Fentanyl Addiction: Rehabilitation, Signs, Symptoms, and Risks

Fentanyl is a powerful opioid that is 50 to 100 times stronger than morphine. While fentanyl is only indicated to treat severe post-surgical pain, many people self-administer it for its euphoric properties.

The difference between the therapeutic dose and fatal dose is small, and in 2021 over 70,000 people overdosed on the drug. It is often cut into drugs like heroin, which makes it exponentially more dangerous to consume.

Key Points

• Fentanyl is a strong opioid drug that is 50x to 100x more powerful than morphine.
• It’s a Schedule II controlled substance and among the most dangerous drugs.
• Serious short-term side effects include drowsiness, nausea, confusion or hallucinations, constipation, sedation or unconsciousness, problems breathing, visual disturbances, movement with no purpose, and an inability to feel pain.
• Long-term risks of taking fentanyl include respiratory depression, coma, death, brain damage, lack of impulse control, poor decision-making, and an inability to feel pleasure or reward naturally.
• Treatment for fentanyl use includes medical detox, inpatient treatment, and long-term aftercare interventions.

What is Fentanyl?

Fentanyl is a strong opioid drug used to treat severe post-surgical pain in a hospital setting. Its painkiller properties are 50 to 100 times more powerful than morphine.

Fentanyl binds to a whole subclass of opioid receptors in your brain.[1] While it can attach to the delta and kappa receptors, the most important binding happens on the mu-opioid receptors. These receptors are responsible for pleasure and reward.

Because of this, your body quickly builds up a tolerance to fentanyl. Individuals require ever-larger doses to achieve the same euphoric effects. Because fentanyl is so potent, the variance between a casual dose and a fatal dose is minuscule.

The only antidote for fentanyl toxicity is Naloxone, a competitive opioid antagonist that binds to the mu opioid receptors to block the effects of fentanyl.

Fentanyl is so powerful sometimes it takes multiple doses of Naloxone to block its effects.[2]

One of the most dangerous side effects of fentanyl is respiratory depression. This is when your breathing functions slow down, a potentially life-threatening side effect. If a fatal dose of fentanyl is absorbed, your breathing will slow, and oxygenated blood cannot reach your brain. Brain damage occurs in minutes.

After the brain damage occurs, then you will experience cardiac arrest, and your heart will stop beating.

Side Effects of Fentanyl

Fentanyl’s painkiller properties are intended for post-surgical patients experiencing severe pain and should only be administered by trained professionals.

Similar to heroin users, fentanyl users might crave the euphoric effects of the drug but will also inherit serious short-term side effects which can culminate in death[3][4]:

• Drowsiness
• Nausea
• Confusion or hallucinations
• Constipation
• Sedation or unconsciousness
• Problems breathing
• Visual disturbances
• Movement with no purpose
• Inability to feel pain
• Stoppage of the flow of intestinal contents
• Tense muscles
• Addiction
• Low blood pressure
• Coma

How is Fentanyl Taken?

First produced in 1960 and approved for use in the US in 1968, fentanyl has been a critically important pain management drug for over 35 years. It’s estimated that 3500 pounds of fentanyl were used globally in healthcare in 2015.[5]

Unfortunately, it is very easy to manufacture illicitly, and the amount of fentanyl produced in off-grid, clandestine laboratories greatly exceeds the amount produced legally.

It is most often given intravenously (veins), intramuscularly (muscles), or intrathecally (spinal cord) through injection. It can also be given transdermally as a slow-release skin patch or nasally through a nasal spray. The nasal spray is extremely volatile and can be fatal if accidentally used by children or an adult.

Fentanyl Quick Reference

Learn About Specific Opioids

Fentanyl is part of the opioid drug family. Opioids bind to the mu-receptors in your central nervous system, which are responsible for the feeling of pleasure and reward. Normally, your body releases dopamine, which binds to the mu opioid receptors, when it is trying to reward you for specific behaviors (like sex, working out, and eating)

Fentanyl is not like dopamine, even though it binds to the same receptors. It is a synthetic opioid, which means it was manufactured in a lab and is hundreds of times stronger than nature produces naturally in other forms, such as opium. This leads to its incredibly addictive tendencies.

Besides synthetic opioids, there are also semi-synthetic and natural opioids. Semi-synthetic opioids are like oxycodone. “Natural” opioids are not dopamine like the name implies, but rather opioids derived from natural sources like heroin, morphine, and codeine.

See additional resources to learn more about specific opioids:

• Heroin
• Methadone
• Opioid Drug Family
• Suboxone
• Subutex

Statistics on Fentanyl Use, Misuse, and Addiction

From 2014 to 2021, fentanyl went from a relatively obscure and unabused opioid (roughly on par with antidepressants) to the most deadly opioid in the United States.

In 2021, over 106,000 fatal drug overdoses were reported.[6] Of those, over 70,000 involved primarily fentanyl.[7] Prescription opioids like oxycodone accounted for less than ⅓ of that number, and some deaths involved more than one kind of drug.

The rural Northeast region and Appalachia have been hit the hardest by the opioid epidemic. West Virginia, the state with the highest per capita opioid overdose rate, started equipping all emergency first responders with Narcan (the brand name for Naloxone).[8] They even installed free Narcan vending machines.

Effects of Fentanyl Abuse

Can You Overdose on Fentanyl?

Yes–you absolutely can. Fentanyl is an incredibly dangerous drug to self-administer outside of monitored clinical settings. Over 70,000 people overdosed primarily on fentanyl in 2021. You are no exception, and it could happen to you.[9]

Signs and Symptoms of Fentanyl Overdose

There is no single tell-tale sign that is present in all opioid overdoses. But the presence of one or more of these symptoms should be cause for opioid overdose alarm[10]:

• Unconscious, not responsive to stimuli (e.g., touching or slapping)
• Shallow, irregular breathing
• Gray, blue, purple, or pale skin color
• Small, “pinpoint” pupils

What to do if you suspect someone is overdosing on Fentanyl:

In case of a suspected overdose, the first thing you should do is to call 911 immediately. Next, if you have it, administer Narcan (aka naloxone). For an unconscious person, begin CPR (if it is safe to do so) until help arrives. If there is no change, it may be advisable to administer a second dose of Narcan.

If the individual regains consciousness, stay calm and comfort them. There has been a misconception amongst first responders that merely touching Fentanyl would be enough to self-administer a fatal dose. However, nitrile rubber gloves and N95 masks provide sufficient protection from incidental fentanyl exposure.[11]

Dangers of Long-Term Fentanyl Use

After exposure to fentanyl, the body quickly builds up a tolerance to it. You will need an increasingly potent dose to achieve the same euphoria as your initial dose.

Respiratory depression is a common side effect of fentanyl use, which can lead to coma or death. Even if you survive, your brain’s white and gray matter will have deteriorated. Your impulse control and decision-making will suffer.

You won’t be able to feel pleasure as strongly as before. Eating, drinking, and sex will not feel as rewarding as they had previously because your opioid receptors will be less sensitive to your body’s naturally produced dopamine.

Mixing Fentanyl with Other Drugs

Since fentanyl is among the most powerful of opioids and the cheapest to produce, it is rarely cut with more expensive, less powerful mystery agents. Rather, other opioids like heroin are regularly cut with fentanyl to boost profits and potency.

Regardless, mixing fentanyl with other drugs is dangerous because it intensifies the effects of both drugs on your body. Heroin will likely be cut with fentanyl by the time it reaches the drug buyer. No matter the kind, mixing drugs is extremely dangerous. And Fentanyl is incredibly dangerous on its own and even more so with other drugs.

Fentanyl Addiction and Abuse

Abuse and addiction often go hand-in-hand. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), addiction to fentanyl is clinically referred to as an “opioid use disorder”.[12]

You may be diagnosed with an opioid use disorder if you meet at least 2 of the following DSM-5 criteria in a 12-month period[13]:

1. Large amounts of opioid use over a long period of time.
2. Inability to control opioid use.
3. Spending time getting the opioid, using the opioid, or recovering from its effects.
4. Craving
5. Failure to fulfill scholastic or professional expectations
6. Familial problems or interpersonal tension
7. Giving up old hobbies.
8. Using opioids in places in which your physical safety in not guaranteed.
9. Use despite declining physical and mental health.
10. Using more and more opioids to achieve the same effects.
11. Not using opioids is painful, both physically and mentally

A “mild” diagnosis requires 2-3 criteria, a “moderate” diagnosis requires 4-5 criteria, and a “severe” diagnosis requires 6+ criteria.

Is Fentanyl Addictive?

Fentanyl is a Schedule II controlled substance. It has extremely limited medical uses and can only be possessed in clinical settings. It is 50 to 100 times more powerful than morphine, which means it is incredibly addictive.

Signs of Addiction to Fentanyl

There are many different symptoms of fentanyl addiction, and everybody will experience their own unique set of symptoms.

Some signs of addiction to fentanyl could include withdrawal symptoms, strained relationships, increasing isolation, decreased libido, changes in sleep habits, failure to fulfill obligations, cravings, and more.

Fentanyl Addiction and Mental Health

Existing mental health disorders will exacerbate a fentanyl addiction. Anxiety or depression can be a trigger to seek out fentanyl for its euphoric effects. Sometimes, fentanyl rehab wouldn’t be complete without also diagnosing a co-occurring mental disorder. This is called a dual diagnosis.

If you suffer from both substance abuse and mental disorders, then you need unique interventions and treatments for each.

Cutting Agents Used for Fentanyl

Since fentanyl is among the most powerful of opioids and the cheapest to produce, it is rarely cut with more expensive, less powerful mystery agents. Rather, other opioids like heroin are regularly cut with fentanyl to boost profits and potency.

However, there have been increasing reports that some drug users are intentionally cutting fentanyl with xylazine, a non-opioid veterinarian tranquilizer.[14] For Philadelphia in 2015, drug overdoses involving xylazine accounted for 2% of all drug overdoses; in 2020, drug overdoses involving xylazine accounted for 26% of all overdoses.[15]

Fentanyl Addiction Treatment Cost

The cost of fentanyl rehab depends on several factors. The length of stay, the intensity of care, chosen therapies, and whether or not your insurance is accepted can all influence the final cost.

You need a dedicated team of medical professionals working collaboratively with you to ensure the greatest chance of lasting success. And in the end, regaining control of your life is priceless. Rather than regretting wasted time, look forward to the time you have remaining.

Fentanyl Addiction Treatment Levels of Care

There are four primary levels of care in fentanyl rehab. Here at Paramount Wellness, we have many treatment options that will all be customized according to your unique needs, history, and long-term goals.

• Medically Supervised Detox: Safe and supportive environment to eliminate harmful substances.
• Medically-Assisted Treatment: Reduce the discomfort and danger associated with withdrawal.
• Inpatient Treatment: Focused and holistic healing in an idyllic countryside space.
• Aftercare Programs: Long-term support for recovery and sobriety.

Therapies Used in Fentanyl Addiction Treatment

Fentanyl rehab therapy doesn’t have to be cut and dry. There are many evidence-based therapies that can be customized to fit your needs, history, and wellness goals:

• Individual Therapy
• Cognitive Behavioral Therapy (CBT)
• 12-Step Facilitation Therapy
• Dialectical Behavioral Therapy (DBT)
• Group Therapy
• Holistic Treatment Modalities Therapy
• Trauma-Informed Group Therapy
• Acceptance And Commitment Therapy (ACT)
• Family Therapy
• Experiential Therapy
• Anger Management Therapy
• Smoking Cessation Therapy
• Psychoeducation Therapy
• Biofeedback Therapy

Co-Occurring Disorders

Co-occurring disorders are more common than you might think. According to the National Institute on Drug Abuse, over 7.7 million Americans suffer from co-occurring substance abuse and mental disorders.[16] It’s hard to say which disorder came first or if one caused the other, but it’s more important to address them both holistically.

Of these sufferers, over half (52.5%) did not receive any treatment, 34.5% received mental disorder treatment only, and 3.9% received substance abuse treatment only. Only a scant 9.1% of sufferers with co-occurring disorders received BOTH substance abuse and mental disorder treatments.

How to Find Fentanyl Addiction Treatment in Connecticut

It might not look like it on a map, but Connecticut is a big state. There are many fentanyl rehab providers here. Sometimes, finding them can be a bit of a challenge. If you’ve read this far, we know you are up for the challenge.

Cost is always a deterrent for care. Don’t let this stand in the way of taking back control of your life. Try checking with your insurance company first. They might have specific providers they partner with or modalities of treatment they cover.

There is free help through the “Behavioral Health Services Locator” tool offered by SAMHSA.[17] SAMHSA is a government organization that offers many free resources online to people interested in mental health.

Once you search your desired area, check Google for reviews of the local treatment center.

Find Fentanyl Rehab Treatment Near Me

Facilities that specialize in Fentanyl addiction treatment
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Fentanyl Withdrawal Symptoms

Be careful trying to go cold turkey on fentanyl without monitored opioid assistance. There are medicines that help ease the opioid withdrawal process. Without help, in as little as a few hours, you could experience withdrawal symptoms including:[17]

• Muscle and bone pain
• Difficulty getting to sleep or staying asleep
• Nausea
• Diarrhea
• Cold flashes with goosebumps
• Leg movements with no purpose
• Craving