What is Fentanyl?

What is Fentanyl?

Fentanyl is a potent synthetic opioid used to treat people with severe pain. It is also used after major surgeries for the treatment of the associated pain and for those who experience chronic pain with tolerance to other opioids. Prescription fentanyl is known by names such as Actiq®, Duragesic®, and Sublimaze®. This Schedule II prescription drug is similar to morphine but 50 to 100 times more powerful, rendering it highly addictive and dangerous when misused. When used under medical supervision for medical purposes, fentanyl can be useful for pain management, however, this is not the case with illicit fentanyl.

Illicit fentanyl is made in underground, mostly foreign labs. Street names for fentanyl are Apace, China Town, China Girl, Dance Fever, China White, Goodfellas, Great Bear, He-Man, Poison and Tango and Cash. This dangerous and highly addictive drug is smuggled into the United States through Mexico and distributed on the illegal drug market. Fentanyl is added to various types of other drugs in order to increase potency and addictive properties. Today, fentanyl has been found in various drugs including heroin, cocaine, methamphetamines, MDMA, and even marijuana.

The low cost of fentanyl and its addictive properties are two reasons why it is being mixed with other drugs. The low cost and availability of fentanyl contribute to this deadly and growing problem. This dangerous practice has led to a jump in overdose deaths from illicit drugs. Many unsuspecting users of drugs like cocaine and marijuana are even more susceptible as they most likely have never used any type of opioid, therefore the levels of fentanyl for them can be immediately lethal.

Fentanyl Statistics

According to the Drug Enforcement Agency (DEA), drug dealers typically sell fentanyl by kilogram. One kilogram of fentanyl has the ability to kill 500,000 people. In addition, the National Institute on Drug Abuse (NIDA) reports that in 2017, 59% of opioid-related overdose deaths involved fentanyl as compared to 14.3% in 2010. There’s no question—fentanyl and the practice of mixing it with other drugs is killing thousands of people. Awareness of this is needed in order to save lives.

Side Effects of Fentanyl

Illicit fentanyl is rarely taken by itself but is taken mixed with other drugs as mentioned. Depending on what drug it is mixed into the side effects can vary. For example, the effects of fentanyl mixed with cocaine will be some mix of effects between both drugs. It’s also important to note that side effects are also dependent on factors unique to the individual such as weight and health if they have used opioids before, what other drugs they are taking, and how potent the fentanyl is.

Short-term side effects can include:

• Feelings of euphoria
• Pain relief
• Drowsiness and sleepiness
• Nausea and vomiting
• Constipation or diarrhea
• Weakness or fatigue
• Confusion
• Slurred speech
• Problems with balance
• Slowed pulse or blood pressure
• Respiratory depression
• Unconsciousness

Long-term side effects can include:

• Respiratory issues
• Ongoing constipation
• Menstrual cycle issues
• Mood swings
• Reduced sex drive

If the person using fentanyl is using it with another drug and injecting it, there is an increased risk for developing HIV/AIDS as well as hepatitis B and C.

Signs and Symptoms of Fentanyl

When a person stops taking prescription fentanyl or another drug laced with illicit fentanyl, withdrawal symptoms can occur within just a few hours. Many of these symptoms can be extremely uncomfortable and challenging to navigate without medical supervision.

Withdrawal symptoms usually last about a week or so with days one through three being the most difficult.

Physical Withdrawal Symptoms

• Muscle aches and pains
• Bone aches and pains
• Diarrhea
• Vomiting
• Cold flashes and chills
• Involuntary and uncontrollable leg movements
• Cravings
• Insomnia
• Loss of appetite
• Fatigue and weakness
• Increased blood pressure
• Increased heart rate

Behavioral Withdrawal Symptoms

• Mood swings
• Irritability
• Restlessness
• Depression
• Anxiety

Many of these symptoms can be so uncomfortable that the person trying to stop taking fentanyl will relapse. This is one reason why seeking treatment for a fentanyl addition at an addiction treatment center is highly recommended for anyone who is trying to stop taking fentanyl. There are medications that can help to ease some of these difficult withdrawal symptoms.

Treatment for Fentanyl Addiction

There are some medications and devices that have been approved by the Food and Drug Administration (FDA) that can help to ease the symptoms of fentanyl withdrawal, especially during the acute phase. Two of these are: Lofexidine, a non-opioid treatment for opioid (including fentanyl) withdrawal and an NSS-2 Bridge device, which is a small electrical nerve stimulator. The NSS-2 is placed behind the ear and eases symptoms for up to five days.

In addition, there are medications used to reduce cravings and symptoms of withdrawal such as buprenorphine and methadone. Naltrexone is used to block the effects of fentanyl and other opioids if taken.

Behavioral therapies are an essential part of treatment for an addiction to opioids such as fentanyl. These therapies help individuals to change their thinking and behaviors related to drug and drug use as well as develop healthy coping skills and habits.

Cognitive-behavioral therapy (CBT) has been found to be successful in the treatment of fentanyl addiction. Contingency management or motivational approaches are also useful. With these, the individual is rewarded for not using the drug and for negative drug tests.

Another helpful behavioral therapy for fentanyl addiction is motivational interviewing. During this type of therapy, the counselor helps the individual to uncover their mixed feelings about stopping taking fentanyl and changing their lifestyle.