Fentanyl Drug Rehabilitation: Treatment and Recovery

What is Fentanyl?

Fentanyl is a synthetic opioid used in medical settings for severe pain that requires strong, carefully monitored medication.[1]

Pharmaceutical fentanyl is made in regulated doses and in a few different forms.

• Transdermal fentanyl patches are worn on the skin and release medication slowly over time, so they are generally used for ongoing severe pain in people who are already opioid-tolerant.
• Lozenges, sublingual tablets, and nasal sprays work more quickly and may be used for sudden episodes of severe pain in patients who are already being treated with opioids.
• Injectable fentanyl is typically used in closely supervised medical settings, such as surgery, anesthesia, or hospital-based pain control.

Illicit fentanyl is not the same as pharmaceutical fentanyl. On the street, fentanyl is commonly known as fetty, fent, fenties, or synthetic heroin, while counterfeit prescription pills containing the drug are often called blues, M30s, or dirty 30s. It is made or sold outside medical supervision, so the dose, strength, and contents are unpredictable. This type of fentanyl is what is driving the current opioid crisis and often contaminates counterfeit pills, powders, or other drugs, sometimes without the person using the substance knowing fentanyl is present. Because fentanyl is 50 to 100 times more powerful than morphine or heroin, illegally produced fentanyl has contributed to a sharp increase in opioid addiction and overdoses.[2]

Understanding Fentanyl Addiction

Fentanyl is one of the most addictive drugs due to its potency.[3] Because of the powerful impact on the brain, dependence develops more quickly than it does with other opiates, leading to withdrawal symptoms if usage is reduced or abruptly discontinued. The result is more severe dependence and withdrawal symptoms than with other opiates like heroin. Help is available.

Addiction is more common with illicit fentanyl, but it can also begin with prescription fentanyl when the medication is misused or taken outside medical guidance. This includes using a higher dose than prescribed, taking medication that belongs to someone else, or changing how fentanyl enters the body. With patches, misuse may involve applying extra patches or trying to make the drug absorb faster, which can increase both addiction risk and overdose risk.

What Does Fentanyl Look Like?

Fentanyl can look different depending on whether it comes from a pharmacy, medical setting, or the illicit drug supply. Prescription fentanyl may be dispensed as a patch worn on the skin, a lozenge, a sublingual tablet, a nasal spray, or an injectable medication. These forms are used in different medical situations depending on the patient’s pain level, opioid tolerance, and treatment needs.

Illegally produced fentanyl is often sold as a white powder, tablet, or liquid.[4] It may also be mixed with cocaine, heroin, MDMA, or other drugs, sometimes without the person using the drug knowing fentanyl is present. Because fentanyl can appear in several forms and may be hidden in other substances, it is not always possible to identify it by sight, smell, or taste.

The Effects of Fentanyl

Like other opioids such as heroin and morphine, fentanyl reaches the brain quickly, binding to the opioid receptors responsible for feelings of pain and pleasure. It also triggers a flood of dopamine, leading to intense feelings of happiness and well-being.[5] A depressant substance, fentanyl relaxes the central nervous system and slows respiration and heart rate. Various factors influence how quickly the body processes and clears fentanyl.

The way fentanyl enters the body also matters. A powder, counterfeit pill, or injected form may take effect differently than a prescribed patch. With transdermal fentanyl, the drug is absorbed through the skin over time. Heat, fever, heating pads, hot baths, or other sources of warmth can increase absorption and make the dose stronger than intended.[6] This is one reason fentanyl patches can become dangerous when they are misused or not carefully monitored.

How Does Fentanyl Affect the Body?

The physical effects of fentanyl include urinary retention, constricted pupils, and relaxation of the muscles. It numbs the body’s ability to feel pain and may also cause dizziness, sweating, drowsiness, difficulty urinating, stomach discomfort, and mood changes. When fentanyl is used as a patch, it may also cause skin irritation where the patch is worn, such as redness, itching, or swelling.

The most serious physical effects of fentanyl include slowing of the heart and respiration, which may result in cardiac arrest or death. This life-threatening slowed breathing is respiratory depression, and the risk becomes greater when fentanyl is combined with alcohol, benzodiazepines, other opioids, or other sedating substances.

How Does Fentanyl Affect the Brain?

Fentanyl affects the brain before the body, one of the reasons this drug is so dangerous. EEG tests by Harvard researchers demonstrate a four-minute delay between fentanyl arriving at the brain and slowing down respiration and heart rate, making overdose even more likely than with other opiates.[7]

By binding to the opiate receptors in the brain, fentanyl causes a release of endorphins that cause this opiate’s signature rush of euphoria. Other mental effects of fentanyl may include:

• Extreme happiness and satisfaction
• Drowsiness
• Relaxation
• Loss of appetite
• Concentration problems
• Confusion

What Are the Long-Term Effects of Fentanyl?

Any use of fentanyl without supervision in a medical environment puts individuals at risk of serious mental and physical problems. Some common long-term and pervasive challenges faced by individuals who use fentanyl include:

• Opioid Use Disorder
• Depression and suicidal thoughts
• Difficulty in controlling impulsive behavior
• Constipation
• Sexual problems in men
• Poor nutrition, weight loss
• Irregular menstrual cycles in women

Long-term fentanyl use can also lead to tolerance and dependence, meaning the body becomes used to the drug and may need more of it to feel the same effects. This can happen with illegally produced fentanyl, but it can also happen when prescription fentanyl is used in ways other than prescribed.

With fentanyl patches, this risk can increase when someone applies more than one patch, uses a patch prescribed to someone else, or tries to change how the medication is released. Because patches are designed to deliver fentanyl slowly over time, misusing them can make the dose unpredictable and much more dangerous.

How Can You Tell If Someone Is Overdosing on Fentanyl?

A fentanyl overdose is a serious medical emergency and may occur even if an individual thinks they’re taking a different substance. Call an ambulance and use naloxone immediately if any of the following overdose signs occur:

• Blue lips and complexion
• Clammy skin
• Extremely slow breathing
• Gasping breath
• Choking on vomit
• Pinpoint pupils
• Chest pain
• Seizures or stiffening of the body
• Disorientation, delirium, or strange behavior
• Loss of consciousness
• Coma

How to Stop a Fentanyl Overdose

Naloxone is the best way to delay the life-threatening effects of a fentanyl overdose until an ambulance arrives.[8] Naloxone contains an opioid antagonist, rapidly returning normal breathing and heart rate. Multiple doses of naloxone may be required.

Most pharmacies can provide free naloxone kits and show you how to use them. Anyone who uses recreational drugs should stock naloxone in their home.

If an overdose is suspected, do not leave the person by themselves. Call 911 or seek medical attention right away. If naloxone is available, administer it as soon as possible and try to keep the person awake and breathing until emergency responders arrive. If the person is unconscious or struggling to breathe, lay them on their side to help prevent choking.

How Do You Know If Someone Is Addicted to Fentanyl?

Like any addiction, fentanyl addiction is a disease. Getting a proper diagnosis is the first step to accessing the medical and psychological support needed to recover. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), fentanyl addiction is classified as an Opioid Use Disorder (OUD).[9]

To confirm a diagnosis of Opioid Use Disorder (OUD), at least two of the following should be observed within a 12-month period:

• Fentanyl is often taken in larger amounts or over a longer period than was intended.
• There is a persistent desire or unsuccessful efforts to cut down or control fentanyl use.
• A great deal of time is spent in activities necessary to obtain fentanyl, use fentanyl, or recover from its effects.
• Craving, or a strong desire or urge to use fentanyl.
• Recurrent fentanyl use results in a failure to fulfill major role obligations at work, school, or home.
• Continued fentanyl use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
• Important social, occupational, or recreational activities are given up or reduced because of fentanyl use.
• Recurrent fentanyl use in situations in which it is physically hazardous.
• Continued fentanyl use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
• The user exhibits tolerance to fentanyl, requiring a markedly increased amount to achieve the desired effects.
• The user exhibits withdrawal symptoms.

Drug Rehab and Fentanyl Addiction Treatment Program Options

Recovery from fentanyl addiction is possible. Addiction health researchers have found that a combination of medications, psychological treatment, and social support can help an individual to recover from Opioid Use Disorder.[10] Recovery typically occurs in three stages: detox and withdrawal management, therapeutic interventions, and post-recovery lifestyle maintenance.

Healing from fentanyl addiction takes strength and support. Our caring teams provide individualized rehabilitation to help you recover with dignity.

Managing Fentanyl Withdrawal

The unfortunate truth is that fentanyl withdrawal comes with severe physical and mental symptoms, which may require in-patient treatment to overcome. These symptoms can be managed and lessened with a combination of medications and the support of physicians and an addiction specialist team. Some symptoms of fentanyl withdrawal may include:

• Nausea, diarrhea, stomach pain, and vomiting
• Increased heart rate and body temperature
• High blood pressure
• Muscle and bone pain
• Insomnia
• Anxiety and depression
• Chills with goosebumps
• Sweating
• Severe cravings

Most opioid withdrawal symptoms are not life-threatening. They will be most intense after 36 to 72 hours and typically begin to subside after 7 to 10 days, although in some cases, they may persist for a few more weeks.

The timing and intensity of withdrawal can vary based on how fentanyl was used, how long it was used, and how much the body has come to rely on it. Prescription patches can complicate this process because they release fentanyl gradually and may continue affecting the body after removal. This is one reason stopping fentanyl suddenly or changing a prescribed dose without medical guidance can be difficult to manage safely.

Medications and Therapy for Fentanyl Addiction

Medications for Opioid Use Disorder are called MOUDs. They’re typically given to people with Opioid Use Disorder beginning during withdrawal and may be taken for months or years following an addiction to fentanyl or other opiates. Some of the most common MOUDs are methadone, buprenorphine, and naltrexone, which are FDA-approved medications that help stabilize brain chemistry and curb cravings.

Therapeutic treatment for fentanyl-associated Opioid Use Disorder may include one-on-one talk therapy, counseling, family therapy, and behavioral skills training such as dialectical behavior therapy (DBT) or Cognitive Behavioral Therapy (CBT). Treatment may take place in an in-patient or out-patient setting after medical detox.

The goal of therapy is to help individuals understand the underlying causes behind their fentanyl use and build the skills and support needed to sustain recovery in the long term. After detox, ongoing therapy and medication can significantly reduce the risk of relapse after treatment, and people need to attend therapy to strengthen long-term recovery.

Long-Term Lifestyle Maintenance to Prevent Relapse for Opioid Use Disorder

Recovery from fentanyl addiction is an ongoing journey that continues long after treatment is over. But the 25 million Americans currently in recovery prove that lasting sobriety is possible and likely, with the support of family, friends, therapists, and your medical team.[11]

Research also suggests that a 90-day rehab program after detox is linked to higher sobriety rates.

Building a life that supports ongoing health and wellness is as individual as the person in recovery. Research shows that living a life attuned to your values, eating well, building a solid support system, and abstaining from harmful substances are all key parts of a post-addiction lifestyle. SAMHSA’s National Helpline also offers confidential treatment referrals for people who need ongoing help or next steps.

Many people also find attending a peer-led support group such as Narcotics Anonymous helpful, as it gives them a place to find ongoing support, learn from one another, and perhaps most importantly, create friendships that support continued recovery.

Compassionate Treatment for Fentanyl Addiction

Fentanyl addiction is a difficult thing to overcome, but it can be done and people do it every day.

If you or someone you care about is struggling with an addiction to fentanyl or other opioids, help is available. Reach out to Epiphany Wellness today. Our admissions team is available to answer your questions, walk you through your options, verify your insurance, and find the right treatment plan for you.