Author: Ruben Bermea, LPC

Fentanyl is a synthetic opioid prescribed to treat severe pain. Classified as a Schedule 2 narcotic with a high potential for psychological or physical dependency, fentanyl has a high risk of addiction.¹ With potency levels over 50-100 times greater than opioids such as morphine and heroin, fentanyl’s effects on the body can impose life-threatening challenges.² If you or someone you know is struggling with fentanyl addiction, treatment is available.

In This Article:

• Fentanyl Addiction Now the No. 1 Cause of Drug Overdose
• Signs You May Need Fentanyl Addiction Treatment
• Fentanyl Addiction, Withdrawal, and Overdose Risk
• Treatment for Fentanyl Addiction
• Continuing Recovery Support

Fentanyl Addiction Now the No. 1 Cause of Drug Overdose

Fentanyl is sometimes prescribed to treat severe pain following surgery. It may also be prescribed to treat chronic pain in individuals who have become drug-tolerant to other opioid medications. As a prescription medication, fentanyl comes in the branded forms such as Duragesic, Actiq, and Sublimaze.²

Like other opioid drugs, fentanyl affects areas of the brain that control pain and emotions.² After using fentanyl over time, a person may develop physical and psychological dependency and find it hard to experience pleasure from anything else.²

Fentanyl addiction, whether starting from a legal prescription or from street versions of the drug, can have devastating consequences. With the widespread availability of illegally made fentanyl, this drug has surpassed heroin as the leading cause of overdose death in the U.S. In 2020, nearly 60,000 people in the U.S. died from overdoses related to fentanyl addiction.⁴

Illegal fentanyl includes fentanyl “analogs” or slightly altered versions of the drug, such as acetylfentanyl and carfentanil, that are even more powerful than prescription fentanyl.² Fentanyl analogs are made in labs outside of the country and distributed illegally as white powder, tablets, nasal sprays, or eye droppers.²

Signs You May Need Fentanyl Addiction Treatment

How can you tell when you or someone you know needs treatment for fentanyl addiction? Some effects of fentanyl use include:^2,6

• Euphoria, or elevated happiness
• Drowsiness
• Strange thoughts or dreams
• Dry mouth
• Problems sleeping
• Mood changes
• Swelling in different body parts
• Pain in the body
• Reddening of the face, neck, or chest
• Sweating
• Fever
• Stomach problems
• Breathing problems
• Problems staying conscious

These signs can depend on several factors, including when the last dose of fentanyl was taken, how much was used, and how the substance was ingested.⁷

Side effects of fentanyl use can become severe, even life-threatening.⁶ Changes to heart rate, appetite, menstruation, or sexual desire can indicate the presence of fentanyl use symptoms requiring medical care. Seizures, severe vomiting, diarrhea, loss of coordination, and muscle problems may also require medical support.⁶

Other concerning signs of fentanyl use comes from the psychological changes that a person may experience while using this drug.^1,6 Beyond mood changes, fentanyl misuse can cause a person to become agitated or develop hallucinations.⁶

Signs of Fentanyl Addiction

According to the American Psychiatric Association, anyone who uses an opioid medication such as fentanyl can develop physical or psychological drug dependence. Addiction is defined when a person’s dependence on the drug affects their daily behavior. To be diagnosed with fentanyl addiction, known clinically as “opioid use disorder” (OUD), a person needs to show some of the following symptoms within a 12-month period:⁸

• Wanting to stop using fentanyl and struggling to do so
• Using fentanyl longer, or in higher doses, than prescribed
• Neglecting important responsibilities due to fentanyl use
• Using fentanyl despite risks to physical or psychological health
• Having strong cravings or urges to use fentanyl
• Using fentanyl in physically dangerous situations
• Continuing to use fentanyl despite the problems doing so causes in relationships and other important areas of life
• Giving up hobbies or other activities due to fentanyl use
• Spending a significant amount of time seeking or recovering from fentanyl use
• Developing symptoms of tolerance to fentanyl
• Developing symptoms of withdrawal when stopping or reducing fentanyl use

The severity of an OUD diagnosis is ranked according to the number of above indications present. The presence of 2-3 symptoms indicates a mild addiction, 4-5 symptoms indicates a moderate addiction, and 6 or more symptoms indicates a severe addiction.⁸

Another dangerous consequence of prolonged fentanyl use is tolerance. Tolerance occurs when people become desensitized, or accustomed to, the effects of a substance. This causes a person to need larger or more frequent doses of a drug to maintain the desired effects.

If a person who has used fentanyl for a while tries to stop using the drug, they will likely experience withdrawal. The discomfort and suffering associated with withdrawal symptoms often lead to ongoing fentanyl misuse.

The symptoms of fentanyl tolerance, addiction, and withdrawal can increase a person’s risk of facing life-threatening consequences.^1,7,8 Only a qualified treatment professional can offer a diagnosis and recommend appropriate treatment for fentanyl addiction. For more information on accessing addiction treatment, call 800-934-1582(Who Answers?) today.

Fentanyl Addiction, Withdrawal, and Overdose Risk

If you or someone you know shows signs of fentanyl misuse, getting professional help for fentanyl addiction treatment is essential.

Trying to overcome fentanyl addiction by yourself can be difficult to do and result in harmful consequences. First, withdrawing from fentanyl without medical supervision can be dangerous.⁷

Second, it’s common to relapse after stopping use of an opioid drug like fentanyl due to powerful cravings. Resuming fentanyl use can be more dangerous than when you used the drug originally because your body’s tolerance has reset and become more sensitive to the drug. At this stage, you are more vulnerable to experiencing an overdose.⁸

Fentanyl overdose, or opioid toxicity, can be life-threatening.⁶ Fentanyl overdose can cause a person to stop breathing, resulting in death without immediate emergency intervention.

Naloxone is a medication that can reverse the effects of a fentanyl overdose.⁹ Naloxone is available in the form of a nasal spray under the brand names Kloxxado and Narcan. It is available in some states without a prescription. Or you can ask you primary care doctor for a prescription. Emergency medical assistance for an overdose is still necessary after administering naloxone.

Treatment for Fentanyl Addiction

Professional addiction treatment can help you safely withdraw from fentanyl use. Treatment involves medication to help you manage cravings and a variety of therapy to help you succeed in recovery.

Each person’s needs in recovery will depend on their circumstances.⁷ Though no “one-size-fits-all” approach to recovery exists, treatment can offer a menu of services, interventions, and tools to help a person live free of opioid addiction.

Detox

Commonly referred to as detox, opiate withdrawal management includes services to help a person safely clear toxic substances from their body.⁷

Withdrawal management can occur in various settings, including inpatient, residential, and outpatient treatment centers.⁷ Clinical specialists provide monitoring and interventions to preserve a person’s physical health as they go through the detox process. They may prescribe medication such as buprenorphine or methadone that can help manage undesirable withdrawal symptoms.

The withdrawal process can become complicated by many factors.⁷ These factors may require a person to receive treatment in an inpatient hospital or residential treatment setting. The detox process serves as the start, not the end, of comprehensive treatment for fentanyl addiction.

Inpatient Rehab

Inpatient hospitalization for fentanyl rehab provides the highest level of care for individuals with the greatest needs in recovery.⁷ This level of care can help individuals facing severe psychological conditions, especially those which may lead a person to harm themselves or others.

Individuals experiencing addiction to multiple substances may also benefit from inpatient treatment.⁷ Multiple substance misuse can create additional health concerns and complicate the treatment process, requiring more extensive medical management.

Fentanyl rehab residential treatment can offer a community of support where monitoring can take place 24 hours a day. Staying at a residential treatment center gives people time and space away from environments that may promote fentanyl misuse.

Both inpatient hospitalization and residential rehab can offer counseling, medication management, case management services, and other staples of a comprehensive treatment program. If your needs in recovery require care at these levels, you may want to continue your work in outpatient settings when you are discharged. Ongoing treatment services can support the progress you make in a hospital or residential rehab program.⁷

Outpatient Treatment

Outpatient treatment settings offer a spectrum of services to meet the varying intensities of individuals’ OUD symptoms.⁷ Partial Hospitalization Programs (PHP) can offer near-daily services, including continued medication-assisted therapy, counseling, and connection to a community of recovery.

A lower level of intensive care is available through Intensive Outpatient Programs (IOP).⁷ An IOP can offer similar services to those available in PHP settings. These programs will typically involve fewer sessions as people spend more time back in the routine of their daily lives.

Normal outpatient  services constitute the lowest level of care. These sessions take place at a pace that meets your recovery needs. For individuals with the ability to independently manage addiction symptoms, outpatient services can provide ongoing support.

Therapies for Fentanyl Addiction Treatment

Effective treatment for fentanyl addiction will depend on a person’s unique background, circumstances, and personal needs.

Services offered in comprehensive fentanyl rehab program may include:⁷

• Individual therapy
• Group therapy
• Family therapy
• Peer support
• Medication management
• Case management
• Referrals for supportive housing
• Skills training
• Mindfulness interventions

Specific therapies provided vary from person to person. You care provider will work with you to develop a treatment plan that fits your unique needs and preferences.

Holistic Interventions

Many addiction treatment programs also incorporate complementary treatments to address a person’s holistic health through mind, body, and spiritual wellness.¹¹

Complementary interventions can work well with established treatment approaches as part of a comprehensive addiction treatment program.¹²

Supplementary interventions may include:¹¹

• Dance therapy
• Yoga
• Tai Chi
• Special diets
• Hypnosis
• Music Therapy

While different holistic therapies will benefit certain people more than others, complementary approaches cannot replace evidence-based addiction treatment.¹¹ Talk with your treatment provider to ensure that any supplementary treatment interventions you choose meet your overall recovery goals.

Continuing Recovery Support

Ongoing recovery support, also known as aftercare, can be key to helping you maintain sobriety following fentanyl rehab.⁷ Ongoing therapy sessions, medication management, and community support can reinforce the skills introduced in treatment for fentanyl addiction.

Sources of support can also come from sober living programs, facilities that offer housing in communities designed to promote recovery.⁹ These programs offer an environment centered around sobriety that promotes independent functioning as you work toward long-term wellness.

Joining a mutual help group can also provide valuable peer support in recovery.⁷ Twelve-step programs like Narcotics Anonymous (NA) provide structure and connection for individuals in recovery. Self Management and Recovery Training (SMART) and Celebrate Recovery are other groups that provide ongoing peer support.

For more information on how to find a program that meets your needs in fentanyl addiction treatment, call 800-934-1582(Who Answers?) .

References

1. U.S. Drug Enforcement Administration. (2020). Drugs of Abuse: A DEA Resource Guide/2020 Edition.
2. National Institute on Drug Abuse. (2019). Fentanyl DrugFacts.
3. Baldwin, G.T., Seth, P., & Noonan, R.K. (2021, March 23). Continued Increases in Overdose Deaths Related to Synthetic Opioids: Implications for Clinical Practice. JAMA, 325(12), 1151-1152.
4. Centers for Disease Control and Prevention. (2021, August 8). Provisional Drug Overdose Death Counts. National Center for Health Statistics.
5. U.S. Attorney’s Office, Western District of North Carolina. (2020, January 30).  Congress Must Ban Fentanyl Analogues
6. U.S. National Library of Medicine. (2021, May 25). Fentanyl. MedlinePlus.
7. Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating Addiction: A Guide for Professionals (2nd ed.). The Guilford Press.
8. American Psychiatric Association. (2013). In Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
9. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction DrugFacts.
10. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.
11. Adedoyin, C., Burns, N., Jackson, H. M., & Franklin, S. (2014). Revisiting holistic interventions in substance abuse treatment. Journal of Human Behavior in the Social Environment, 24(5), 538–546.
12. National Center for Complementary and Integrative Health. (April 2021). Complementary, Alternative, or Integrative Health: What’s In a name?
13. Adedoyin, C., Burns, N., Jackson, H. M., & Franklin, S. (2014). Revisiting holistic interventions in substance abuse treatment. Journal of Human Behavior in the Social Environment, 24(5), 538–546.
14. National Center for Complementary and Integrative Health. (April 2021). Complementary, alternative, or integrative health: What’s in a name? U.S. National Institute of Health.