Fentanyl is an opioid medication used to treat chronic pain. However, it is now being found in street drugs such as heroin and pills like Xanax. Fentanyl is one of the leading causes of preventable deaths and accounts for a large number of opioid-related death rates in the United States.
Fentanyl is highly addictive since it is 50 to 100 times more potent than morphine. Addiction to fentanyl leads to dependence, tolerance, and fentanyl withdrawal—all of which are extremely dangerous and have the potential to be fatal.
In 2016, synthetic opioids like fentanyl were responsible for over 20,000 overdose deaths, according to the National Institute on Drug Abuse. Fentanyl which made up more than 30 percent of all overdose deaths that year. This is almost a tenfold increase from 2012, and the numbers are only rising. To combat this epidemic, we aim to educate and to treat those who are struggling from an addiction to fentanyl.
Since fentanyl acts like an opioid, the withdrawal symptoms mimic those of other drugs in its class. Fentanyl withdrawal symptoms can vary in severity depending on the individual, how much they are using, and how long they have been using it. Fentanyl is actually more dangerous during active addiction than when you are experiencing withdrawal. However, fentanyl withdrawal is severe, and it can be agonizing.
An opioid activates and binds to opioid receptors in the brain-altering brain chemistry and proper body functioning. When there is an influx of fentanyl entering the body, both the body and brain become dependent on the increase of dopamine. This dependence creates a tolerance, which will develop greater over time.
Dependence and heightened tolerance are only two symptoms of fentanyl use. Fentanyl withdrawal occurs when the drug is no longer entering the body. The withdrawal aspect of addiction is the most feared and one of the hardest obstacles to overcome.
On top of the physical withdrawal symptoms, these psychological effects can linger long after the fentanyl is out of your system:
These long-term psychological effects make up a phenomenon known as Post-Acute Withdrawal Syndrome (PAWS), which may not dissipate for several months after the last use of fentanyl. This is because opioid abuse creates, not only a physical dependence but also a psychological dependence, establishing the drug as a source of comfort and happiness. When that is removed, it can be difficult to find a more stable and constructive source for these things. This is why continued treatment is essential once the detox process is over.
Fentanyl is commonly used in the medical field as a powerful pain reliever and is often prescribed as an injection, patch, or a lollipop. Once the drug has been absorbed into the body or injected into the skin, the molecules are received by opioid receptors in the central nervous system, causing a sharp reduction in pain and generate a feeling of euphoria and drowsiness.
Overall, under the influence of fentanyl, your emotions, speech, critical thinking, judgment, and motor skills will all be impaired. This is due to the fact that its presence affects the neurotransmitter response between brain cells and depresses the central nervous system.
One such neurotransmitter is dopamine, which is responsible for the pleasure/reward system in your brain. By artificially flooding your brain with dopamine, your body will naturally stop producing it on its own, which leads to severe withdrawal symptoms if you stop using fentanyl cold turkey. This is why psychological symptoms, such as anxiety and depression, can linger for months after detox.
Initial symptoms of fentanyl withdrawal will be acute. The symptoms will vary from mild to severe throughout the duration of withdrawal, depending on the individual. The beginning symptoms of withdrawal can begin in as little as three hours after the last dose.
First several hours – The symptoms you might experience consist of sweating, muscle aches, upset stomach, and dilated pupils. As the body adjusts to the lack of fentanyl, the symptoms will then begin to worsen.
The first two days – Full fentanyl withdrawal will take effect. This time will be critical and may require medication to ease the withdrawal symptoms.
Three to 10 days – The withdrawal symptoms will peak. During this time, you might experience diarrhea, vomiting, restless leg syndrome, extreme irritability, and mood swings. Withdrawal can last anywhere up to 10 days.
More than one week – Although the most extreme aspect of withdrawal may be over with, PAWS can last anywhere up to four months after the last dose.
The timeline of fentanyl withdrawal varies from person-to-person. Some people might not have as severe of withdrawal as the next. The treatment timeline for fentanyl withdrawal and addiction may also vary depending on your unique situation, your insurance coverage, and your willingness to see treatment all the way through.
Medication-Assisted Treatment (MAT) is the commonly-used method of administering medications during detox to help mitigate the withdrawal symptoms. Because the withdrawal process from substances like opioids and alcohol can be severe, MAT is essential in many cases.
These medications can be used alongside clinically-proven therapies, so treatment as a whole can be as effective as possible. Merely administering the medication without therapy is like putting a small bandage on a gaping wound. Instead, these medications serve to replace the more dangerous opioid (such as fentanyl) and allow the user to taper off of opioid dependence in relative safety.
Here are some common medications used for fentanyl withdrawal:
A well-known option for MAT, Suboxone binds with opioid receptors without delivering the addictive high provided by drugs like fentanyl and heroin. This helps with cravings, alleviates painful withdrawal symptoms, and allows you to taper off more easily. However, a dependence on Suboxone can develop if not done correctly.
Also known by its brand name Narcan, Naltrexone is both useful as a tool to fight fentanyl withdrawal symptoms and also as an overdose reversal agent.
Used to fight both opioid and alcohol relapse, Naltrexone (Vivitrol) has the primary purpose of decreasing the desire to use drugs such as fentanyl. However, this should not be used in conjunction with another opioid such as Suboxone.
This strong pain reliever is both effective and safe to treat fentanyl withdrawal when taken as prescribed by a doctor. It is a primary element in Suboxone.
This highly controversial medication acts similarly to Suboxone, but dependence on Methadone is common. For this reason, Methadone is becoming less and less popular for fentanyl withdrawal.
Fentanyl is an extremely powerful opioid that can cause intensely uncomfortable withdrawal symptoms. People that go through it describe it as the worst flu-like symptoms they’ve ever experienced. So what happens if you try to get through withdrawal symptoms on your own? What if you quit cold turkey?
Opioids like fentanyl are sometimes grouped with depressants because of their sedative effects. However, opioids work differently in the brain, and they don’t cause the same symptoms during withdrawal. Depressants are known to be the most dangerous class of drugs to withdrawal from, but opioids may not be as life-threatening. Opioids aren’t known to cause deadly withdrawal symptoms like seizures or delirium tremens.
However, in some cases, opioid withdrawal can lead to possible medical complications.
One way a fentanyl withdrawal could be dangerous is due to dehydration. Withdrawal can cause excessive sweating, diarrhea, and vomiting. In bad cases, you can lose water quickly, and it needs to be replenished. This is part of the reason your doctor always tells you to drink plenty of fluids when you get sick. If you don’t drink enough while going through withdrawal, some symptoms may get worse like nausea, and you may add symptoms like a headache.
Most people would feel the effects of dehydration and drink some fluids to quench their thirst. It’s the bodies natural response to losing water. However, in situations where you can’t or choose not to hydrate, withdrawal can be deadly.
One report pointed out that people who are neglected while going through withdrawal in prison settings have died because of dehydration. Because opioid withdrawal is generally thought of as uncomfortable but not dangerous, prisoners’ needs were neglected in the past. While instances of dehydration death are rare and in specific circumstances, it’s essential to recognize the potential threat.
Fentanyl withdrawal can also be dangerous for people that might be vulnerable to the flu. Very young and older people might experience more dangerous complications. For instance, babies born to mothers who are dependent on opioids are delivered and immediately go through withdrawal. This condition is called neonatal abstinence syndrome, and it can be deadly without medical care. Pregnant mothers who are dependent on opioids may also need medical help if they want to quit before delivering their baby.
You may also need medical help to get through withdrawal if you have other physical conditions that might be complicated by withdrawal. For instance, withdrawal symptoms might affect your heart rate and blood pressure. Vomiting might cause you to strain yourself more than you usually would. If you have a heart condition that could be affected by sudden changes in heart rate or blood pressure, you should seek medical attention before going through withdrawal.
Seeking medical help for fentanyl addiction and withdrawal will be your best option in successfully abstaining from the mind or mood-altering substances. Fentanyl withdrawal is not usually fatal.
However, the symptoms are uncomfortable, can lead to fatal complications, and they can lead a person to give in to their addiction if they are not in a medical facility. Quitting any drug cold-turkey decreases the success rates of maintaining long-term sobriety. Not to mention the fact that it is grueling, painful, and uncomfortable.
Additionally, detox is a vital first step to overall treatment. By ridding your body of the addictive substance, you are setting yourself up for a much more successful therapeutic process. Imagine trying to explore your behavioral motivations for using while you are experiencing intense withdrawal symptoms and cravings. Detoxing first helps you get your mind in the right place before starting treatment.
The detoxification process in a professional setting will ensure your safety and comfort throughout the process. Medical staff will guide you through cravings and provide you with the proper care and medication you need to safely combat fentanyl withdrawal. The drugs used in detox programs will alleviate and can sometimes diminish all of the symptoms of fentanyl withdrawal.
After successfully completing a detoxification program, you will be suggested to attend a higher level of care. Inpatient programs can help you continue sobriety and allow you more time away from environments that may trigger a relapse.
Inpatient and residential treatment programs are highly beneficial, and the success rates after completing the program are higher than if you were to only detox without continuing care.
Solidifying a foundation in early recovery is vital, and the tools to help you learn how to do so can be provided in licensed facilities such as The Palm Beach Institute.
An inpatient program typically lasts around 45 days. The goal of extended care is to assess the root of addiction and treat it using effective and proven therapeutic methods. You will also be educated in relapse prevention while learning how to use coping mechanisms to sustain recovery.
Fentanyl addiction is currently sweeping the nation, which is why it is critical to seek medical attention and complete an entire treatment program beginning with detox. After inpatient or residential programs, you will be suggested to attend the final level of care: intensive outpatient and outpatient.
This type of program is less extensive. However, it still provides you with the support and therapy you need in early recovery. These programs also subject their patients to drugs screenings, which will keep you accountable and motivated.
U.S. Centers for Disease Control and Prevention. (2018, December 19). Opioid Overdose. Retrieved from https://www.cdc.gov/drugoverdose/opioids/fentanyl.html
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U.S. National Library of Medicine. (2019, July 10). Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. Retrieved from https://medlineplus.gov/ency/article/000949.htm