If you are in an immediate emergency, call 911. If you are looking for more information on substance abuse treatment and it is not a medical emergency, call our 24/7 Fentanyl Helpline at 407-680-1226.
Fentanyl is one of the strongest prescription opioids prescribed to humans. The medication was originally created to treat severe pain, especially for people who live with chronic pain and have developed a tolerance to other opioids. Fentanyl is up to 100 times more potent than morphine and 50 times more powerful than heroin, an illicit opioid drug.
Due to the drug’s potency and addictive qualities, physicians restrict fentanyl prescriptions for severe situations, such as terminal cancer patients. Fentanyl is typically prescribed to manage pain after surgery or to treat chronic pain.
When prescribed, fentanyl is administered through an injection, transdermal patch or in lozenge form. However, fentanyl is also sold illegally as a powder. The powder form can be mixed in with heroin or cocaine products sold by drug dealers. This combination can lead to overdose, coma or death, especially when someone is unaware that their drug contains fentanyl.
Fentanyl is used for a variety of severe pain conditions, but it is most commonly used as a painkiller during and after surgery. It can also be used to sedate patients in intensive care. When given as an outpatient prescription, it may be used for chronic and severe pain, such as pain associated with cancer.
Fentanyl is extremely potent and should never be used by people who are “opioid-naive,” meaning they have not used other opioids in the past. Fentanyl is most useful for people who have taken less potent opioids, such as hydrocodone or oxycodone, and now have a tolerance.
Fentanyl comes in a variety of forms and brand names, including:
Fentanyl has a variety of street names, including:
The fentanyl dosage varies widely from person to person based on many different factors. The primary factor that determines the right dose is the person’s tolerance to opioids. If someone has been taking opioids for a long time for the treatment of pain, they will need higher doses. The same concept applies if someone is abusing fentanyl or using it illegally. The more they are taking, the more they will need to get the same effect.
The initial dose of fentanyl is generally based on the fentanyl patches, and the lowest dose is 12 to 25 micrograms per hour over 24 hours. For some people, they will need as high as 200 to 400 micrograms per hour over 24 hours.
Fentanyl is not available in pill form and does not come in a tablet or a capsule. It is only available as a liquid for injection, a patch, a lozenge or a lollipop.
Fentanyl lollipops (Actiq) are used exclusively for patients aged 16 or older who need around-the-clock pain control for cancer pain. It should only be used in people who are opioid-tolerant, meaning they are taking at least 25 micrograms of fentanyl per hour.
The purpose of the lollipop is to make the fentanyl lozenge easier to manage. If the lozenge is swallowed by mistake, it will not be as effective.
Sublingual fentanyl (Abstral) is also only approved for the treatment of around-the-clock cancer pain. It is approved for patients who are 18 years of age and older. When taking this drug, a person should immediately remove it from the blister pack and place it under the tongue. It should not be chewed, sucked or swallowed.
Duragesic, the brand name for fentanyl patches, is one of the more commonly prescribed formulations of fentanyl outside of a hospital. Duragesic is approved for use in both pediatric and adult patients. It is approved for the treatment of chronic cancer pain but is often used for other types of pain as well.
Fentanyl injections (Sublimaze) are used almost exclusively during and after surgery instead of for cancer pain. It is used as an anesthetic for a variety of procedures and should only ever be used in a hospital setting.
Fentanyl is extremely addictive. The clearest way to clarify the addictiveness of fentanyl is to consider the drug’s direct impact on the brain’s reward system.
The main job of a neurotransmitter is to communicate chemical messages in the brain by docking into receptor sites. Fentanyl mimics natural neurotransmitters that relieve pain by interacting with a receptor site in the brain and sending a message to release chemicals that eliminate the awareness of pain. A dose of fentanyl can make a person feel relaxed and euphoric.
Fentanyl can cause the brain to release dopamine in larger amounts than would typically occur without the drug’s presence. The more dopamine that is released, the faster the onset of the addiction. The patient will need to keep taking more fentanyl to block the brain’s effort to correct the excess dopamine production.
Approximately 115 people die from overdosing on opioids every day in the United States, and many of these deaths are due to fentanyl. Because it is much more potent than other prescription opioids, fentanyl is more likely to cause an overdose. While the number of deaths caused by opioid prescriptions alone was down in 2016 compared to 2015, those involving fentanyl in combination with other opioids increased.
From 2014 to 2017, the number of fentanyl-related deaths increased 540%. Most fentanyl overdose deaths occur in the eastern part of the United States. In 2016, 32% of drug-related deaths in Maine involved fentanyl; in Philadelphia the same year, 27% of drug-related deaths included fentanyl. In parts of Florida, fentanyl-related deaths increased over 500% from 2014 to 2017.
Side effects are common with opioids. Fentanyl has a powerful impact on the body, causing side effects that can include:
Fentanyl has a significant addictive potential and a high likelihood of unintentional abuse. Once someone develops a tolerance to fentanyl’s narcotic properties, they will depend on it to feel normal. This leads to requiring more fentanyl, both in greater doses and higher frequency.
When someone needs fentanyl to feel normal, it’s known as dependence. Dependence and addiction are not the same, and someone can be dependent even if they are using fentanyl with a prescription. When someone is dependent on fentanyl, they will experience withdrawal symptoms if they stop taking it. Withdrawal symptoms are one of the primary reasons that people keep using it, even if it’s causing a negative impact on their life.
Withdrawal can begin anywhere between eight to 48 hours after last use, depending on the formulation of fentanyl. Longer-acting formulations will take longer for withdrawal symptoms to emerge.
Common fentanyl withdrawal symptoms include:
Fentanyl stays in the system for varying amounts of time depending on the formulation. In general, it will take five half-lives for a drug to clear the body. Fentanyl patches have a half-life of about 34 hours, so they will stay in the system for approximately seven days.
If the urine is being tested for fentanyl, it is usually detectable for up to three days. Saliva is generally not tested for fentanyl because the test is not reliable. Like other drugs, fentanyl can also be detected in hair for up to 90 days.
Fentanyl is extremely easy to overdose on because of how potent it is. Risk factors for a fentanyl overdose include being opioid-naive, not knowing the amount you are using, mixing with other drugs and intentionally taking high doses.
A fentanyl overdose will look like other opioid overdoses, with symptoms that include:
In the event of an overdose, call 911. Fentanyl overdose is a medical emergency, and there is a high risk of death because a person can stop breathing. If you have naloxone (Narcan), an opioid antagonist, you should use it after calling 911. It will help to reverse the overdose until the ambulance arrives.
The estimated lethal dose of fentanyl is 2 mg (or 2000 micrograms) for most normal-sized adults. However, a smaller person or a child is likely to have a fatal reaction at lower doses.
Detox is a normal process in any drug addiction treatment program. During detox, the drug is leaving the body, and the body is readjusting to functioning without it. Withdrawal symptoms occur during this period, and there is a high risk of relapse.
For short-acting fentanyl, withdrawal symptoms will usually start eight to 24 hours after the last dose and can last for four to 10 days. For longer-acting forms of fentanyl, symptoms can begin within 12 to 48 hours after the last dose and may last as long as 20 days.
Undergoing detox in an addiction treatment facility is effective because there are options for withdrawal support. Different medications can be prescribed to manage withdrawal symptoms, making a person more likely to successfully avoid relapse. Medical detox is also helpful because the support team can address other areas of a person’s life that make fentanyl appealing, such as chronic pain, mood disorders and other life stressors.
There are thousands of treatment centers in the country, but not every rehab option fits each person’s specific needs. If you are looking for help, find a center that offers treatment for fentanyl or opioid addiction and values patient comfort. Finding a center that treats addiction to other drugs as well as co-occurring mental health disorders is also important.
The three main levels of addiction treatment include outpatient, intensive outpatient, and inpatient. Outpatient is the least intensive, and a person can continue to fulfill their obligations while attending treatment sessions and support meetings. Intensive outpatient is a step up from this. The highest level of care is inpatient, also referred to as residential. For people with severe addiction, this is the gold standard of treatment. In inpatient rehab, clients live in the facility throughout detox and treatment, as being in the facility helps to remove relapse triggers.
The Orlando Recovery Center has a wide range of rehabilitation programs and resources available to help treat addiction. Our mental health experts work with clients to reduce or eliminate substance use while addressing co-occurring disorders as well as physical and psychological symptoms. The Orlando Recovery Center’s treatment resources include detoxification, inpatient and outpatient rehabilitation programs, follow-up aftercare and much more.
If you or someone you know is currently using fentanyl and needs help in Orlando, Florida, Orlando Recovery Center can help. Contact us today to speak with a representative and learn more about treatment options that can work well for your needs.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.