Fentanyl Addiction: Symptoms, Risks, and Treatment Resources
- Fentanyl is a powerful opiate produced and sold legally and illegally
- As a Schedule II drug, fentanyl is considered to have a high potential for abuse which may lead to severe psychological or physical dependence
- Fentanyl works quickly in the brain, binding to the opioid receptors and reducing heart rate and breathing within 4 minutes
- Overdosing on fentanyl is likely, and is fatal without the use of naloxone and prompt medical intervention
- Fentanyl addiction is considered an Opioid Use Disorder in the DSM-5
- Treatment options include supervised withdrawal, therapy, and ongoing lifestyle maintenance
- Recovery from fentanyl addiction is possible
What is Fentanyl?
Fentanyl is a synthetic opioid developed to treat patients suffering from chronic or severe pain. This opiate is 50 to 100 times more powerful than morphine or heroin. Illegally procured and/or produced fentanyl has also flooded the black market, contributing to a new wave of opioid addiction and overdoses.
Fentanyl Quick Reference Chart
|Drug Category||Commercial & Street Names||DEA Schedule||Administration|
Commercial: ActiqⓇ, FentoraⓇ, AbstralⓇ, SubsysⓇ, LazandaⓇ, DuragesicⓇ
Street: Apache, China Girl, China Town, Dance Fever, Friend, Goodfellas, Great Bear, He-Man, Jackpot, King Ivory, Murder 8, and Tango & Cash
What Does Fentanyl Look Like?
Legal fentanyl is available as a prescription and is dispensed as transdermal patches, ‘lollipop’ style edibles, sublingual tablets, and nasal sprays. Black market fentanyl is sold in tablet form, as a white powder, or in liquid form and is sometimes dispensed in combination with cocaine, heroin, MDMA, or other drugs.
Fentanyl’s Effects on the Body and Mind
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. A depressant substance, fentanyl, relaxes the central nervous system and slows respiration and heart rate.
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 and sweating. The most serious physical effects of fentanyl include slowing of the heart and respiration, which may result in cardiac arrest or death.
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.
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
- Loss of appetite
- Concentration problems
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
- Sexual problems in men
- Poor nutrition, weight loss
- Irregular menstrual cycles in women
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
How to Stop a Fentanyl Overdose
Naloxone is the best way to delay the life-threatening effects of a fentanyl overdose until an ambulance can arrive. 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.
Understanding Fentanyl Addiction
Fentanyl is one of the most addictive drugs due to its potency. Because of the powerful impact on the brain, it causes individuals to stop producing the normal neurochemicals they need to function each day at a much larger scale. The result is more severe dependence and withdrawal symptoms than with other opiates like heroin. Help is available.
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).
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.
- User exhibits tolerance to fentanyl, requiring a markedly increased amount to achieve the desired effects.
- User exhibits withdrawal symptoms.
Treatment Options for Fentanyl Addiction
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. Recovery typically occurs in three stages — detox and withdrawal management, therapeutic interventions, and post-recovery lifestyle maintenance.
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
- Anxiety and depression
- Chills with goosebumps
- Severe cravings
Most 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.
Medications for Fentanyl-Related Opioid Use Disorder
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.
Therapeutic Treatment for Fentanyl Addiction
The second stage of recovery for fentanyl-associated Opioid Use Disorder (OUD) involves therapeutic interventions. These may include one-on-one talk therapy, family therapy, and behavioral skills training such as Dialectical Behavioral Therapy (DBT) or Cognitive Behavioral Therapy (CBT). Therapeutic treatment may take place in an in-patient or out-patient setting.
The goal of therapeutic treatments is to help individuals understand the underlying causes behind their fentanyl use and to give them skills and support to sustain their recovery in the long term.
Long-Term Lifestyle Maintenance 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.
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.
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.
Fentanyl use during pregnancy increases the risk of miscarriage, premature delivery, infant mortality, and low birth rate.
The DEA defines a lethal amount of fentanyl as 2 mg or 0.0002 teaspoons.
You can’t tell if other drugs, such as heroin, MDMA, 2CB, or other substances, contain fentanyl. If you’re using an illegal drug, be vigilant for signs of overdose, keep naloxone on hand, and don’t use it alone.
Are you or a loved one struggling with Fentanyl use?
 U.S. Department of Health and Human Services. (2023c, March 3). Fentanyl drug facts. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/drugfacts/fentanyl#ref on June 7, 2023.
 Facts about fentanyl. DEA. (n.d.-b). Retrieved from https://www.dea.gov/resources/facts-about-fentanyl on June 7, 2023.
 Hampton, T. (2022, September 1). Study reveals Fentanyl’s effects on the brain. Harvard Gazette. Retrieved from https://news.harvard.edu/gazette/story/2022/08/study-reveals-fentanyls-effects-on-the-brain/ on June 7, 2023.
 Strang, J., McDonald, R., Campbell, G., Degenhardt, L., Nielsen, S., Ritter, A., & Dale, O. (n.d.). Take-home naloxone for the emergency interim management of opioid overdose: The Public Health Application of an emergency medicine. Drugs. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31352603/ on June 7, 2023.
 Department of Justice (DEA) . (2020, April). Fentanyl – National Institute on Drug Abuse (NIDA). Retrieved from https://nida.nih.gov/sites/default/files/drugfacts-fentanyl.pdf on June 7, 2023.
 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Retrieved from https://doi.org/10.1176/appi.books.9780890425596 on June 7, 2023.
 Hoffman, K. A., Ponce Terashima, J., & McCarty, D. (2019, November 25). Opioid use disorder and treatment: Challenges and opportunities. BMC health services research. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876068/ on June 7, 2023.
 U.S. Department of Health and Human Services. (2023c, February 23). Living in recovery: What works?. National Institutes of Health. Retrieved from https://heal.nih.gov/news/stories/recovery-what-works on June 7, 2023.