We all have seen the headlines about the current opioid crisis in America. Whether prescription, illegal, or illegally manufactured prescription drugs, tens of thousands of Americans die every year from opioid related overdoses. One of the drugs at the center of this crisis is fentanyl. The rates of overdose deaths involving fentanyl and fentanyl analogs increased by over 16% from 2018 to 2019. These rates accelerated in 2020 due to the COVID-19 pandemic. A significant factor which contributed to the rise of fentanyl overdose deaths in America is a lack of awareness among the public about the drug, how addictive it is, and the symptoms associated with a fentanyl overdose. To do our part to help fight against the opioid crisis, we here to provide answers to your questions about fentanyl and what you can do to help those closest to you who suffer from opioid addiction.
What is fentanyl?
Fentanyl is a synthetic opioid most commonly found in prescription painkillers such as Actiq, Duragesic, and Sublimaze. Typically given as a shot, a patch, or a lozenge to patients for pain relief before and after surgery, it also is used to help mitigate pain in cancer patients. For people who suffer from chronic pain and already have a narcotic pain treatment plan, fentanyl is used to treat flare-ups of intense pain or when they become tolerant to other, weaker opioids.
How does it work?
Fentanyl works in a similar way to morphine. It blocks pain receptors in the brain and increasing the production of dopamine – the happiness-inducing brain chemical. Because fentanyl is highly addictive, a program has been set up to decrease the risk of addiction. First, your doctor needs to be enrolled in the national program to prescribe fentanyl, and your prescription has to be filled at a pharmacy also enrolled in the program. Your doctor will talk to you about the risks and benefits associated with fentanyl, as well as how to safely use, store, and dispose it. After you have been given this information and all your questions are answered, you will sign a form acknowledging that you have received the information, understand the risks, and will follow your doctor’s instructions about how to use it safely. Your doctor will then send this form to the national program and you will be able to receive your prescription. Do not use fentanyl more than four times a day. If your pain persists, call your doctor to adjust your pain management regiment.
Are there any side effects?
People who are given fentanyl experience feelings of extreme happiness. However, they also can experience negative side effects like drowsiness, nausea, confusion, constipation, sedation, problems breathing, and periods of unconsciousness while using it. The negative effects are mitigated by health professionals who closely monitor patients and their pain levels while under their care. Taking certain medications with fentanyl can also increase the chances of developing serious or life-threatening problems. Be sure to tell your doctor about any other drugs or herbal supplements you are taking before taking fentanyl for pain management. If you develop unusual dizziness, lightheadedness, extreme sleepiness, difficulty breathing, swelling of the limbs, insomnia, or sudden reddening of the face, neck, or upper chest, call your doctor immediately or seek emergency medical care. Be sure your caregiver or family member know about these symptoms and what to do if you being experiencing them or become unresponsive.
Is fentanyl illegal?
When prescribed by a medical professional, fentanyl is a legal drug. While it has similar effects to morphine, fentanyl is 50-100 times more potent. This increased potency makes is much more addictive and increases its desirability on the illegal drug market. Illegal forms of fentanyl are known as Apace, China Girl, China White, Dance Fever, Goodfellas, He-Man, among others. They are administered as powders either dropped onto blotter papers and dissolved on the tongue, mixed into eye drops or nasal sprays, or in pill form. The ease and low cost of fentanyl manufacturing makes the drug attractive on the illegal drug market and had led to an increase in production. Not only is fentanyl sold on its own, it also is mixed with other drugs like heroin and/or cocaine to increase the potency and addictiveness of the drugs. Many people who buy these drugs are unaware that fentanyl has been mixed in. This dangerous practice and lack of awareness among users has led to higher rates of overdose and death.
Why is fentanyl addictive?
Fentanyl is highly addictive because it blocks the pain receptors in the brain and creates euphoric feelings in users. Its potency intensifies these feelings and causes users to seeking stronger doses as they build up a tolerance over time. People using fentanyl can also experience withdrawal symptoms such as muscle and bone pain, sleep problem, cold flashes, uncontrollable leg movements, severe cravings, diarrhea, and vomiting as early as a few hours after they have taken their last dose. The short amount of time between euphoric high and miserable withdraw symptoms leads people to use the drug more frequently and in higher doses.
Because it is prescribed by medical professionals, many people are unaware of fentanyl’s addictiveness. This lack of awareness leads to a higher likelihood for accidental or intentional abuse. If you are concerned that someone close to you might be struggling with an addiction to fentanyl, there are several red flags you can look for in their behavior. These include:
- Ignoring commitments and responsibilities
- Unexplained absences
- Sudden mood swings and changes in behavior
- Unusual lack of motivation
- Problems at work, school, or at home
- Lapses in concentration or memory
- Withdrawal from normal social contacts
- Weight loss or changes in physical appearance
- Being oddly secretive about parts of their personal life
- Drastic changes in sleeping patterns
It is important to remember that everyone is different and it might be harder to detect an addiction in some people than it is in others.
What are the signs of a fentanyl overdose?
It is vitally important to recognize the signs of an overdose because time is of the essence to save someone’s life. Signs of an overdose include:
- Pinpoint pupils
- Breathing slows or stops
- Blue lips, fingernails, and a blueish purple skin tone (for lighter skinned people) or a grayish or ashen skin tone (for darker skinned people)
- A slow, erratic, or non-existent pulse
- Awake but unable to talk
If someone is showing any of these symptoms call 911 immediately and report a drug overdose. While you wait for medical help to arrive, try to rouse the person by speaking loudly and rubbing your knuckles vigorously up and down their sternum. Make sure the person is breathing and if they are not, administer rescue breathing (mouth-to-mouth), then turn them on their side once they resumed breathing on their own. Whatever you do, do not leave the person until medical help has arrived.
How to treat a fentanyl overdose? One way to treat a fentanyl overdose is to administer naloxone if you have it with you and know how to administer it. During the recovery process, medical professionals will prescribe drugs like Suboxone to help mitigate withdrawal symptoms and suppress fentanyl cravings. These drugs, combined with in/out patient therapy, group support, and counseling are vital steps on the recovery process to overcoming a fentanyl addiction.