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Fentanyl – Use, Addiction, Withdrawal, Overdose and Detox Options

What is Fentanyl?

Fentanyl (Duragesic®, E-TRANS® Fentanyl) is a powerful synthetic opioid stronger than Morphine. It is one of the most potent opioid analgesics. Much like Heroin, opioids, and other drugs, Fentanyl acts upon specific receptors in your brain and spinal cord to decrease the feeling of pain and to reduce your emotional response to pain. This drug comes in many forms, such as a patch, lollypop, and the traditional pill. This Schedule II controlled substance was introduced in the 1960s as an intravenous anesthetic under Sublimaze’s trade name. Chemical formula:

  • C22H28N2O∙ C6H8O7 – Fentanyl Citrate

Brand Names:

  • Abstral
  • Actiq
  • Duragesic
  • Fentora
  • Onsolis

Like Heroin, this drug acts on receptors in the brain to reduce pain and create a euphoric state. It also has a noticeably lesser euphoric effect than Heroin. However, as a sedative, it is 50 to 100 times stronger than morphine. The FDA warned that Fentanyl is “only intended for treating persistent, moderate to severe pain in patients who are opioid-tolerant.” When those who are not opiate-tolerant take this drug, there is a very high chance of overdose. The FDA defines opiate tolerance as those who take “regular, daily, around-the-clock narcotic pain medicine.” Additionally, those who are more “resistant to the dangerous side effects of narcotic pain medications than patients who occasionally take these drugs.”

Fentanyl is a Schedule II controlled substance.  A study by the Division of Public Health Sciences, Wake Forest University School of Medicine, and the Institute for Safe Medication Practices showed that this drug was the second most dangerous drug on the market and had the second-highest rate drug-related deaths.

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What is Fentanyl Used for?

Doctors typically prescribe Fentanyl to treat severe pain, manage pain after surgery, or treat those suffering from chronic pain. However, patients who express great physical tolerance to opiates also use this drug. The patch’s introduction was in the mid-1990s to provide slow-release pain relief over a 48 to 72-hour period. This drug also comes in lozenge form (Actiq) for fast-acting relief of breakthrough pain. Furthermore, because this drug can be habit-forming and has a high potential for abuse in all its forms, the U.S. Food and Drug Administration has issued public health alerts regarding its use. The patch comes in five sizes, delivering between 12.5 and 100 micrograms per hour. The lozenges are berry-flavored lollipops that dissolve slowly in the mouth and are intended for opiate-tolerant users. It is available in six dosages, from 200-1600 micrograms.

This drug comes as a transdermal patch, lollipop, or in traditional pill form. It can also be injected into a muscle or given intravenously by a medical professional. Frequently, people take Fentanyl orally, but like heroin, they can smoke, snort, and inject it. Besides, on the black market, drug dealers mostly sell it in a patch form. Users can cut up or eat the patch, and they can even extract the gel from the inside to smoke it.

What are the risks of taking Fentanyl?

The FDA said the transdermal patch is “only intended for treating persistent, moderate to severe pain in patients who are opioid-tolerant, meaning those patients who take a regular, daily, around-the-clock narcotic pain medicine.” The agency received several reports of deaths and life-threatening side effects despite a July 2005 advisory that emphasized safe use. The FDA said some doctors prescribe the patch inappropriately for pain following surgery, headaches, and occasional or mild pain. FDA reports have shown that some patients misuse the patch by replacing it more frequently than prescribed or applying a heat source to the patch, causing a dangerously high drug level in the bloodstream.

This drug has similar biological effects to heroin but is thought to be a stronger sedative and much more potent than street heroin. Furthermore, some heroin dealers mix this drug with low-grade heroin to add bulk and make it more powerful. A combination of Fentanyl with either cocaine or heroin has caused an outbreak of overdoses in different parts of the country.  Regular users may quickly become addicted.

Fentanyl Side Effects

Side effects may include:

  • diarrhea
  • nausea
  • constipation
  • dry mouth
  • confusion
  • sweating
  • abdominal pain
  • a headache
  • fatigue
  • weight loss
  • dizziness
  • hallucinations
  • anxiety
  • depression
  • flu-like symptoms

In 2006, the FDA began investigating several respiratory deaths linked to the use of this drug.  Because the effects are 50 to 100 times stronger than morphine when used by people who are not tolerant of opioids, the consequences can be dire. Even those with tolerance are at risk of an overdose when improperly used.

Some medications can interact with this drug to cause Serotonin Syndrome; this is mainly the case for SSRIs and other antidepressant medications. Moreover,  even when taken as directed by a doctor, patients using the patch have suffered the effects of “leaky” patches. A leaky patch will release the medication much more quickly than the desired 72 hours, causing an accidental overdose. In 2004, there was a recall of 2.2 million defective Duragesic patches.

More details on Fentanyl Side Effects.

Fentanyl Withdrawal Symptoms

Faced with the mounting emotional and physiological risks that dependence brings, many people began searching for the best substance abuse treatment available. Many have tried to quit independently but could not handle the distress caused by the withdrawal symptoms. The extreme discomfort of acute opioid withdrawal can become too difficult and sometimes too risky for a person to bear. As a result, relapse during this challenging phase is quite common.

Withdrawal symptoms may also include:

  • Chills
  • Anxiety
  • Extreme restlessness
  • High blood pressure
  • Insomnia
  • Irritability
  • Muscle and bone pain
  • Nausea
  • Stomach pains
  • Sweating
  • Watery eyes

More details on Fentanyl Withdrawal Symptoms.

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Tolerance and Dependence

Medical professionals still consider opioids to be the most potent and effective drugs available to treat pain. They naturally bind to the mu-opioid receptors throughout the brain and spinal cord and are responsible for reducing or inhibiting pain symptoms.  The abuse of opioid drugs causes euphoria in an area of the brain known as the nucleus accumbens. This euphoria becomes repeatedly craved by the user and often the reason for developing dangerous and compulsive drug use.

Physical tolerance to the drug quickly develops because of a continued use pattern that decreases the drug effects’ response and its active duration. As a result, the patient begins to need higher doses to achieve the same original effect. This repeated pattern often results in a combination of physical and emotional negative consequences.  With the limitation or prevention of access to the drug, the emergence of panic, anxiety, and irritability becomes prevalent. At this point, one will notice signs of dependence and addiction. After realizing that dependence and addiction are present, the next step is to identify the most effective drug treatment available.

Fentanyl deaths affect all parts of our society. Rolling Stone Magazine discusses how this drug was responsible for the death of Prince and Tom Petty.

Fentanyl Addiction Treatment

Withdrawal without adequate medically-assisted detoxification is very uncomfortable and can also be potentially dangerous for the patient. Inpatient medical monitoring during detoxification is essential to minimize the risks of relapse and possibly a fatal overdose. People with a history of opioid dependence may additionally be dealing with different known and unknown health issues. Therefore, this warrants the consideration of close medical supervision and an individualized treatment plan.

Waismann Method®, located in Southern California, is the forerunner in advancing medical opiate detoxification and rapid detox for over 22 years. Furthermore, this commitment to providing opiate-dependent patients results is just as strong today as over two decades ago. Our physicians and staff fully commit. Not only to provide the best opiate detox available but also for patient safety and comfort. Additionally, we strive to ensure we maintain the highest level of professional standards. Ultimately, we treat our patients in a compassionate, dignified, and private manner.

We provide our patients with superior medical care, individualized attention, quadruple board-certified medical director, facility credentials and our exclusive, comprehensive and private recovery retreat.

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