Fentanyl is responsible for more overdoses than any other drug in American history. It is one of the world’s most potent drugs and has found its way into many illicit drugs like cocaine, heroin, and counterfeit pills, exposing users to its effects whether they are aware of it or not. Fentanyl addiction is one of the most dangerous and complex addictive diseases, but recovery can happen with the right clinical support.
What Is Fentanyl?
Fentanyl is a fully synthetic opioid that was developed to treat severe pain, particularly in surgical and cancer care settings. Pharmaceutical fentanyl is available by prescription and can come in the form of a transdermal patch, lozenge, or injectable. Fentanyl is classified as a Schedule II controlled substance, meaning it has an accepted medical use but a high potential for abuse and physical and psychological dependence.[1]
Illicitly manufactured and distributed fentanyl, however, is entirely different and poses a greater degree of danger. Illicitly manufactured fentanyl (IMF) has contributed to the rising number of overdose deaths, accounting for approximately 68% of all overdose deaths in 2022.[2] The substance is frequently pressed into counterfeit pills that closely resemble prescription medications like Xanax and Klonopin or mixed into heroin and cocaine, resulting in users consuming it without knowing they are doing so.
Why Is Fentanyl So Dangerous?
Fentanyl’s extreme potency is what makes it so dangerous.
Fentanyl is one of the world’s most potent drugs, approximately 50 to 100 times more powerful than morphine.[3] A fatal dose is approximately two milligrams, making the margin between a dose that produces euphoria and one that suppresses breathing and causes death an extremely narrow one.[4]
Naloxone (Narcan) can reverse a fentanyl overdose, but due to fentanyl’s potency, multiple doses may be required. Anyone with a fentanyl use disorder or a loved one with fentanyl exposure should have naloxone on hand and know how to use it.
Signs of Fentanyl Use and Addiction
The immediate signs of fentanyl use include:
- Extreme drowsiness or suddenly falling asleep (“nodding off”)
- Pinpoint pupils
- Inability to maintain a steady heart rate
- Slowed or stopped breathing
- Confusion and disorientation
- Nausea and vomiting
- Pale, clammy, or bluish skin. This is a sign of overdose requiring immediate emergency intervention
Signs of fentanyl addiction and longer-term use include:
- Dramatically increased tolerance, requiring larger and more frequent doses
- Withdrawal symptoms beginning within hours of the last dose
- Continued use despite awareness of the risk of overdose
- Obtaining fentanyl from multiple sources or through increasingly risky means
- Neglecting family, friends, work, social obligations, and personal hygiene
- Financial problems and social isolation
- Repeated unsuccessful attempts to quit
Recognizing Fentanyl Addiction in a Loved One
Because illicitly manufactured fentanyl is so often present in other drugs, a loved one may be exposed to fentanyl without knowing it. If someone you care about is using any illicit substance or getting pills from non-pharmacy sources, the risk of fentanyl exposure is a real possibility. The signs of fentanyl addiction are similar to those of opioid use disorder: secrecy, financial problems, withdrawal from family and friends, and feeling well only shortly after using.
If you suspect a loved one has been using fentanyl, having naloxone on hand and knowing how to administer it is a reasonable and potentially life-saving precaution.
Effects of Fentanyl Abuse
The effects of fentanyl abuse are far-reaching and can cause long-term health problems, including:
- Severe physical dependence developing rapidly due to fentanyl’s potency
- Neurological changes affecting mood, cognition, and the ability to experience pleasure
- Cardiovascular effects including slowed heart rate and dysregulated blood pressure
- Significant weight loss, malnutrition, and reduced immune function
- Respiratory complications from repeated episodes of respiratory depression
- Co-occurring mental health disorders including depression, anxiety, and PTSD, which are extremely common in people with opioid use disorder
Fentanyl Withdrawal: Why Home Detox Is Dangerous
Fentanyl’s intensely uncomfortable withdrawal is a significant reason why medical detox is strongly recommended over attempting to quit yourself. The potency of fentanyl and the degree of physical dependence it produces can cause severe withdrawal symptoms that begin within hours of the last dose.
Fentanyl withdrawal symptoms include:
- Intense and overwhelming cravings
- Severe anxiety and agitation
- Muscle pain, cramping, and uncontrollable restlessness
- Profuse sweating, chills, and goosebumps
- Nausea, vomiting, and diarrhea
- Insomnia
- Elevated heart rate and blood pressure
The primary reason detoxing from fentanyl at home is dangerous is not the withdrawal itself, but the risk of relapse. Unbearable withdrawal symptoms and intense cravings lead to a low success rate for unassisted detox.[5] When a relapse occurs, tolerance drops off drastically, even after only a brief period of abstinence, and using the same amount of fentanyl that was previously tolerated post-relapse can cause a fatal overdose.
Emergency medical interventions for fentanyl withdrawal may include IV fluids, antiemetics, clonidine for autonomic symptoms, and, in some cases, rapid initiation of buprenorphine — all of which require assessment and monitoring by a medical professional.[6]
Medical detox at an accredited treatment facility provides round-the-clock medical supervision and medication-assisted treatment for withdrawal symptoms, both of which are essential for safely transitioning into the next phase of treatment.
Fentanyl Addiction Treatment at All In Solutions
Successful recovery from fentanyl requires comprehensive care that takes a client through medically supervised detox to individualized treatment and ultimately through structured aftercare. All In Solutions provides comprehensive fentanyl addiction treatment based on each client’s unique needs, utilizing the complete continuum of care.
