Guide to Fentanyl

Fentanyl is the driving force behind the third wave of the opioid epidemic.

In the late 1990s, the aggressive and misleading marketing of opioids by big pharmaceutical companies led to this highly addictive medication being prescribed widely for the treatment of chronic pain.

The dangers of opioid painkillers are now well-known, but the opioid epidemic has entered a new phase thanks to the deadly drug fentanyl, a synthetic cousin of heroin in much more potent form. According to the DEA, fentanyl is up to 100 times stronger than morphine. 

With just a few grains of this drug enough to produce deadly outcomes, today’s guide to fentanyl will shine a light on how this potent painkiller works, as well as highlight the growing menace of illicitly manufactured fentanyl (IMF) in the United States.

 

What is Fentanyl?

This opioid comes in two main types: 

1. Pharmaceutical fentanyl
2. Illicitly manufactured fentanyl

Pharmaceutical fentanyl is sometimes used to treat severe pain during surgery. The synthetic opioid can also be used to treat pain after an operation or after a serious injury. The opioid is also sometimes prescribed to alleviate the symptoms of chronic pain in those physically tolerant to opioids. 

You can find pharmaceutical opioids in these forms: 

• Fentanyl patch
• Sublingual fentanyl tablet
• Buccal fentanyl tablet
• Oral fentanyl lozenge
• Nasal fentanyl spray
• Fentanyl injectable

The transdermal patch is often sold in the branded form Duragesic. Generic patches are widely available and cost much less than branded fentanyl. 

In most cases, transdermal fentanyl patches are not used in isolation, but rather as one component of combination therapy with other medications.

Whatever the route of administration, this drug binds to your body’s opioid receptors, causing dopamine levels in the central nervous system to spike. 

The effects of this drug manifest rapidly, sedating you and relieving pain within minutes. The effects are fleeting, though, lasting anywhere from 30 to 90 minutes, depending on the dose and other variables. 

Fentanyl is classified as a schedule II prescription narcotic and analgesic. Like all drugs under schedule II of the Controlled Substances Act, it is considered dangerous and with a high potential for abuse, despite some limited medical applications.

 

Is Fentanyl an Opioid?

To recap, fentanyl is a wholly synthetic opioid, many times stronger than morphine and heroin. 

Pharmaceutical fentanyl was developed in patch form for pain management in cancer patients. The powerful opioid properties of this drug mean it is also sometimes diverted for abuse.

 

What Is Fentanyl Used For?

Pharmaceutical fentanyl can be legally prescribed in the following medical settings: 

• Pain management (cancer): This drug can help to effectively manage breakthrough cancer pain experienced by those already taking opioid medications for chronic pain.
• Anesthesia: This drug is frequently prescribed for those undergoing heart surgery and patients with poor overall heart function.
• Pain management (chronic pain): This drug can be used to manage persistent, chronic pain requiring continuous delivery of strong opioids.
• Pain management (other types): Opioid-tolerant patients might benefit from injections.

This opioid is considered safe and effective in the above clinical settings. 

Most of the overdoses and problems associated with abuse involve illicitly manufactured fentanyl. This lethal substance is now being used as a cutting agent for heroin, cocaine, meth, and MDMA, often with deadly consequences for unsuspecting users.

 

Fentanyl Side Effects

This potent opioid can cause a wide range of side effects, from mild to serious. 

Mild Fentanyl Side Effects

• Vomiting
• Nausea
• Constipation
• Loss of appetite
• Increased sweating
• Headache
• Feeling cold
• Dizziness
• Diarrhea
• Red or irritated skin
• Tiredness
• Insomnia

These common and relatively mild side effects should dissipate within a few days. If they persist for weeks or become more severe, consult your physician for guidance.

Serious Fentanyl Side Effects 

The following side effects are more serious:

• Androgen deficiency
• Adrenal insufficiency
• Fast heart rate
• Fast breathing rate
• Serious breathing problems
• Chills
• Backache
• Muscle ache
• Dilated pupils
• Increased blood pressure
• Extremely low blood pressure
• Physical dependence and addiction
• Withdrawal symptoms presenting
• Vomiting
• Stomach cramps

Another common side effect is constipation. This can be mitigated with stool softeners, laxatives, and by making dietary tweaks.

 

Fentanyl Overdose

Where 30mg is a fatal dose of heroin, just 3mg of fentanyl – a few grains – is enough to kill an adult male. 

If not taken correctly and as prescribed, a single dose of this drug can cause a fatal overdose. 

In powdered form, it is challenging to effectively dilute. This can lead to even more potent mixtures, potentially deadly even for those with heightened tolerance for opioids. 

A fentanyl overdose can occur after exposure to the contents of transdermal patches. As such, these patches must be safely secured and then flushed down the toilet to mitigate this. 

The opioid overdose reversal medication Naloxone can treat a fentanyl overdose. Naloxone needs to be administered promptly and sometimes in higher doses due to the strength of this drug.

 

Symptoms

These are the most common signs of a fentanyl overdose:

• Severe sleepiness
• Confusion
• Feeling faint
• Dizziness
• Cold, clammy skin
• Shallow breathing
• Slow heartbeat
• Difficulty talking and walking
• Unresponsiveness

 

Fentanyl Deaths

This 2021 CDC press release showed that over 100,000 people died of drug overdoses in the United States in the year ending April 2021. This represents almost a one-third increase over the previous year. 

The main driver of these deaths is opioids, involved in 70% of all drug overdose fatalities. 

It is primarily fentanyl and other synthetic opioids aside from methadone responsible, with over 72% of all opioid-related overdose deaths due to synthetic opioids like fentanyl. 

The DEA reports that this opioid is present in almost all street drugs, in addition to appearing in a variety of counterfeit prescription medications known as pressed pills.

Fentanyl Rehab at The District Recovery Center

Now for the good news: while this drug is fiercely addictive and potentially deadly, medication-assisted treatment (MAT) means recovering from addiction is possible, even in more severe cases of opioid use disorder. 

Here at The District Recovery Center, we specialize in the outpatient treatment of addiction to opioids without requiring you to pack your bags and head to residential rehab. 

We offer gender-specific programming, enabling you to focus fully on conquering addiction in one of the following programs:

• Outpatient program (OP)
• Intensive outpatient program (IOP)
• Partial hospitalization program (PHP)

Like all opioid addictions, fentanyl addiction responds most favorably to MAT delivered in combination with evidence-based psychotherapies and counseling. 

We’ll help you beat the physical and psychological components of addiction here at The District, helping you to embrace sober living. Kickstart your recovery today by calling 949.570.7600.