Fentanyl Abuse and Addiction: America’s Deadliest Drug

Fentanyl, the synthetic pharmaceutical drug has been in headline news recently for good reason. It’s an opioid pain reliever that can be up to 100 times stronger than morphine. In a hospital setting, it’s used for surgery and cancer treatment. It was never meant to be used for lacing into illicit drugs. However, for those in the black market, this was a perfect addition to street drugs. It is the most potent opioid and puts you at great risk of drug addiction and abuse.

You’ve heard about the growing opioid epidemic that America is facing today. It’s been in the papers. The government has talked about it liberally and organizations are always trying to bring awareness to the public. On average, nearly 100 people die every single day in this country from an opioid overdose.

Fentanyl will often slow down a person’s breathing rate to the point of death by overdose. This drug is so dangerous that first responders will wear hazmat suits if they suspect it’s a fentanyl overdose. This is in case they inhale particles of the drug. It’s so strong that one can even be affected if they’re near someone who has taken it. Accidental overdoses have occurred just from people being near an overdose scene where fentanyl was present.

Fentanyl is claiming more lives each year than both Oxycontin and heroin. Fentanyl abuse and addiction is increasingly becoming America’s deadliest problem. We take a look at what makes this drug so hazardous along with a few other things you need to know about this dangerous substance of abuse.

NIDA has spoken out about Fentanyl, saying that an epidemic could develop because its potency can cause overdose and it’s potential for addiction is high. There is an intense euphoria that is much like being high on heroin.

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Fentanyl Statistics in Washington

This short clip talk about the Fentanyl deaths in Washington. There is a brief explanation on why people are overdosing. The fact that it’s impossible to know just how much fentanyl will be laced in any given drug makes it lethal.

Deaths from Fentanyl have occurred all over the country. This includes places like Seattle and Everett. There are addiction recovery centers in the area for Fentanyl abuse. The reason this is so important is because of the fatality rate associated with Fentanyl. The stats are still not available for 2019 but last year in King County, 51 people had died from Fentanyl overdoses. The year before, it was 33 people. 

Dr. Jeffery Duchin is a health officer at Public Health in Seattle and King County. He spoke about how Public Health is doing all they can to intervene people abusing Fentanyl or other street drugs. They are working on inpatient rehabs and ER to get people treatment. This is due to the high risks of using Fentanyl or streets drugs like heroin that might be laced with Fentanyl.

At the end of 2018, there was a major drug bust that shut down the main drug pipeline. Across 5 counties in Washington over 30 people were arrested. The counties included: 

  • Pierce
  • King
  • Kitsap
  • Skagit
  • Snohomish

All arrested were associated with a Mexican drug cartel. The cartel was bringing heroin, fentanyl, cocaine, and meth into Washington State. They had fentanyl-laced oxycodone pills as well. They used a California business to launder money, sending it to Mexico. 

“The dangerous pills containing fentanyl flowing through this pipeline operated by this Western Washington distribution network has been shut down,” Keith Weis, a Drug Enforcement Administration special agent, said in a statement.

At the beginning of 2019, public health officials believed that Fentanyl caused 7 overdoses in North Seattle. This happened in just one day. Thankfully none of the overdoses were fatal in this situation. Officials believe it was Fentanyl that responsible because one of the syringes tested positive for the narcotic. 

The needle exchange in King County offers a safe place for people to use. They can get clean needles which prevents from H.I.V. They have put up a warning about certain drugs being laced with Fentanyl. As Seattle has had so many overdoses relating to Fentanyl, there is an overdose response plan. The organization DESC (formerly the Downtown Emergency Service Center) in Seattle, Washington aim to help fight against the opioid epidemic. They implemented a plan for Opioid Overdose Response and Naloxone Administration. There are 17 service sites which are all equipped with naloxone. This revives a person who has taken a dose of opioids that was too much for their body to handle.

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What is Fentanyl?

Fentanyl is a potent opioid that is often 100 times more potent than morphine. Rather than being derived straight from opium poppies like natural opioids, fentanyl is instead a fully synthetic opioid that is entirely manmade and can only legally be obtained through a licensed physician. It will often be administered via injection, transdermal patch, or in the form of lozenges. It is for patients with severe pain. Often used for cancer patients who are terminally ill. 

Fentanyl is one of the most commonly abused prescription drugs on the market today. It is an extremely potent and exceedingly powerful opioid analgesic used to treat severe pain. Additionally, it is also used in patients that have already developed a tolerance to other opioids. 

Like many other opioids, fentanyl can be highly addictive and as such is categorized by the DEA as a Schedule II substance. Due to the high potential for abuse, physicians are generally hesitant to prescribe it and will more often than not use it only in the short term to prevent any undesirable physical dependencies that may develop.

Chemical Makeup of Fentanyl

Molecular Formula: C22H28N2O

A synthetic, lipophilic phenylpiperidine opioid agonist with properties to relax the body and block pain. 

Fentanyl is a potent narcotic analgesic and a mu-opioid agonist. This indicates that there’s a high chance of abuse, habituation, and addiction. It acts as a Full Opioid Agonist where some opioids have a ceiling of how much it affects the body. This is what makes it so dangerous. 

How it works as a painkiller is it binds to the mu-receptor in the central nervous system. It gives you the same effect as a natural opiate like morphine or heroin. Fentanyl reduces the release of neurotransmitters such as GABA, dopamine, acetylcholine, and noradrenaline. It is a lot like morphine metabolically. 

History of Fentanyl

Janssen Pharmaceutica was the first to develop fentanyl in 1959. It was used mainly as an anesthetic and pain reliever. In the 1960’s the medical industry began using it as an intraenous anesthetic which was branded Sublimaze. In the 1990’s, a fentanyl patch was developed to help people with chronic pain. It was a slow release process and good for pain treatment at the time. Then the lollipop followed, branded as Actiq.

Where is the Fentanyl Coming From?

The fentanyl that is on the streets is rarely stolen from a hospital to then be laced into heroin or cocaine. Most of it is coming from China now. Due to lack of regulations in the pharmaceutical industry in China, they have become to largest distributor so illegal drugs and chemicals. China exports a variety of fentanyl products worldwide. This includes raw fentanyl, fentanyl analogs and counterfeit prescription medications. They often lace fentanyl into an oxycodone medicine. 

Fentanyl may come to the US directly from China. However, most of the shipments will go through Mexico and then into the States. Sometimes, they try to smuggle it through Canada but this is rare as it is riskier. 

The US has signed legislation into law known as the Synthetic Trafficking and Overdose Prevention Act. China is also showing an interest in stopping fentanyl from being exported out of their country illegally. So far, it hasn’t stopped the fentanyl problem but there are steps being put in place to fight against the drug.

Fentanyl is sold under a number of different brand names including:

Actiq
This is fentanyl that comes as a lozenge on a stick. It is put under the tongue and looks like a lollipop. It’s main use is for patients who are already on a pain medication.

Duragesic
This is the fentanyl patch which slowly goes into your system to treat severe pain for up to 72 hours at a time. 

Sublimaze
This brand is often administered in a hospital setting with anesthetic. It is injectable and is pain management before and after a surgical procedure. 

Subsys
This sublingual spray is put under the patients tongue where it offers immediate relief from pain. It’s use is for helping cancer patients with their acute pain. 

Abstral
This is for patients that already have a tolerance for opioids. It is for breakthrough cancer pain and is a fast-dissolving tablet which is put under the tongue. 

Lazanda
A nasal spray that is sprayed up the nose, used to help cancer patients with pain.

Fentanyl blocks pain receptors in the brain and increases dopamine which is a happiness-inducing chemical in your body. When used as a substance of abuse, fentanyl can come in the form of a powder, tablets, spiked blotter paper, or mixed with heroin. According to the National Institute on Drug Abuse (NIDA), fentanyl can be produced in unregulated laboratories and sold on the street in these forms.

Methods of abusing fentanyl include swallowing it, snorting it, injecting it, or absorbing it through the mucous membranes via blotter paper.

As a substance of abuse, fentanyl has a number of street names that let drug users and dealers refer to the substance in secrecy. What’s more, these street names are also often more memorable than the actual name of the product and thus make it easier for substance abusers to find what they’re looking for.

Some of the most common street names for fentanyl and fentanyl-laced heroin according to the National Institute on Drug Abuse (NIDA) include:

  • Apache
  • China White
  • Friend
  • Jackpot
  • TNT
  • Tango
  • Murder 8
  • Goodfella
  • Dance Fever
  • China Girl

Fentanyl Effects on the Brain

Duragesic and other fentanyl-based medications interact with the brain on a variety of different levels. Similar to other opioids, fentanyl’s main mechanism of action is binding to opioid receptors found throughout a number of areas in the brain.

Receptors are essentially little switches located on the nerve cells of the brain. When a certain chemical with the proper structure attaches to them, they tend to set in motion a variety of different effects, from mood changes and thought processes to autonomic functions and physical movements. 

These receptors are one of the primary methods your brain’s cells use to communicate with each other.

The opioid receptors that fentanyl interacts with (technically known as the mu-opioid receptors) help control pain relief and happiness. When opioids bind to these receptors, the pairing creates a burst of dopamine in the brain’s reward centers, resulting in immense pleasure and sometimes sedation.

What’s more, opioids have recently been found to also play a part in spurring the production of another neurotransmitter called serotonin. This chemical has a significant role in sleep, memory, sexual desire, mood, and even addiction and withdrawal

As the brain is continually exposed to Abstral and other drugs with fentanyl, it begins to get used to the chemical’s effects and build up a tolerance. Additionally, the surges of dopamine in the reward center of the brain also cause it to start craving the drug more often. 

After enough instances of fentanyl abuse, the brain eventually becomes physically dependent on it and can soon sink into full-blown addiction.

Fentanyl High vs. Oxycodone & Other Opioids

One of the most common measures for the potency of opioids is comparing the effectiveness of one to that of morphine. For instance, it takes only 15 to 20 mg of oxycodone to match the potency of 30 mg of morphine, making it 2X to 1.5X times as powerful.

Sounds pretty potent, doesn’t it?

When it comes to fentanyl though, the difference is even more pronounced. When administered intravenously, just 0.2 mg of fentanyl is equivalent to 10 mg of morphine according to Medscape.  

As NIDA points out, fentanyl may be similar to morphine but it is in reality 50 to 100 times more potent than this already dangerous drug.

It’s worth remembering, then, that while many opioids share similar qualities and effects, not all of them are equally potent. And fentanyl is undoubtedly one of the strongest available today.

Fentanyl Interaction with Other Substances 

Fentanyl is often mixed in with illicit street drugs so you may unsuspectingly be causing a cross addiction. It takes very little to produce a high when fentanyl is incorporated into anything. This makes it cheaper and drug manufacturers find this appealing. It causes great risks however because users don’t realize it’s contained. They will abuse heroin or cocaine the way they always have but with fentanyl, this can cause overdose. You’ll be taking strong opioids than your body is used to. There is also the factor of fentanyl being a central nervous system depressant. With a mixture of certain substances, it can depress your system too much to the point you stop breathing.

What Happens When You Mix Fentanyl and Alcohol?

Mixing fentanyl and alcohol even once can kill you. A tiny amount of fentanyl is deadly and alcohol exacerbates its effects. This increases your risk of mental and bodily damage even if it doesn’t cause death. When you abuse alcohol and fentanyl together, you can cause respiratory arrest, a coma, an irregular heart rate, or death. 

Mixing opioids of any kind with alcohol can prove deadly. Alcohol and fentanyl depress the nervous system. They enhance each other’s effects slowing down your heart rate to the point where you’re not getting enough oxygen to the brain. The warning label on fentanyl prescriptions say you should not mix the painkiller with alcohol as the combination can cause fatality. It’s sadly quite common for people to abuse fentanyl and alcohol. ER admissions showed that 18.5% involved alcohol with opioid abuse. Also, 22.1% of deaths related to opioids also included alcohol.

What Happens When You Mix Heroin and Fentanyl?

When heroin and fentanyl are mixed, their potency is amplified. Both drugs are dangerous on their own but together, they become extremely dangerous. The high is powerful but so are the side effects and risks. Both drugs are also depressants so they cause drowsiness, extreme sedation, and respiratory depression. This can cause you to fall into a coma or die suddenly. 

When someone injects heroin that has fentanyl in it, they can die in just a few minutes. This has been found true by a series of documented events. Usually when someone is suffering from a heroin overdose, there are signs of overdose before they become unconscious. When fentanyl is involved, the signs usually aren’t there. It’s usually not possible to know if heroin is mixed with fentanyl although there is a slight color difference. Heroin is more yellow while fentanyl is white.

Fentanyl Overdose Symptoms

One of the most dangerous long-term effects of fentanyl addiction and abuse is the heightened risk of an overdose which can end up being fatal.

As with overdosing on other substances, the earlier you can detect an overdose and get expert medical help, the better the chances of surviving the event will be. As such, it’s absolutely crucial that you familiarize yourself with the signs and symptoms of a fentanyl overdose.

The most common signs of fentanyl overdose include:

  • Drowsiness
  • Dizziness
  • Confusion
  • Slow, shallow breathing or stopped breathing
  • Pinpoint pupils 

The Substance Abuse and Mental Health Services Administration (SAMHSA) also points out a variety of other symptoms of opioid overdose in general including:

  • Extremely pale face and clammy skin
  • Body is limp
  • Fingernails and lips have a purple or blue color
  • Vomiting or making gurgling noises
  • Unconsciousness or an inability to speak
  • Especially slow heartbeat 

If you or someone you know are experiencing any of these signs, contact medical help immediately by calling 911 or the national poison control hotline at 1-800-222-1222.

And remember, every second counts.

Every year the opioid epidemic continues to get worse and worse.

The CDC reports that an alarming 91 Americans die every single day due to opioid overdoses, a number that includes both heroin and prescription painkiller overdoses.

One of the main contributors to this startling statistic is fentanyl. In fact, the abuse of fentanyl and fentanyl-based medications has led to an astounding increase in overdoses.

In just three years, fentanyl and fentanyl analogue overdose deaths grew by 540%, a more significant rise than nearly any other drug on the market. 

To put these numbers into perspective, in 2016 alone there were:

  • 15,400 heroin overdose deaths
  • 14,400 prescription opioid overdose deaths
  • 10,600 cocaine overdose deaths
  • 7,660 methamphetamine overdose deaths
  • 3,280 methadone overdose deaths 

The number of fentanyl overdose deaths: 20,100 people.

The takeaway here is that fentanyl has become one of the deadliest drugs on the market today, topping even heroin by almost 33%. If you’re addicted to fentanyl, you need to get help today.

Signs of Fentanyl Addiction

Patients using opioids of any kind don’t believe they are at risk of drug addiction. Due to this fact, it’s more likely they will inhibit risky behaviors. Accidental and intentional abuse are a risk. Fentanyl addiction can occur the first time you use it. It heavily impacts your central nervous system, raising your endorphins to give you a euphoric feeling. In time, this will alter your brain chemistry. These changes can cause dependency. A person won’t feel normal if they don’t have it in their system. This is why physical symptoms occur and are something you should look out for.

The Diagnostic and Statistical Manual of Mental Disorders’ criteria helps to know what fentanyl addiction looks like as an outsider. Or if you’re the addict, it allows you to look at your own behaviors. A healthcare professional will also have an easier time figuring out the behaviors that fit the bill for opioid addiction. 

Addiction to fentanyl is characterized as a number of compulsive and destructive drug seeking behaviors. Just like many other chronic diseases, if a fentanyl substance use disorder is left untreated, it can have disastrous and potentially life-threatening consequences.

But the first step in treating a fentanyl addiction is actually identifying the substance use disorder in the first place. 

This step can be particularly difficult for some. Recognizing the signs of addiction in others may be simple enough but admitting addiction in yourself, well, that is a bit harder.

That’s where self-assessments come in. While it can be tough to actually make the leap to admitting you have a problem, these tests break down patterns of behavior into more recognizable forms. It’s easier to say, for instance, that you occasionally abuse fentanyl in risky situations than it is to admit you actually have a full-blown addiction. 

There are a number of assessment tools out there to help you look at your behaviors objectively and give you a better idea of whether or not you actually have a fentanyl addiction.

You can, for instance, take a quick online addiction quiz to get a brief yet fairly accurate evaluation of your habits and behaviors.

For an even more comprehensive assessment, have a look at the criteria for substance use disorders found in the Diagnostic and Statistical Manual of Mental Disorders as provided by NIDA. This goes into a bit more detail and is actually the same set of standards used by physicians and psychiatrists.

Whatever method you choose, identifying the problem is the first step in solving it for good.

Like many other opioids, detoxing from Duragesic, Subsys, and other fentanyl-based drugs can be an incredibly painful experience. There is a long list of uncomfortable symptoms of withdrawal (both physical and psychological), many of which tend to last for weeks at a time.

In fact, many fentanyl abusers actually turn back to using simply for relief from these unbearable symptoms. This is one of the reasons why the opioid epidemic has gotten so out of hand: detoxing from such drugs can feel like you’re losing your mind

Luckily though, there are several ways that addiction experts and medical researchers are combating this problem.

For one, a growing number of rehab facilities around the country have begun to finally make use of medication-assisted treatments (MATs). These types of treatment programs incorporate a variety of drugs to help stave off cravings, eliminate withdrawal symptoms, and disincentivize old patterns of abuse. 

Some of these drugs are milder opioids that reduce the severity of withdrawals without producing a “high” (Suboxone is one) while others block the receptors that cause euphoria entirely, taking away the appeal from using again.

Such medications like buprenorphine have been shown to decrease opioid use and opioid-related overdose deaths while also reducing criminal activity and the spread of infectious disease. 

Using a professional rehab center that offers these medications to help you kick your opioid addiction will ensure a much more pain-free fentanyl detoxification compared to simply going cold turkey.

The symptoms of fentanyl withdrawal are similar to those of other opioids though they may end up being more intense due to the potency of the substance.

Some of the most commonly encountered physical symptoms as noted by Mental Health Daily include:

  • Cravings
  • Diarrhea
  • Dilated pupils
  • Dizziness
  • Fatigue
  • Goosebumps
  • Headaches
  • Heart palpitations
  • High blood pressure
  • Hot flashes
  • Itchiness
  • Muscle aches
  • Nausea
  • Runny nose
  • Sweating
  • Vomiting
  • Watery eyes yawning 

There are also a number of psychological symptoms as well, some of which may be even more unbearable than the physical ones:

  • Suicidal thoughts
  • Paranoia
  • Panic attacks
  • Memory problems
  • Irritability
  • Insomnia
  • Depression
  • Crying spells
  • Concentration problems
  • Anxiety
  • Agitation 

Another aspect of withdrawals worth noting is the fact that these symptoms can actually end up lasting for weeks at a time with varying severity. An even more protracted condition known as PAWS (post-acute-withdrawal syndrome) may also result in longer-lasting psychological side effects that can make it quite difficult to function normally.

With the help of a qualified professional though, the intensity of these symptoms can be reduced dramatically and managed over the entire course of the detoxification process.

Despite just how unbearable the withdrawals of fentanyl may seem, the truth is that the detoxification process alone is rarely fatal. In fact, most substances of abuse do not actually have potentially fatal withdrawal symptoms (though alcohol, benzodiazepines, and glucocorticoids do).

Having said that though, going through the fentanyl detoxification process and relapsing can be extremely deadly.

To explain, physical dependence is often a major aspect of fentanyl addiction. As the body becomes more and more used to having a steady and consistent stream of fentanyl in the system, it tends to adapt in order to counteract the drug’s potency. As a result, you build up a tolerance to the drug. 

When you successfully make it through the detoxification phase of recovery, your body returns to its previous state incredibly quickly, making you far less tolerant to fentanyl than when you began the detox process.

Relapsing and returning to abusing the same amount of fentanyl as before, then, can easily lead to a potentially fatal accidental overdose.

That’s why it’s critical that you ensure your recovery program has a variety of strategies to help you prevent relapsing. After all, returning to fentanyl abuse might just end up costing you your life.

Fentanyl: One Potent Opioid You Don’t Want to Mess With

One of the biggest and most recognizable contributors to the modern opioid epidemic, fentanyl is becoming an increasingly deadly problem across the country. Its exceptional potency has resulted in the deaths of thousands and when abused, can also have a number of long-term consequences that result in permanent damage as well.

It’s absolutely essential then that if you think you or someone you love is suffering from a fentanyl addiction, you seek the help required to overcome this deadly disorder today.

Talk to a Rehab Specialist

Our Evergreen at Northpoint treatment might not be right for you but we can guide you in the right direction. The most important thing is that you get the help you need. Fentanyl addiction and abuse is a serious thing. You’re risking your life every time you use it. If you’re abusing other opioids off the streets, they could be laced with Fentanyl.

Each time you abuse these drugs, you’re putting your life in jeopardy. This is one of the main risks of being addicted to illicit drugs today. Our admissions coordinators are here to help you get started with treatment the right way. They'll verify your health insurance, help set up travel arrangements, and make sure your transition into treatment is smooth and hassle-free. Help is available and it could save your life.

Talk to a Rehab Specialist

Our admissions coordinators are here to help you get started with treatment the right way. They'll verify your health insurance, help set up travel arrangements, and make sure your transition into treatment is smooth and hassle-free.

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