Fentanyl Addiction

Fentanyl is a highly potent opioid that is widely abused on the black market, leading to fatal overdoses. However, real fentanyl has a valid medical purpose for severe pain when used under medical supervision. Learn about legal use, its counterfeit street version, abuse side effects, and addiction recovery.

About Fentanyl Addiction

Fentanyl has become one of the most abused opioids due to its explosive growth on the black market. In addition to being significantly stronger than morphine, it has caused the overdose deaths of thousands of people.

However, prescription fentanyl has a legitimate medical use—particularly for individuals with severe pain. It is considered safe to use under the direction of a physician or similar medical professional.

Learn more about this potent opioid, including what you should know if you use it legally, what potential side effects it can cause when abused, and what to expect from addiction and recovery from opioid use disorder.

What Is Fentanyl?

Fentanyl is a strong painkiller (i.e., analgesic) and one of the most potent prescription opioids available. Doctors typically prescribe fentanyl for chronic or severe pain patients.

This list provides some context for fentanyl’s potency and how it compares to other opiates:

• Morphine: Commonly used when lesser painkillers are no longer effective.
• Oxycodone: 1.5x stronger than morphine
• Heroin: 2-5x stronger than morphine
• Fentanyl: 50-100x stronger than morphine

Prescription Fentanyl VS Illicit Fentanyl

Prescription fentanyl is commonly prescribed as a wearable patch, but doctors may also prescribe it as a tablet, intravenous shot, or nasal spray.

The most common name brands of fentanyl prescriptions include:

• Actiq®
• Duragesic®
• Sublimaze®

Fentanyl carries the same risks as all Schedule II drugs, having a high likelihood of abuse, dependence, and addiction. Use as directed by your doctor or healthcare provider to reduce your risk.

Illicit fentanyl, unlike its prescription drug counterpart, is mass-produced in unsafe facilities (like underground basements) in China and Mexico.

In recent years, fentanyl is also being mixed in with other drugs—including heroin, meth, ecstasy, and cocaine. It has also appeared in other drugs like marijuana.

As of 2022, the U.S. Drug Enforcement Administration (DEA) posted a public health alert to announce that 6 out of 10 fake pills contain a potentially lethal dose of fentanyl.

Fentanyl Abuse and Addiction

Fentanyl can seem appealing to illicit drug users due to its potency. In contrast, other illicit drug users may not be aware that fentanyl is present in the drug they are taking (typically cocaine, methamphetamine, ecstasy, and heroin).

Someone abusing pharmaceutical fentanyl will typically misuse fentanyl patches or pills. The fentanyl patches are chewed, sucked on, inserted, or scraped to remove the gel to inject it. Pills are consumed normally or crushed to be smoked, snorted, or injected.

The following warning signs may indicate a person is abusing fentanyl:

• Pinpoint pupils
• Being unusually drowsy, potentially coming in and out of consciousness
• Used fentanyl patches that appear scraped
• Crushed pills
• Multiple prescriptions, sometimes from more than one doctor

People hiding an addiction may also self-isolate and lose interest in activities they once enjoyed. They may also begin to have issues at work or in relationships as they become more devoted to their fentanyl habit.

Additional behavioral changes like poor hygiene, abnormal sleep schedules, or financial problems may also indicate a substance use problem.

Side Effects of Fentanyl Abuse

Fentanyl works like other opiates by binding to your brain’s opioid receptors, which control pain and emotions. When fentanyl binds to this part of your brain, it blocks sensations caused by chronic pain.

Fentanyl is also a respiratory depressant, which slows down your breathing and heart rate. When a person abuses fentanyl, they risk causing their heart rate or breathing to slow down to life-threatening levels.

Additional effects that fentanyl may cause are:

• Euphoria
• Confusion, inability to focus
• Nausea
• Pinpoint pupils
• Constipation
• Chills or feeling cold
• Trouble sleeping
• Slowed breathing
• Unusual drowsiness and sedation
• Unconsciousness

Risks of Fentanyl Abuse

Fentanyl is incredibly potent and designed to treat severe or end-of-life pain. As a result, abusing fentanyl has a high risk of causing addiction, overdose, and death.

Unfortunately, some drug users seek out fentanyl due to its potency. It is approximately 50 times stronger than heroin, putting the user at a greater risk of overdose.

Some illicit drug distributors have also started adding fentanyl to other substances to make them stronger and more addictive. In many cases, these drug users are unaware that their drugs contain fentanyl and that they have a much higher chance of overdosing.

Fentanyl Overdose

Because fentanyl is so potent, even a tiny amount can lead to an overdose. A victim of fentanyl overdose will first become drowsy and fall asleep, and it will be difficult to wake them.

The most common fentanyl overdose signs include:

• Small or pinned pupils
• Slowed or no breathing
• Unconsciousness
• Cold, clammy skin
• The body is unusually limp
• Unresponsive to touch or sound
• Vomiting
• Shallow, gasping breaths (also known as the “death rattle”)
• Blue or grayish tint to the skin, especially around the eyes and mouth

What to Do for a Fentanyl Overdose

1. Immediately call 911 and report an overdose.
2. Try to awaken the victim. You can speak loudly, pinch them, or perform a sternum rub by running your knuckles up and down the bony center of their chest.
3. Administer naloxone (e.g., Narcan®). Note that naloxone only pauses the effects of the fentanyl. The victim may become conscious, but this DOES NOT mean the overdose is over!
4. Encourage the overdose victim to wait for emergency personnel, as they can return to an overdose once the naloxone wears off.
5. Stay with the victim until help arrives. 

Fentanyl Addiction Treatment

If you have found yourself addicted to or abusing fentanyl and want to stop, you’ve come to the right place. We’ve compiled a list of fentanyl treatment options and what to expect along your journey to recovery.

Medical Detox

Medical detox is highly recommended as the first step in fentanyl addiction treatment.

Not only will a medically supervised detox lessen the potential withdrawal symptoms, but it will also prevent more severe complications like seizures or coma.

Fentanyl withdrawal symptoms can include:

• Chills
• Muscle aches or soreness
• Restless leg syndrome
• Runny nose
• Trouble sleeping
• Anxiety
• Strong cravings for fentanyl
• Nausea, stomach cramps, vomiting, or diarrhea

During your medical detox from fentanyl, a healthcare provider may also prescribe a safer opioid medication to help your body get used to the lack of fentanyl in your system. This process is also known as tapering.