Misusing any opioid could put your health and future at risk. But, of all the drugs you could try, fentanyl is one of the most dangerous. Fentanyl is extremely potent - even more so than heroin, and therefore carries a high risk of addiction. It also carries a high risk of overdose. Lastly, it is purchased illicitly which means it can frequently be contaminated with other substances.
If you’re using fentanyl, treatment can help. Your program should involve both counseling and medications to ease your cravings. With a structured treatment, you can discontinue fentanyl use.
What Is Fentanyl?
Fentanyl is a powerful synthetic opioid. It is used in the hospital for acute, severe pain like surgeries. It can also occasionally be prescribed as a patch for patients with severe chronic pain.
However, most of the time now we hear about it because it is synthesized, sold and then used illegally.
Fentanyl is 50 to 100 times more potent than morphine. [1]
Over the last decade, many fentanyl and fentanyl-like compounds have been mass-produced by the black market in numerous forms.
Fentanyl and other similar compounds are often added to heroin, and vice versa, without the buyer's knowledge.[2]
Drug dealers often sell these synthetic analogs as counterfeit prescription opioids. Examples of highly potent synthetic opioids found on the streets include fentanyl and other fentanyl analogs like these:[3]
- Sufentanil
- Alfentanil
- Remifentanil
- Carfentanil
This list also contains novel illicitly manufactured synthetic opioids, such as these:[4]
- Acetyl fentanyl
- Butyryl fentanyl
- Beta-hydroxythiofentanyl
- Furanyl fentanyl
- U-47700
Is Fentanyl Illegal?
There are a few situations in which fentanyl is legal. It can be used in the hospital and given through an IV, or can be prescribed for pain treatment and taken as directed by your doctor.
However, when taken recreationally or purchased without a prescription, it is illegal. There are severe penalties for patients found to be in possession or found to be selling illegal fentanyl.
Common Ways Fentanyl Is Misused
Illicitly manufactured fentanyl is sold in the form of a powder, dropped on blotter paper like small candies, in eye droppers or nasal sprays, or as pills that resemble real prescription opioids.[5]
When misused, fentanyl can be ingested through various mechanisms: [6]
- Swallowed
- absorbed under the tongue
- Injected
- Inhaled/snorted
Signs of Fentanyl Use Disorder
People who misuse fentanyl and other synthetic opioids can develop opioid use disorder (OUD). This means they have lost control of their use, are using the drug recklessly, and have a compulsive need to keep using it despite all the negative consequences on their lives.
People with OUD also experience tolerance that involves taking more of the drug to achieve the same effect. In addition to tolerance, individuals with OUD can experience severe and uncomfortable symptoms during withdrawal, which happens when someone stops using the opioid.
The physical and psychological signs of fentanyl misuse, substance use disorder, and withdrawal are similar to those associated with other opioids and are well described in this article.
Some of the most common effects of fentanyl and other opioids include:[7]
- Euphoria
- Analgesia
- Reduced anxiety
- Drowsiness
- Relaxation
- Reduced respiratory drive
- Constipation
- Confusion
- Urinary retention
- Constricted pupils
- Nausea
- Itching
- Cough suppression
- Low blood pressure
- Fainting
Common symptoms of overdose from fentanyl and other opioids include:[4]
- Stupor
- Cold and clammy skin
- Bluish skin coloration
- Pinpoint pupils
- Coma
- Respiratory failure
- Death
The Dangers of Fentanyl Misuse
As with other opioids, misuse of fentanyl, either pharmaceutical grade or illicitly manufactured, carries numerous risks.
Addiction Risks
All opioids can cause euphoria. If they are taken almost daily or daily, tolerance and withdrawal come about, leading to the development of addiction or OUD.
OUD often brings significant impairment in function, resulting in job loss, loss of friends and family, and financial strain.
Overdose & Death
It is extremely easy to overdose on fentanyl because it is so potent. Overdose death rates from these compounds are now the most common cause of opioid overdoses in the United States.[3] In 2017, nearly 50,000 people died of an opioid overdose, 60% of which were attributable to fentanyl or high-potency synthetic opioids other than methadone.
Drug Contamination
Illicitly manufactured synthetic opioids like fentanyl are often laced with stimulants (such as methamphetamine, cocaine, or MDMA) and other toxic chemicals. Therefore, additional adverse but unforeseen consequences can often ensue if someone ingests them.
Getting Treatment for Fentanyl Dependence
There are solutions if you or your loved one needs help with fentanyl use.
For OUD, counseling and support groups greatly help, but the cornerstone of treatment involves using medications that reduce cravings and prevent relapse. This evidence-based approach is often referred to as Medication for Addiction Treatment (MAT).
MAT involves using one of three classes of medication (namely buprenorphine aka Suboxone, naltrexone, and methadone) that have been established through numerous studies to improve function and reduce overdose risk.
Suboxone is an excellent first-line treatment for people with a fentanyl use disorder. If you are using Fentanyl or other opioids and want help discontinuing use, reach out to your doctor or to us here at Bicycle Health for more information.
Photo: dea.gov
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