You’ve likely heard about the growing opioid epidemic that America is facing today – that almost 100 people die every single day in this country from an opioid overdose.
And while you may be under the impression that drugs like heroin or even big-name painkillers like OxyContin are wholly to blame, there’s a new prescription medication that’s being abused in record numbers. And in fact, it’s claiming more lives each year than both of these drugs.
The culprit – fentanyl.
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.
One of the most commonly abused prescription drugs on the market today, fentanyl 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.
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.
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.
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:
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.
Essentially, 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.
Given that opioids like fentanyl directly affect the brain’s opioid receptors which have major roles in pain relief and mood, it should come as no surprise that the most notable effect of a fentanyl high is a sense of euphoria.
Users from the online drug community Bluelight describe it as “very sedating… annoyingly itchy,” “floaty,” “sleepy,” and having a “nice warm content opiate feeling.”
One user from another online drug community called Erowid describes the experience as such:
I was in full Fentanyl bliss… My body had grown numb, and I could think of nothing but a feeling of being tremendously Okay, more Okay than I’d ever felt in my entire life. It begs the question why the feeling a drug gives could be the most pleasant I’ve ever felt in my life… It scared the hell out of me.
Depending on the method of administering the drug, the experience can be as short-lived as 20 to 30 minutes or as long as 3 to 6 hours. In general, the quicker it gets into the bloodstream, the shorter the high is going to be.
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.
In addition to the high associated with abusing Sublimaze and other fentanyl containing drugs, this substance can also bring with it a number of additional short-term side effects as well.
According to MedlinePlus, these symptoms include:
More serious side effects include:
Depending on the duration and severity of your fentanyl abuse, these symptoms may vary in intensity as well.
Watching someone you love succumb to the dangers of fentanyl abuse or addiction can be incredibly heartbreaking. In addition to feeling powerless as they turn more and more of their life over to this dangerous drug, you may also constantly worry about whether or not you are actually helping them get better or simply enabling their addiction.
What’s more, you may not even be sure if they’re actually addicted in the first place. Rest assured though, a gut feeling that they might be struggling with a substance abuse problem is one of the first signs to watch out for.
A few other indicators of fentanyl abuse may be:
There are a number of other signs to watch out for as well so be sure to keep your eyes open.
While the short-term effects of opioid abuse are very well documented, the long-term effects are still being researched in the medical field today, especially when it comes to synthetic opioids like Duragesic, Ionsys, and other fentanyl-based painkillers.
Part of the delay has to do with the fact that fentanyl has only recently seen a significant boon in use and prescriptions. As such, long-term data for its abuse isn’t as readily available as, say, morphine which was administered in the early 1800s.
However, as an opioid itself, fentanyl’s long-term effects are generally estimated to be similar to those of other drugs from the same class. Heroin, for example, which is actually 50X less potent than fentanyl, comes with a number of long term effects including:
Beyond that, researchers are currently studying the effects that depressed respiration (a common characteristic among opioids) may have on brain function as a whole according to NIDA. This condition, known as hypoxia, can have both psychological and neurological effects including coma as well as permanent brain damage.
So, while the jury may still be out on the exact effects of long-term fentanyl abuse, it seems that the effects may be significant, detrimental, and permanent.
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 Substance Abuse and Mental Health Services Administration (SAMHSA) also points out a variety of other symptoms of opioid overdose in general including:
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:
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.
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.
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 bad: 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:
There are also a number of psychological symptoms as well, some of which may be even more unbearable than the physical ones:
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.
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.