriety can at least partially reverse many of the issues associated with fentanyl abuse.

Effects of Fentanyl Addiction

Fentanyl binds to opioid receptors in the brain and throughout the body. These receptors are in areas that influence both the perception of pain centers for breathing and alertness and the way someone experiences emotions. The biological effect of this binding is a significant reduction in the body’s ability to feel pain. However, upon binding to these receptors, opioids like fentanyl also cause the brain to release a compound called dopamine. Dopamine plays a critical role in the brain’s reward pathway by triggering feelings of pleasure.

Usually, the brain only releases relatively small amounts of dopamine at a time. When you enjoy a cool glass of water or bask in the feeling of a job well done, your brain releases just a little bit of dopamine as a means of reinforcing the rewarding behaviors.

When fentanyl enters the brain and binds to opioid receptors, it triggers a massive rush of dopamine much more extensive than any ordinary activity can produce. The “high” includes feelings of extreme happiness and euphoria. Users of illicit fentanyl report it feels significantly stronger and better than heroin, but that the adverse effects come on more quickly and more intensely. Some of the unpleasant short-term fentanyl side effects include:

• Sleepiness
• Confusion and disorientation
• Constipation
• Nausea
• Intense flushing or hot flashes
• Breathing problems

Fentanyl’s short-term effects are similar to those of other opioids, but because fentanyl is so fast-acting, people who use it must inject, smoke or snort it more often than with heroin or other drugs. The extreme amount of dopamine release caused by fentanyl and misuse of other opioids also causes the brain to build tolerance, which recalibrates the amount of dopamine and pain stimulation that the body considers the “normal” state. This contributes to the onset of depression, anxiety and pain when the body does not have a constant level of opioids.

One of the medical advantages of fentanyl is that the body rapidly absorbs it, and it starts working within minutes. The system also eliminates it faster than other opioids. The most common way to use fentanyl illicitly is intravenous injection.

Fentanyl is mostly metabolized by the liver and the kidneys then remove its metabolites from urine. Fentanyl in its active form has a half-life of between four and seven hours when injected, meaning that 75% of it is removed within 14 hours. A high-quality urine test for fentanyl could detect the drug for up to nearly a week. Most tests, however, only reveal use that occurred within the last three or four days.

Blood tests can detect fentanyl for up to two days, and hair follicle tests offer the longest window of detection at up to 90 days.

One common question is, what does fentanyl do in the long run? Because opioids influence the activity of the central nervous system, they have severe effects on health over time.

One of the most dangerous long-term symptoms of fentanyl abuse is brain injury due to repeated injuries from depression of the respiratory system. These injuries can cause loss of overall brain mass, similar to what is seen in some elderly patients with dementia from accumulation of damage from many small strokes. When the brain gets starved of oxygen repeatedly, it loses function slowly. When someone stops breathing for a couple of minutes during a non-fatal overdose, the damage can be severe. The term for opioid-related brain damage is anoxic brain injury.

Fentanyl Addiction Treatment

People who are abusing or addicted to fentanyl are at a higher risk of overdose and permanent adverse effects than those who use any other opioid. However, people living with a fentanyl addiction can overcome it with appropriate treatment and the motivation to succeed.

Since the 1970s, the gold standard for opioid addiction treatment has been methadone maintenance. This form of medication-assisted treatment works by keeping the majority of withdrawal symptoms at bay throughout the process of recovery.

Methadone occupies the brain’s opioid receptors, but doesn’t create a high when taken at prescribed dosages. Instead, it engages the receptors enough to keep withdrawal symptoms from setting in. It is an essential step in reducing cravings to a manageable level, and allows individuals to feel relatively normal as they navigate the road to recovery.

Buprenorphine, also known as Suboxone^®, is a new medication introduced in 2002, which works in a manner similar to methadone. It is also branded as Zubsolv^®, and known on the illicit market as “strips” or “subs.” It is well-established to be highly effective at treating opioid use disorder, but has not been tested specifically for fentanyl use disorder. It is theorized to be likely more effective than methadone for fentanyl use disorder, but this is currently unknown.

After you’ve completed a detox program for Fentanyl addiction, you can continue your treatment with a long-term rehab program. Continuing your addiction treatment after detox can help you address the psychological problems related to your addiction and pinpoint the primary causes of your addictive behaviors.

According to the National Institute on Drug Abuse (NIDA), addiction treatment that lasts less than 90 days has limited effectiveness, especially for those who want to sustain long-term sobriety. As a result, if your intention is to get sober and stay that way, you may want to consider enrolling in a 90-day drug rehab program after detox.

If you’ve never been to drug rehab, there are a few things you can expect. During rehab, clients attend educational lectures about the disease of addiction, work the 12 steps (or similar recovery program), learn and implement relapse prevention strategies, attend group and individual counseling, and gain important life skills while adhering to a structured daily schedule.

Overall, drug and alcohol rehab is designed to help individuals get down to the root causes of their addiction and learn how to maintain a lifestyle of sobriety on their own.

There are several different types of rehab programs for Fentanyl addiction and choosing the right type of treatment is essential for lasting recovery. If you are looking for a rehab program, you may want to consider the following factors before choosing a program:

• Your financial ability and the cost of the program
• Your health insurance coverage
• The location of the rehab center
• The type of treatment offered at the rehab center
• The severity of your addiction and your treatment needs

The two main types of drug rehab programs are inpatient rehab programs and outpatient rehab programs. Here’s what you can expect if you are enrolled in one or the other.

As a client at a residential rehab program, you can expect to:

• Temporarily live in group housing at the rehab center while you complete your treatment program
• Maintain a structured daily schedule
• Attend individual and group counseling sessions
• Participate in a variety of different types of behavioral therapies, including family therapy
• Have immediate access to medical and clinical care on-site

As a client at an outpatient rehab program, you can expect to:

• Live at home while completing your rehab treatment
• Attend regular weekly meetings at a clinical location
• Complete program work and homework assignments on your own at home
• Continue tending to your daily responsibilities at work, school, or home while also completing treatment
• Attend individual counseling
• Have limited access to clinical and medical care while enrolled in treatment

Although inpatient and outpatient rehab programs are different, neither one is necessarily better or more effective than the other. The right program for you is the one that best meets your treatment needs.

The cost of a rehab program will also vary depending on the type of program, its location, amenities, treatment services, and its contracts with insurance companies. You may also have access to several different payment options, such as:

• Health insurance benefits
• HSA funds
• Employee Assistance Program (EAP) benefits
• Privately financed healthcare loans
• Personal loans from family members
• Treatment scholarships
• Out-of-pocket payments

After you complete drug rehab, you may also choose to continue your addiction treatment with a sober living program or aftercare program. Other forms of aftercare may include:

• Peer recovery support programs
• Personal monitoring programs

Aftercare programs are specifically designed to support alumni of detox and rehab programs. Many people use aftercare as a way to check-in with their sober peers on a regular basis. Otherwise, weekly aftercare meetings offer a safe, supportive, and judgment-free zone where people in recovery can share successes and struggles pertaining to life in recovery. Aftercare programs can be extremely therapeutic and supportive for people in any stage of recovery.

An addict cannot get through it alone. Fentanyl addiction treatment should be approached in holistic manner including intensive therapy, behavioral therapies and support that leading rehab centers provide. If you are fighting urges to use, even if you believe the problem is under control, call us right now at 855-706-9275. Our helpline representatives can answer your questions and provide you with tips for immediate treatment options at the appropriate recovery center in your area.