Addiction to opioid pain medications has been all over the news in recent months. Medical professionals, addiction specialists, and politicians have all expressed concern that opioid drug abuse has turned into an epidemic in the United States and are taking steps to address the issue.
One of the most dangerous and addictive opioids on the market is fentanyl. If you have a loved one who’s taking fentanyl and you’re worried that they might be abusing it, it can be extremely stressful.
The signs and symptoms of fentanyl abuse are not as easy to spot as those of alcoholism and some other addictions. We get a lot of calls at Alpine Recovery Lodge about fentanyl abuse – so let’s talk about the signs and symptoms to help you determine whether you or a loved one has a problem with this dangerous drug.
What Is Fentanyl?
Fentanyl is an opioid drug. Opioids may be natural or synthetic. The natural drugs in this category are derived from the poppy plant. They are most commonly used for pain relief. Some well-known opioids include legal prescription drugs such as oxycontin, codeine, and morphine, as well as the illegal drug heroin.
Fentanyl is a synthetic opioid that doctors prescribe for breakthrough pain. When a patient has been taking opioid drugs for some time and develops a resistance to them, fentanyl is often the drug chosen to help them manage their pain.
Most fentanyl prescriptions take one of the following forms:
- Skin patch
- Dissolvable pill
- Dissolvable tongue film
In structure, fentanyl is similar to morphine. It’s considered a Class II drug. It’s sold under the brand names Actiq®, Duragesic®, and Sublimaze®. Because of its strength, it is sometimes sold on the street under names like China White, Jackpot, and TNT.
How Does Fentanyl Compare to Other Opioid Drugs?
Any opioid drug can be addictive, but there are some things that make fentanyl different from its relatives.
First, fentanyl is very strong. It’s 50 to 100 times stronger than morphine and 30 to 50 times stronger than heroin. Most people understand that heroin is dangerous, yet view a prescription medication like fentanyl as being safe because a doctor prescribes it.
In fact, fentanyl is so strong that even inhaling it can cause dizziness and shortness of breath. It acts on the brain in the same way that other opioids do, so its strength is what sets it apart from the other opioid drugs.
Why is Fentanyl Dangerous?
Opioid drugs are addictive because of the way they act on the brain. More specifically, they act on opioid receptors in the brain and spine to reduce feelings of pain.
Pain relief alone would not be enough to make these medications addictive. The reason they can be dangerous is that they affect parts of the brain that stimulate emotion. When it comes to reducing pain, this effect can be a good thing because it makes the patient less receptive to pain signals.
However, opioids also affect the reward center of the brain. In some patients, taking drugs like fentanyl can create a sense of euphoria. Thus, even patients who take opioids as prescribed have a chance of becoming addicted to them.
Fentanyl is a powerful drug, but its effects don’t last very long. That’s another reason that it’s highly addictive – people may feel the need to use fentanyl at quicker intervals to keep the euphoria feeling and the pain away. If they take it this way , their bodies will begin to develop a tolerance that can lead to increased usage.
The most dangerous aspect of fentanyl is how small one dose can lead to lethal consequences. You know that heroin can be lethal in high enough doses, but fentanyl is much worse. To give you an idea of why fentanyl can be dangerous, we will compare the lethal doses of the two drugs:
- A lethal dose of heroin is approximately 30 milligrams
- A lethal dose of fentanyl is only 3 milligrams
A fentanyl addiction is dangerous because the difference between a safe dose and a lethal one is miniscule. Someone who isn’t aware of the thin margin between safety and death could easily take too much fentanyl and overdose.
Symptoms of Fentanyl Addiction
A person who has developed an addiction to fentanyl will most likely show physical symptoms from their addiction. If you suspect that someone you care about has a problem with fentanyl, here are some of the symptoms to look for:
- Constricted pupils (pupils are smaller than usual)
- Noticeable elation or euphoria (due to the stimulation of the reward center of the brain)
- Persistent drowsiness or sedation (a tendency to sleep more than usual or want to sleep at strange times)
- Confusion or mental fog (losing track of important information; difficulty focusing)
- Constipation (most opioid drugs cause stool hardening or constipation that can be painful and even debilitating)
- Slowed breathing (opioids slow respiration and very slow respiration can be a symptom of addiction)
- Nodding off or losing consciousness (people taking heavy doses of opioids may fall asleep in the middle of a conversation or pass out)
A person who takes opioid medication for pain may have some of these symptoms even if they are not addicted. However, the presence of severe symptoms should be viewed as a red flag that the person may have a problem.
Behavioral Signs of Fentanyl Addiction
In addition to the physical symptoms listed in the previous section, people who abuse opioid drugs may also demonstrate behavioral changes that can alert their loved ones to the problem. Here are some signs that your loved one might be addicted to fentanyl:
- Money shortage or financial problems. Fentanyl is expensive and may be even more expensive if the person in question is buying it on the street.
- Doctor shopping. It’s very common for people with opioid addictions to shop for doctors in the hopes that if one doctor won’t give them the drugs they want, another one will. Doctors are aware of the dangers of fentanyl and are cautious about prescribing it.
- Pharmacy shopping. Just as doctors operate carefully with fentanyl, the same is true of pharmacists. An alert pharmacist or pharmacy technician would notice if a person came into their pharmacy with fentanyl prescriptions from two (or more) doctors. A person with an addiction might frequent pharmacies in different locations (and different chains) to avoid detection.
- Extra pill bottles. People who are abusing fentanyl may have more pill bottles than they should. If you notice that your loved one has extra pill bottles lying around or in the trash, you should be concerned.
- Mood swings and irritability. People who are struggling to hide an addiction to fentanyl can get angry and irritable if they are questioned about it. It’s common for addicts to react defensively when they feel their addictive behavior has been noticed.
- Social withdrawal and isolation. A person who has an addiction to fentanyl may withdraw from social activities and avoid friends and family members. It may be difficult for them to hide the signs of their drug abuse and it’s easier for them to choose solitude over company.
Other signs may include the appearance of new friends and acquaintances, a change in appearance or body odor, secretive behavior, and nervousness.
The nature of addictive behavior is that it encourages secret-keeping. If your loved one demonstrates a significant change in their personality, grooming, and behavior, it might be a sign that they have an addiction.
What happens when someone who has an addiction to fentanyl can’t get the drugs they want? The simple answer is that they will exhibit signs of fentanyl withdrawal:
- Runny nose and watery eyes
- Stomach cramps
- Body hair standing on end
- Joint and muscle pain
Withdrawal symptoms usually begin between 12 and 30 hours after the last dose of fentanyl was taken. It may take longer – up to 72 hours – if the person was using a fentanyl patch.
Because of fentanyl’s strength, cold turkey withdrawal is not recommended. However, if an addict runs out of money or can’t get access to more fentanyl, the withdrawal symptoms may be unavoidable.
Opioid withdrawal symptoms are painful and for that reason, addiction specialists usually recommend a tapering of fentanyl use. Sometimes patients are given another opioid drug as an interim measure, getting increasingly lower doses as time goes on.
What to Do If You Know Someone Who’s Addicted to Fentanyl
Now that you know the signs and symptoms of fentanyl abuse, you’re probably wondering what the next step is. If you or someone you know has an addiction to fentanyl, the time to act is now. As we mentioned, fentanyl addiction is exceedingly dangerous due to the low lethal dose.
At Alpine Recovery Center, we have extensive experience helping people who have developed addictions to fentanyl and other prescription drugs get on the road to recovery. Contact us if you’d like to learn more about our program or talk to someone about your loved one.