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Side Effects Of Fentanyl Abuse And Addiction

John Schaffer, LPCC

Medically reviewed by

John Schaffer, LPCC

April 12, 2019

Fentanyl is an extremely potent, synthetic opioid. A drug as strong as fentanyl has an increased potential to become a substance of abuse or lead to addiction and can have many adverse side effects.

Fentanyl is an opioid originally intended to treat breakthrough pain in cancer patients, and now includes pain management for opioid-tolerant individuals. Per the prescribing information for fentanyl, it should only be given to patients who are already taking other opioids. This means that if a person’s body is not used to taking opioids, introducing fentanyl to the system could be fatal, even with the first use.

Fentanyl is about 30 to 50 times stronger than heroin, and up to 100 times more potent than morphine. When fentanyl is obtained illegally or on the streets, it has the potential to be mixed with other substances that may make it stronger and even more deadly, such as heroin. Fentanyl was involved in over 1,000 deaths in a span of less than two years.

Signs Of Fentanyl Abuse And Addiction

As with any substance abuse or addiction situation, some people may attempt to keep their substance misuse a secret. While it may not be extremely noticeable at first, there are warning signs and symptoms associated with fentanyl abuse and addiction, most of which occur due to the side effects of the drug.

Some behaviors that indicate fentanyl misuse, abuse, or addiction could be:

  • taking higher doses or more often than prescribed
  • manipulating release mechanisms (adding heat to fentanyl patch)
  • snorting, injecting, or smoking fentanyl
  • combining fentanyl with other drugs (alcohol, benzodiazepines, or stimulants)

In addition to behaviors that could indicate abuse or addiction, there are other side effects (signs and symptoms) that often occur when a person is misusing fentanyl. These include:

  • developing a tolerance (need to take more fentanyl to get the same effects)
  • constipation
  • itchy skin
  • sweating
  • weakness
  • shallow breathing
  • changes in heart rate
  • confusion
  • constricted pupils

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How Is Fentanyl Prescribed?

Fentanyl is commonly known to be available as a transdermal patch (Duragesic). In patch form, the medication is absorbed through the skin, but it is also available as a spray (Lazanda, Subsys), tablet (Fentora, Abstral), film (Onsolis), lozenge or lollipop (Actiq), or as a supplemental powder form. Fentanyl is not recommended being taken in any way other than prescribed.

If a person has fentanyl in any other form, it may contain additional substances other than fentanyl, and may result in respiratory failure, overdose, and possibly death.

Risks Of Abusing Fentanyl

Some people become dependent on fentanyl after being prescribed the medication for a short period of time, and there is higher risk for abuse in these individuals. People who work in the healthcare industry and hospital environments are also at increased risk for developing an addiction to fentanyl simply due to increased availability of the drug in these settings.

Clandestine laboratories (makeshift labs) are making illicit fentanyl in places like basements and motel rooms, along with other synthetic drugs. Obtaining fentanyl in an illegal or non-medical setting or without a prescription is considered abuse of the drug. Sometimes these labs add other drugs, including cocaine and heroin, that make fentanyl even more dangerous than it is on its own.

Additionally, in these “labs”, other potent opioids are being synthesized, like carfentanil (an elephant tranquilizer), and acetyl-fentanyl, and furanylfentanyl. The lack of protocol could lead to an accidental mix up and prove to be fatal for someone who uses fentanyl created in these settings.

Abusing fentanyl in any form is ill-advised. Fentanyl can be fatal at a two milligram dose. This is about equal to a few grains of sand. This potent of an opioid can lead to an accidental overdose if misused in any way. Ingesting any amount of a drug this strong from an unregulated laboratory could result in devastating consequences, including permanent brain damage and death.

Withdrawal From Fentanyl

Symptoms of withdrawal from fentanyl are similar to opioid withdrawal, and due to the potency of fentanyl, some people may experience similar symptoms after the initial high of using fentanyl recreationally.

Fentanyl withdrawal symptoms include:

  • mood swings
  • loss of appetite
  • drowsiness
  • headaches
  • nausea
  • a runny nose
  • problems thinking or concentrating
  • tremors or shaking
  • fever
  • diarrhea
  • cramping
  • chills
  • depression
  • anxiety
  • trouble urinating
  • seizures
  • craving more fentanyl

An addiction treatment facility can help ease the discomfort of withdrawal. Some of the more intense withdrawal symptoms can be reduced significantly in a detoxification program and some can be avoided entirely.

Like other opioids, it is not advised that anyone attempt to withdraw from fentanyl by stopping use of it completely. Attending a detox program can safely guide someone through withdrawal and into a treatment program.

Signs And Symptoms Of A Fentanyl Overdose

Taking fentanyl in ways other than prescribed or recreationally significantly increases the potential for an overdose. At the first sign of a fentanyl overdose, it is important to call 9-1-1.

Fentanyl overdoses are extremely dangerous and can be fatal. Some signs of overdose include:

  • severe confusion
  • difficulty swallowing
  • clammy skin
  • pinpoint pupils
  • excessive sleepiness
  • muscle weakness
  • dizziness
  • weak pulse
  • shallow breathing
  • lips or fingers having a bluish tint
  • loss of consciousness
  • not breathing

During a fentanyl overdose, heart rate and breathing decrease and can lead to a condition referred to as hypoxia. With hypoxia, the tissues in the body do not receive enough oxygen, which can cause damage, like blindness, lung damage, and inflammation in the tissues of the body. When the brain and the heart do not receive enough oxygen for a period of time, it can result in irreversible damage.

Treatment For Fentanyl Dependence, Abuse Or Addiction

Fentanyl is an opioid, and the misuse of an opioid is classified as an opioid use disorder (OUD). Treatment services are available for misuse of any opioid. These services include a detox program with medication when necessary, and an addiction treatment program that is federally regulated to ensure treatment is thorough, inclusive, and multidimensional.

If you are concerned that you or a loved one is struggling with fentanyl abuse or addiction, we can help. Reach out to us today.

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