Fentanyl Addiction: Effects, Withdrawal & Detox

Fentanyl is a powerful synthetic opioid that is similar in effects to morphine but is 50 to 100 times more potent.1 Like morphine, fentanyl is typically used to treat severe pain, especially following surgery or to treat patients with chronic pain who have become physically tolerant to other drugs.1 It is a prescription drug that is given as a shot, a patch that is put on the patient’s skin, or as lozenges that are taken orally. In its prescription form, fentanyl is known by such brand names as Actiq®, Duragesic®, and Sublimaze®. 

Illicit or illegal fentanyl is made in labs and sold on the street as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that can look like prescription opioids.1 Illicit fentanyl is distributed through illegal drug markets for its powerful, heroin-like effects. Common street names for illicit fentanyl include Apache, Dance Fever, Friend, Jackpot, and more.2

Like other opioids, fentanyl works by binding to the body’s opioid receptors, which are found in areas of the brain that control pain and emotion.1 The effects of fentanyl use include relaxation, euphoria, and pain relief. 

 
However, when fentanyl is misused or abused, these pleasurable effects can over time become harder to achieve, requiring ever-larger dosages. This increases the risk of overdose, as individuals take more to achieve their desired effects. 

Some of the common effects of fentanyl abuse include:3 

• Sedation 
• Confusion 
• Euphoria
• Unconsciousness
• Drowsiness 
• Dizziness 
• Nausea and vomiting 
• Urinary retention 
• Respiratory depression, or slowed breathing

Synthetic opioids like fentanyl are the most common illicit substances involved in drug overdose deaths in the U.S.2 This is due to fentanyl’s high potency, high addiction rate, and low cost, all of which makes it attractive to illegal drug makers and distributors. Furthermore, fentanyl is tasteless and odorless, so users likely do not even know when they are ingesting a possibly lethal dose of fentanyl. 

It should be noted that, unless a drug is prescribed by a licensed medical professional and dispensed by a legitimate pharmacy, you can’t know if it’s fake or legitimate. Also, there’s no way to know the amount of illicit fentanyl in any individual pill without laboratory testing. 

The U.S. Drug Enforcement Administration found in 2022 that, of the fentanyl-laced illicit prescription pills analyzed, six out of ten were found to contain a possibly lethal dose of fentanyl.4 Some drugs that are commonly laced with fentanyl include:

• Heroin 
• Cocaine 
• Counterfeit medications (oxycodone, hydrocodone, Xanax, Adderall) 
• Methamphetamine
• Ecstasy/MDMA/Molly

Risk of Fentanyl Overdose

As with other opioids, like heroin and oxycodone, fentanyl runs a high risk of overdose when it is misused or abused.   

The risk of fentanyl overdose is also increased when fentanyl is combined with other substances like alcohol, benzodiazepines, or other opioids. These combinations amplify fentanyl’s sedative effects, increasing the chance of respiratory depression. This decreases the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can lead to coma, permanent brain damage, and death. 

The symptoms of fentanyl overdose include:3 

• Stupor 
• Changes in pupillary size 
• Cold, clammy skin 
• Cyanosis, or blue discoloration of the skin 
• Respiratory failure 
• Coma 

Fortunately, opioid overdose can be reversed with Narcan, a prepackaged nasal spray that contains naloxone, an opioid antagonist that rapidly reverses opioid overdose. Narcan quickly restores normal breathing to someone if their breathing has slowed or stopped because of opioid overdose.5

Because of its potency, fentanyl tends to reinforce its repeated use. Even someone taking prescription fentanyl exactly as instructed by their doctor can develop a dependence on fentanyl.1 Drug dependence is characterized by a tolerance for taking fentanyl and withdrawal symptoms after one has stopped using the drug. It is not the same as drug addiction, which is characterized by the compulsive seeking and taking of a substance despite negative life consequences. Dependence can, however, lead to addiction. 

In fact, people using fentanyl-laced opioids without knowing they are using them—in substances like heroin or counterfeit medications—may find themselves addicted faster, because of fentanyl’s potency. This makes fentanyl-laced opioids extremely dangerous, as users may not be prepared for the intense physical and psychological grip of the drug or its high potential for overdose.

Signs of Fentanyl Addiction

Addiction to fentanyl manifests in a number of physical and behavioral signs. Because fentanyl is an extremely potent opioid, addiction can develop quickly, and recognizing these signs is important for intervention. 

Based on criteria outlined in the DSM-5 for opioid use disorder (OUD), certain signs can identify if and when someone is struggling with fentanyl addiction. The signs of OUD include:6

• Craving or strong desire to use opioids such as fentanyl 
• A persistent desire or unsuccessful efforts to cut down or control opioid use 
• Spending significant time seeking opioids, using opioids, or recovering from their effects 
• Neglecting important social, occupational, or recreational activities because of opioid use Undergoing withdrawal symptoms when not using opioids 

• Continuing to use opioids despite their negative consequences, including legal, social, or physical health consequences

People who have developed a dependence to fentanyl who stop using it can experience uncomfortable withdrawal symptoms. These withdrawal symptoms tend to begin just a few hours after the drug was last taken. The discomfort and intensity of withdrawal symptoms is one of the reasons why people who attempt to quit often relapse.  

A medically supervised detox can help people safely, more comfortably, and more effectively quit fentanyl. In many cases, a medically supervised detox program can prescribe medications to help those who have stopped using fentanyl safely manage the withdrawal process. Common fentanyl withdrawal symptoms include:1 

• Muscle and bone pain 
• Sleep problems 
• Diarrhea and vomiting 
• Cold flashes with goose bumps 
• Uncontrollable leg movements 
• Severe cravings for fentanyl  

It is recommended to those who have completed fentanyl detox that they enter a comprehensive fentanyl addiction treatment program. 

How Long Does It Take to Detox From Fentanyl?

Factors like dosage, duration of use, individual metabolism, and overall health influence the detoxification timeline for fentanyl. Generally, fentanyl detox follows this pattern:

• 6-12 hours after the last dose: Initial symptoms start to appear.
• 1-3 days: Symptoms peak and become most severe. Physical symptoms are at their height during this period.
• 4-7 days: Physical symptoms start to decline in intensity, but psychological symptoms, especially cravings and mood disturbances, may persist.
• 1-2 weeks: Most of the acute physical symptoms have subsided, but emotional and psychological challenges like depression, anxiety, and intense cravings can continue.
• Beyond 2 weeks: While most symptoms might have diminished, post-acute withdrawal symptoms (PAWS) can persist for weeks or months. These can include mood swings, fatigue, sleep disturbances, and persistent cravings.

Detoxing from fentanyl, especially without medical supervision, can be dangerous due to the intense withdrawal symptoms and the risk of relapse and overdose. Professional medical assistance and a structured treatment program can provide a safer and more comfortable environment for individuals looking to detox from fentanyl. Contact us to learn more about fentanyl detox in Atlanta. 

Fentanyl addiction can be treated in a variety of settings, beginning with detox and moving through inpatient or residential treatment, a partial hospitalization program (PHP) outpatient (OP) treatment, aftercare, or some combination thereof.  

Effective fentanyl addiction treatment usually involves therapy, medications to ease withdrawal symptoms, and dual diagnosis treatment, which simultaneously addresses the addiction and possible underlying mental health disorder like depression, anxiety, or bipolar. 

The various settings for treatment for fentanyl addiction include: 

• Detox. This process involves clearing fentanyl from the body while managing withdrawal symptoms. Detox typically lasts three to seven days in a medically supervised setting, where patients receive care in a safe environment. Medications, meanwhile, are sometimes prescribed to ease severe withdrawal symptoms.
• Inpatient Treatment. Inpatient rehab requires patients to stay at a treatment facility, where they receive structured therapy, education, and support. The goal is to help them manage addiction long-term and develop tools for a healthier life. This type of treatment can last from 15 to 90 days, depending on the individual’s needs.
• Partial Hospitalization Programs (PHP). PHP is a step down from inpatient care, offering comprehensive treatment without the need for a residential stay. Patients attend several hours of programming, three to five days per week, focusing on managing long-term withdrawal symptoms and building life and coping skills. PHP typically lasts up to 30 days.
• Intensive Outpatient (IOP). IOP programs involve multiple therapy sessions each week, including individual counseling, group therapy, and educational workshops. It’s ideal for those needing more support than standard outpatient care but less intensity than PHP. 
• Outpatient Programs (OP). OP provides flexible treatment for those with milder substance use issues, allowing patients to live at home and continue with their daily responsibilities while receiving care. It’s a good option for those without co-occurring mental health disorders.
• Aftercare is the stage of addiction treatment that follows more intensive care, including inpatient and outpatient treatment. Aftercare is provided in a variety of formats and modalities, including individual therapy, group counseling, and self-help meetings.7

At Empowered Recovery Center in Atlanta, we strive to empower clients with the life skills they need to effect positive change in their lives. Our fentanyl addiction treatment program can assist you in taking that first step toward long-term recovery.

We offer a wide range of rehab programs to suit your needs. Our programs also include one year of recovery coaching at no extra cost to provide extended support once you’ve completed your program. 

We accept several insurance plans and can also work with out-of-network insurances to get you the help you need. Our admissions team can verify your benefits, either over the phone or online, so that you’ve got the details of paying for rehab, including using insurance to pay for rehab. 

If you’re ready to learn more about our comprehensive fentanyl addiction treatment offerings, call us today or fill out our contact form to take that first step toward a brighter future.

References

1. National Institute on Drug Abuse. (n.d.). Fentanyl Drugfacts. National Institutes of Health. Retrieved September 24, 2024, from https://nida.nih.gov/publications/drugfacts/fentanyl 
2. Centers for Disease Control and Prevention. (n.d.). The facts about fentanyl. Centers for Disease Control and Prevention. Retrieved September 24, 2024, from https://www.cdc.gov/stop-overdose/media/pdfs/2024/05/CDC_Fentanyl-Fact-Sheet_General_508.pdf 
3. U.S. Drug Enforcement Administration. (n.d.). Fentanyl. U.S. Drug Enforcement Administration. Retrieved September 25, 2024, from https://www.dea.gov/factsheets/fentanyl 
4. U.S. Drug Enforcement Administration. (n.d.). DEA Laboratory Testing Reveals that 6 out of 10 Fentanyl-Laced Fake Prescription Pills Now Contain a Potentially Lethal Dose of Fentanyl. U.S. Drug Enforcement Administration. Retrieved October 1, 2024, from https://www.dea.gov/alert/dea-laboratory-testing-reveals-6-out-10-fentanyl-laced-fake-prescription-pills-now-contain 
5. National Institute on Drug Abuse. (n.d.). Naloxone Drugfacts. National Institutes of Health. Retrieved October 1, 2024, from https://nida.nih.gov/publications/drugfacts/naloxone 
6. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association. Retrieved October 1, 2024, from https://www.asam.org/docs/default-source/education-docs/dsm-5-dx-oud-8-28-2017.pdf
7. U.S. National Library of Medicine. (n.d.). Continuing Care Research: What We’ve Learned and Where We’re Going. National Institutes of Health. Retrieved October 1, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670779/