Fentanyl is thus a very powerful drug, and for that reason, it also has a considerable likelihood of abuse. Like any drug that can be abused, abrupt cessation can cause severe and painful effects. Fentanyl withdrawal is a serious problem that endangers patients whose long-lasting pain drove them to addiction.
What Is Fentanyl?
To understand the effects of fentanyl on the body, we need to understand the drug’s effects on the brain – and for that, we need to understand what fentanyl is. The National Institute on Drug Abuse explains that fentanyl is a “powerful synthetic opiate analgesic.” It bears some similarity to morphine, in that it is an opiate. When administered, a patient feels a rush of euphoria before this settles down into an intensely calmed, relaxed state. As the electrical signals sent out by the brain are artificially dulled by the drug attaching itself to the brain’s natural receptors, other effects may include:
- Reduced breathing and heart rate
- Slurred speech
- Impaired focus and concentration,
- Difficulty staying awake
The New Zealand Drug Foundation describes the sensation as “psychologically addicting.”
The “analgesic” comes from the opiate’s properties of being a potent painkiller. Fentanyl is thus prescribed to patients who endure chronic, unrelenting pain, or patients who are experiencing physical discomfort following surgery.
Unlike morphine, however, fentanyl is synthetic. Morphine occurs naturally in opium, from the opium poppy, and it has been used for centuries. The Journal of Pain and Symptom Management tells us that fentanyl was created in a pharmaceutical laboratory as recently as 1960. Fentanyl is not only more potent than morphine, it is between 80 and 100 times more powerful than morphine, and hundreds of times more potent than heroin. “It is a drug of abuse,” unequivocally declares the Centers for Disease Control, and it is duly considered a Schedule II prescription drug in the United States. Under the scheduling system of the U.S. Drug Enforcement Agency, Schedule II drugs have a high potential for abuse, which may lead to severe mental or physical dependency. The DEA even lists fentanyl as an example of a Schedule II drug.
The abuse of fentanyl is an example of prescription drug abuse, whereby a drug that is primarily created and administered for medicinal applications is used by people against medical advice. This may be because users are in such distress from their pain that they take excessive amounts of the drug to alleviate their symptoms, either by unilaterally increasing their dosage or frequency of consumption. They may do this out of a belief that taking more of the fentanyl will ease their pain faster or simply out of sheer desperation. Fentanyl may be particularly potent in this regard because of its rapid onset, giving distressed patients instantaneous – but dangerously addictive – relief. Prescription drug abuse can also emerge in the form of people taking therapeutic drugs for non-medical reasons. With a strong opioid like fentanyl, they may do this to experience the initial euphoria as the drug hits the brain, which then settles into a powerfully sedating and relaxing state. Recreational prescription drug abusers often get their drugs from friends and family members, who are unaware of the dangers of taking prescription medication without a prescription (assuming that since the drugs are authorized by a doctor, they cannot be too harmful), or by simply stealing them from friends and family members who have valid prescriptions. Fentanyl’s reputation as one of the strongest pain medications available today has made it a target for underground and illegal laboratories, where impure and tainted batches are produced for an undiscerning and risk-taking market. Vice reports on a laboratory in Montreal where police discovered equipment capable of churning out 3 million pills a day, at a rate of one fentanyl pill every second. Without regulation and oversight by government and pharmaceutical bodies, this form of fentanyl becomes deadly. The Centers for Disease Control’s Morbidity and Mortality Weekly Report quotes figures of 1,000 deaths related to fentanyl abuse in Chicago and Philadelphia between 2004 and 2005. The Assistant Special Agent in Charge of the DEA’s New Mexico office explained that a couple of grains of fentanyl – which is usually mixed with heroin for black market trade – could be lethal. This form of fentanyl is usually administered via intravenous injection, whereas prescription fentanyl is typically abused by simply swallowing pills.
The dangers of taking unregulated and non-prescribed fentanyl may be enough to make someone want to stop taking the drug, but this is much easier said than done – especially if the user has been taking enough fentanyl, and for long enough, that his body and mind has developed a dependence on the drug.If addiction has reached this state, abruptly cutting off the supply of fentanyl may do more harm than good because of the resultant withdrawal symptoms. PsychCentral explains withdrawal as the patient’s physical and neurological systems being thrown into confusion by the sudden loss of the drug that had completely overpowered and rewritten vital connections throughout the body.When it comes to fentanyl, some of those withdrawal symptoms include:
- Muscle pain and cramps
- Nausea and vomiting
- Rapid heart rate
A study in the Journal of Pediatric Nursing on the topic of “Drug Withdrawal Symptoms in Children After Continuous Infusions of Fentanyl” found that participants who had their fentanyl infusions discontinued exhibited tremors, muscle tension, and rapid, strained breathing. These effects usually occur between 6 and 36 hours after the last use of fentanyl, and can last between one and two days. While this may seem like an easy proposition – simply wait out the withdrawal period – an addict going through this stage is not capable of thinking rationally or being so patient. Unsupervised withdrawal opens the door to the patient simply taking more fentanyl to ease the pain and agony, thereby deepening his addiction and pushing him further away from truly controlling his habit. If you are worried that you’re taking too much fentanyl and thinking of stopping your intake on your own, you should know that this is extremely dangerous. Unsupervised withdrawal can be fatal, and it was the cause of death for singer Amy Winehouse in 2011 (in what Today called “the dangers of detoxing alone”). Instead, please call us at Futures of Palm Beach to find out safer ways to begin your journey away from fentanyl abuse. Other symptoms of suddenly stopping fentanyl intake can include anxiety, diarrhea, tremors and, in cases of long-term or extreme abuse, hallucinations.
Treating Fentanyl Withdrawal and Addiction
Treating fentanyl withdrawal involves gradually weaning patients off their intake, as we’ve seen that there are severe consequences for terminating the abuse without a long-term treatment plan in mind. Since fentanyl is such a powerful medication, patients may have to receive careful doses of anti-anxiety and anticonvulsant medication, to help their bodies acclimatize to the withdrawal process. This is another reason why fentanyl detoxification should not be attempted alone, as it is unlikely a patient will have the access to the necessary drugs, or the knowledge of how to properly administer the drugs so that they have their desired effect and do not cause unwanted side effects, which may include creating a brand new dependency on the withdrawal medication. Once the physical craving for fentanyl has been controlled, treatment moves to a psychological frame. Address the thoughts and habits that led the patient to take his prescription medication beyond recommended limits. The reasons behind prescription drug abuse can be much more complex than simply wanting the pain to go away, and it is a psychotherapist’s job to help the patient understand those reasons to discover how to avoid them and counter them once treatment ends. This is done by using a number of lines of questioning, offering new perspectives and devising plans and strategies to approach pain management in ways that are healthy and positive. There are 69,000 fatalities stemming from opioid overdoses every year, according to the World Health Organization, who also report that 15 million people are addicted – either to illicit opioids like heroin or prescription opioids like fentanyl. Whether you started taking fentanyl to make your pain more manageable, or because it seemed like a harmless and safe way to feel good, it’s not too late to make a change for the better.
At Futures of Palm Beach, we have expert mental health and medical staff members who can answer all your questions about the signs and symptoms of fentanyl abuse and withdrawal. Our admissions coordinators can get you started on the check-in process today.
Please call us to find out how we can make your fentanyl problem a thing of the past.