Fentanyl Abuse

Fentanyl is a synthetic opioid pain reliever that is 50 to 100 times stronger than morphine. It is prescribed to patients suffering from chronic, breakthrough cancer pain, who are regularly taking, and/or are tolerant to, other narcotic pain medications. It functions by altering how the central nervous system responds to pain signals.

Fentanyl can be habit-forming and must be taken exactly as directed by your doctor. Taking a larger dose, or taking it more frequently or for a longer period of time than prescribed, most often leads to physical dependence and addiction.

Understanding Fentanyl Abuse

When prescribed by a medical doctor, fentanyl is usually administered by injection, transdermal patch, or in lozenges. Although some patients under a doctor’s care do become addicted to the drug, most fentanyl-related deaths are related to illegally made doses of fentanyl. The drug sometimes appears as a counterfeit version of a similar, but less powerful drug, such as oxycodone.

The National Institute on Drug Abuse explains that illicit fentanyl is “sold in the following forms: as a powder; spiked on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids. People can swallow, snort, or inject fentanyl, or they can put blotter paper in their mouths so that fentanyl is absorbed through the mucous membrane.”

Like heroin, morphine, and other opioid drugs, fentanyl attaches to opioid receptors in the brain, blocking pain signals. Because opioid receptors are located in the brain’s reward center, they can also cause the brain to release more dopamine, commonly known as the “feel-good” chemical, producing a state of euphoria and relaxation.

According to the U.S. National Library of Medicine, brand names of fentanyl include Actiq, Duragesic, Onsolis, and Sublimaze. Street names for the drug include apache, china girl, china white, dance fever, friend, goodfella, jackpot, murder 8, percopop, tango and cash.

Signs and Symptoms of Fentanyl Abuse

Some signs and symptoms of fentanyl abuse may include:

  • Needing to refill a prescription before it is due
  • Changes in mood
  • Changes in appearance or hygiene
  • Mental clouding
  • Isolation from family and friends
  • Changes in eating habits
  • Nervousness and restlessness
  • Lack of interest in activities the user previously enjoyed

According to the National Institute on Drug Abuse, in addition to causing euphoria, drowsiness and sedation, fentanyl can also cause nausea, confusion, constipation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma, and death.

Dangers of Fentanyl Abuse

Sustained use of fentanyl will create a tolerance for the drug, forcing addicts to increase their dosage to experience the same effects. Taking large amounts of fentanyl will increase the number and severity of side effects, and cause the user to run a much greater risk of fatality.

Opioid receptors are found in the same areas of the brain that control breathing. The fact sheet on fentanyl from the National Institute on Drug Abuse explains that “high doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely, which can lead to death. The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl. Fentanyl sold on the street can be mixed with heroin or cocaine, which markedly amplifies its potency and potential dangers.”

Who Abuses Fentanyl?

A person of any age, gender, financial status, or ethnicity can become addicted to fentanyl. According to The National Institute on Drug Abuse, “regular use—even as prescribed by a doctor—can produce dependence, and when misused or abused, opioid pain relievers can lead to fatal overdose. The current epidemic of prescription opioid abuse has led to increased use of heroin, which presents similar dangers.”

People who seek out illegally manufactured fentanyl usually do so because they already have an opioid addiction and have developed a tolerance for other narcotics. Some people take fentanyl without realizing it, as the drug often appears as counterfeit forms of other opioid medications, or mixed in with heroin or cocaine.

Addicts may take fentanyl to combat feelings of anxiety, to self-medicate depression, or to enjoy feelings of euphoria, but the potency of the drug means that the chance of accidental overdose is high, and the symptoms of withdrawal are severe, making anyone who regularly abuses fentanyl physically unable to quit the drug on their own.

Fentanyl Addiction

When used legally, under a doctor’s instructions, fentanyl can improve a patient’s quality of life during cancer treatment or recovery from surgery. But overuse and abuse will lead to addiction, and serious mental and physical consequences. Taking illegal forms of the drug is especially dangerous, as the lack of federal oversight means the amount of fentanyl in individual pills, lozenges, etc., may vary greatly.

The Drug Enforcement Agency’s intelligence brief on counterfeit pills containing fentanyl says that “in March and April 2016, 52 overdoses and 10 deaths occurred in Sacramento, California from counterfeit Norco® pills containing fentanyl.  University of California Davis laboratory analysis indicated that the pills contained a variety of fentanyl doses; one sample of pills contained between 0.6 and 6.9 milligrams of fentanyl per pill (2 milligrams of fentanyl is a lethal dose for non-opioid users).”

Am I Addicted to Fentanyl?

If you fear that you may be addicted to fentanyl, ask yourself the questions below:

  • Do I abuse fentanyl every day?
  • Do I abuse the drug in order to combat feelings of unhappiness, loneliness, depression, etc.?
  • Have friends or family members mentioned more than once that they are worried about my drug use?
  • Do I become hostile or angry when they do so?
  • Do I ever experience withdrawal symptoms such as: an inability to feel pleasure, feeling irritable or anxious, confusion, hot flashes, sweating, muscle aches, fatigue and/or difficulty sleeping, thoughts of suicide, intense cravings, loss of appetite, stomach pain, changes in respiration or tremors?
  • Do I feel like I can’t have fun, be normal, or complete everyday tasks without fentanyl?
  • Am I secretive about my drug use, and/or do I lie about when I use or how much I take?
  • Do I need more and more fentanyl each time I abuse the drug in order to feel its effects?
  • Have I experienced any major problems in the last year, such as a breakup, job loss, car accident, family problems, financial problems, or getting arrested as a result of my drug use?
  • Despite these problems, do I feel unable to stop using fentanyl on my own?

If you answered yes to one or more of these questions, you may be addicted to fentanyl and in need of professional help.

Fentanyl Addiction Treatment

Addiction is a chronic, relapsing disease. The NIDA explains that “repeated drug use changes the brain, including parts of the brain that enable you to exert self-control. These and other changes can be seen clearly in brain imaging studies of people with drug addictions.”

This is why addicts require professional help to break the cycle of addiction. The treatment specialists at a qualified drug and alcohol rehab are trained in how to manage substance abuse issues and lead addicts safely to recovery.


Detoxification is the first step to any recovery plan. A person needs clarity of mind and a body free from addictive substances before they can be effectively treated. Because withdrawal from fentanyl can be extremely unpleasant, detoxing in a rehab center under the care of medical professionals is ideal. A doctor will likely have you taper off of fentanyl gradually, to minimize withdrawal symptoms.


Whether addicts choose inpatient residential treatment, and/or outpatient treatment, all substance abuse recovery plans will include talk therapy.

Individual therapy allows patients to work intensively on issues specific only to them, while group therapy allows them to both support and experience support from other addicts who are struggling with similar challenges. Family therapy is a valuable tool to ensure individuals encounter the best possible environment at home, to prevent relapse.

Other treatment options include:

  • 12-step meetings: Meetings based on the 12-step program that originated with Alcoholics Anonymous are an invaluable resource to support long term sobriety.
  • Cognitive-behavioral therapy: CBT teaches patients to retrain their brains with new methods of coping with stress and cravings, and avoiding trigger situations
  • Treatment for co-occurring conditions: most addicts suffer from undiagnosed mental health issues that underlie and fuel their substance abuse. These co-occurring disorders must be addressed as a part of recovery.
  • Nutrition, fitness and recreational therapy: a strong body is just as important as a strong mind when it comes to long-term recovery. The better a person feels, the more prepared they will be to handle life as it comes.