What is Fentanyl?
Fentanyl is a powerful synthetic opioid drug that is used as an analgesic or anesthetic. The drug is typically used to treat patients with moderate to severe pain, or to help manage pain after surgery. Fentanyl is one of the strongest opioid drugs available today. Fentanyl has a similar chemical composition to Morphine but is significantly more potent – in fact Fentanyl can be up to one hundred times more potent than Morphine. This is at least partly due to its high lipophilicity, which is the ability of a molecule to dissolve in fats. Because of this property Fentanyl can penetrate the Central Nervous System (CNS) more easily than morphine can. Fentanyl has a very rapid onset of action, but the effects only last for a relatively short time. For this reason it is often used for pain management after surgery, and also for “breakthrough pain”. This term describes temporary pain that is so severe that it “breaks through” the opioid barrier in a person who is already on opioid drugs. It is also sometimes used to treat people with chronic pain who have become physically tolerant to other opioids. Fentanyl is classified as a schedule II prescription drug in the DEA Drug Schedules.
History of Fentanyl
Fentanyl was first synthesized by Dr. Paul Janssen, the founder of Janssen Pharmeceuticals, in 1960. The drug quickly began to be used as a pain reliever due to its high potency and quick action, and then as a general anesthetic under the trade name Sublimaze later in the 1960s. After Sublimaze became so popular and successful, many other analogues, meaning chemical variations, of fentanyl were developed that include Sufentanil, Alfentanil, Lofentanil, and Remifentanil. The Fentanyl patch was developed in the 1990s and could deliver the drug to a patient transdermally. This meant the patch, under the trade name Duragesic, could be worn on the skin and allowed for a slow release of the drug. This can be useful in the management of chronic pain in patients with advanced cancer, or other chronic pain types that required a consistent and constant release of opioid pain medication. The Fentanyl patch is composed of an inert alcohol gel that is infused with specific doses of fentanyl. The active pain-relieving opioids are released by the patch into the body fats, which provides for a slow release into the bloodstream over two or three days, thus allowing for longer term pain relief. Following the success of the Fenatnyl patch, other drug delivery devices were developed. These include the Fentora dissolving tablets and the Actiq lollipop, which were the first quick-acting prescription formulations of Fentanyl for personal use by the patient. A Fentanyl product that has been approved for cancer patients is Onsolis, which consists of a small, bio-erodible polymer film for application to the buccal mucosa (inner lining of the cheek). In this delivery mechanism a soluble film of Fentanyl on a disc can be placed in the mouth and absorbed. This construction prevents the possibility of inhalation or crushing, which can help discourage abuse. Other Fentanyl products included an effervescent lozenge and a dissolving spray. However, the transdermal skin patches are still the most commonly used form of delivery for Fentanyl.
Fentanyl, like all opioids, can produce wonderful feelings of euphoria and relaxation, even if it is being used legitimately. Also, because Fentanyl is such a powerful and quick acting drug, tolerance to its effects occurs rapidly. It also may cause a general increased tolerance to the effects of other opioid drugs as well – an individual who uses Fentanyl may find that other opioid drugs don’t produce the desired pain-relieving effects. For these reasons, a patient trying to alleviate severe pain may unintentionally develop a Fentanyl addiction. Also because of its great potency, Fentanyl is attractive to opioid addicts, especially to those who may have become tolerant to other opioids. Fentanyl may initially produce a powerful high, but then more is required to produce the desired effect. In any case, the result may be an addiction to Fentanyl. Note that some people will become addicted to Fentanyl without ever abusing it. In other words, they will only take it as directed by a doctor, but they can be completely addicted to the drug on a physical level. This person, if willing, can sometimes be weaned off the drug by a physician and not need further treatment.
However, once an addiction occurs it is difficult for the addict to avoid abusing Fentanyl, since prescribed amounts are insufficient. In addition, the tolerance to the drug continues to increase, which leads to ever more desperate measures to obtain the necessary quantities of the drug. This type of individual will typically need Fentanyl detox and rehabilitation to recover from the Fentanyl addiction. Fentanyl is cheap and easy to manufacture, which has resulted in a dramatic increase in illicitly manufactured versions of the drug. It is often made in China and shipped through Mexico. Most fentanyl involved in overdoses is manufactured by these illegal laboratories. Fentanyl is often mixed with heroin or cocaine to increase the effect of the drug. It can also be combined with heroin and sold as heroin. In addition, dealers are now making more money by disguising Fentanyl as Oxycontin or Percocet, which are usually more expensive and thus can be sold for more money. The drug in various formulations is also easy to get on the streets and online.
When an overdose of Fentanyl occurs, the affected individual will begin to experience impaired breathing and respiratory depression, which if not treated immediately can lead to death. Signs of a Fentanyl overdose often include:
- Difficulty in breathing
- Shallow breathing
- Cold or clammy skin
- Extreme sleepiness/sedation
- Inability to walk or talk normally
- Faint, dizzy or confused feelings
Anyone who displays the signs of a Fentanyl overdose needs immediate medical treatment. If you believe someone you know has overdosed on Fentanyl it is imperative to seek emergency medical attention immediately. Quick action can help prevent severe consequences such as unconsciousness and even death. If you are concerned or unsure about a Fentanyl overdose at all, make the call for emergency medical help. This is a case where it is better to be safe than sorry. Overdoses of Fentanyl should be treated immediately with an opioid antagonist. These medications act by blocking the effects of opiate drugs. They are highly effective and very quick-acting. Naloxone is one such antagonist, that is now readily available over-the-counter and without a prescription in many states. The prompt administration of Naloxone can save the life of a person who is experiencing a Fentanyl overdose.
A physical dependence or addiction Fentanyl, as with all opioid drugs, can be created through misuse of the drug but also sometimes with long term prescribed use. Once an individual has become addicted to Fentanyl, decreasing the dosage normally used will result in withdrawal symptoms that could be detrimental physically and mentally. Symptoms can vary from person to person depending on how long Fentanyl has been used and the amount normally consumed. Withdrawal symptoms will typically begin anywhere from 6 to 24 hours after the last use of the drug and can include the following:
- Hot flashes
- Loss of appetite
- Night sweats
- Rapid and/or shallow breathing
- Confusion, possible altered reality
- Muscle aches and pains
Those individuals who have used more potent doses of Fentanyl, or have used for longer periods of time, are likely to experience more severe Fentanyl withdrawal symptoms. Physiological and psychological complications often occur as the body withdraws from the powerful drug. Because of the potential severity of the symptoms, the withdrawal process should always take place under medical supervision. Withdrawal symptoms are usually the most uncomfortable in the first 1 to 2 days after discontinuing the use of the drug. Approved drugs exist to help alleviate symptoms experienced during withdrawal from Fentanyl, and sometimes these will be prescribed by a doctor to make the Fentanyl withdrawal process more comfortable. Fentanyl treatment programs have the necessary resources to safely and efficiently help an individual withdraw from the drug. These professional treatment programs should be utilized as part of the withdrawal and recovery process.
Fentanyl Addiction Treatment
Once a person has developed a Fentanyl addiction it’s extremely difficult, and often very dangerous, to try to stop on one’s own accord. Even if someone wants to stop, and tries to stop, the severe Fentanyl withdrawal symptoms detailed above ensure that at the very least the person will feel miserable. Often the user will use Fentanyl again, or some other available opioid drug, to avoid the intense withdrawal process. This can become a vicious cycle with the individual continuing to return to the drug to avoid the pain of withdrawal. And if the Fentanyl addict does not want to stop, obviously they will not even attempt the withdrawal process, because there is no motivation to do so. Often a “bottom” or some serious consequence needs to occur to drive the addict into treatment. Recall that the effects of abusing Fentanyl are very serious, including symptoms ranging from respiratory depression and nausea, to coma and even death from overdose. The good news is that those struggling with an addiction to Fentanyl can find recovery through Fentanyl Addiction Treatment. Recovery programs for Fentanyl addiction can vary and may be provided on an inpatient or outpatient basis. Both types of treatment often incorporate several steps, which may include the following:
- Safe and comfortable medical detox from Fentanyl
- Therapy (individual and/or group)
- Participation in 12-step recovery programs
- Fun sober activities
- Aftercare planning (such as assignment to high-quality sober living facilities)
The Oceanfront Recovery Fentanyl Addiction Treatment Program can help you or your loved one through the difficult and dangerous process of withdrawal and subsequent recovery from Fentanyl addiction. Our clinicians focus on bringing the underlying causes of addiction to the surface with a modern and effective recovery program in a closed setting. Contact Oceanfront Recovery today for a confidential assessment, and begin the journey of recovery from Fentanyl addiction today.