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America’s Killer New Drug​: A Guide to Fentanyl

Fentanyl is a synthetic opioid chemically similar to other substances like hydrocodone, oxycodone, heroin, and morphine. In recent years, fentanyl has played an increasingly prominent role in the opioid crisis, alongside other prescription medications like Dilaudid. Synthetic opioids are the most common drugs responsible for overdose deaths. In 2010, fentanyl was involved in 14.3% of drug overdose deaths. However, by 2017, fentanyl use accounted for nearly 59% of opioid-related deaths.

Fentanyl was created in 1959 and began being manufactured and distributed in the United States throughout the 1960s. Its original use was as an intravenous medication to treat cancer pain. According to the Drug Enforcement Administration (DEA), fentanyl’s pain-relieving properties are about 100 times more powerful than morphine’s and 50 times more potent than heroin’s.

Fentanyl as a Prescription Medication

To obtain fentanyl legally, a prescription from a doctor is required. Fentanyl is only prescribed to patients experiencing severe pain from cancer and who have developed a physical tolerance to other opioids. Building a tolerance means that a person’s body has gotten used to the drug and requires higher and/or more frequent doses to relieve the pain.

Fentanyl should not be used to treat any other types of pain, especially pain caused by migraines, headaches, an injury, or pain from a medical or dental procedure. Its primary purpose is to treat sudden episodes of pain that occur despite ongoing continuous pain management with other medications. Prescription fentanyl can be taken as an oral lozenge, sublingual tablet or spray, skin patch, nasal spray, or injection.

Fentanyl as an Illegal Street Drug

Fentanyl sourced on the street is often produced illegally in a lab. However, there have been documented cases of distribution through other pathways, including theft and fraudulent prescriptions. Patients, physicians, and pharmacists have also been complicit in contributing to fentanyl’s unlawful circulation. There are several ways fentanyl is misused.

The gel contents of patches can be removed and injected or ingested. Patches can also be frozen, cut into pieces, and put under the tongue or between the gums and cheek. Street-bought fentanyl is sold in similar forms as its prescription counterpart. However, it can also come as a powder, in eye droppers, on blotter papers, and in pills that look like prescription opioids.

On the street, it may be called:

  • Apache
  • China Girl
  • China Town
  • Dance Fever
  • Friend
  • Goodfellas
  • Great Bear
  • He-Man
  • Jackpot
  • King Ivory
  • Murder 8
  • Tango & Cash

What Effects Does Fentanyl Have? 

Besides being very effective at relieving pain, fentanyl causes sensations similar to those produced by other opioid analgesics like morphine: relaxation and euphoria. These are the effects that individuals who use fentanyl illegally are looking to achieve. Some negative side effects of use can include:

  • Nausea
  • Vomiting
  • Sedation
  • Dizziness
  • Confusion
  • Drowsiness
  • Constipation
  • Urinary retention
  • Unconsciousness
  • Constricted pupils
  • Problems breathing
  • Respiratory depression

What Happens When Fentanyl Is Misused? 

Two key conditions can result from the misuse of fentanyl: overdose and addiction. An overdose can occur when too high of a dose of the drug is taken, resulting in life-threatening symptoms like hypoxia. Hypoxia occurs when the brain does not receive enough oxygen, in this case, because a person’s breathing has slowed down or stopped. Hypoxia can cause a person to fall into a coma, suffer permanent brain damage, and die.

Coma, pinpoint pupils, and respiratory depression are strong indicators that a person may be experiencing an opioid overdose and requires emergency medical care. Other signs and symptoms of a fentanyl overdose can include:

  • Stupor
  • Dizziness
  • Confusion
  • Cold and clammy skin
  • Drowsiness or sleepiness
  • Being unable to respond or wake up
  • Bluish discoloration of the skin

Naloxone, also known as NARCAN®, is used to reverse the effects of opioids and can save a person from dying from an overdose. Because fentanyl is so strong, multiple doses may be required for its lifesaving effects to occur.

What Makes Fentanyl So Dangerous?

Fentanyl is a powerful drug, even in very small quantities. Its potency is what makes the possibility of overdose so high. Another major problem with illegal fentanyl is that it is being mixed with other drugs like cocaine, meth, heroin, and MDMA. A person looking for a party drug might end up using fentanyl for the first time without knowing it and accidentally overdose.

Like other opioid painkillers, a person that misuses fentanyl can become addicted. Fentanyl binds to opioid receptors in the brain that are associated with pain and emotions. The brain quickly becomes used to the drug and requires more to achieve euphoria. Additionally, users will begin to suffer withdrawal effects after their high wears off. Once addicted, an individual becomes consumed with seeking out and using the drug, despite the negative consequences their behavior has on their lives and those around them.

How Is Fentanyl Addiction Treated?

Before entering residential treatment, fentanyl addiction may first require medical detox. After withdrawing safely, addiction therapy will likely include a combination of medication and behavioral therapy.

Three medications commonly used to treat fentanyl addiction are buprenorphine, methadone, and naltrexone. Like fentanyl, buprenorphine and methadone bind to opioid receptors in the brain, but they can be used in therapeutic doses to help reduce cravings and lessen withdrawal symptoms. Naltrexone works differently. Instead of binding to the receptors, it blocks them so fentanyl won’t have any effect.

What Behavioral Therapies Help With Fentanyl Addiction?

Behavioral therapies used to treat fentanyl and other opioid addictions include cognitive behavioral therapy (CBT), contingency management, and motivational interviewing. CBT is based on the idea that one’s thoughts, feelings, and behaviors are connected. CBT can modify distorted thought patterns and improve emotional regulation.

Contingency management is also called the “prize method” or the “carrot and stick method.” This approach to addiction therapy is based on the idea that behavior can be shaped by enforcing consequences. Positive behaviors, like passing drug tests or meeting treatment goals, are reinforced by offering rewards. The goal of contingency management is to encourage healthy living.

Motivational interviewing is a process by which a therapist helps enhance a client’s motivation to change negative behaviors regarding substance use. A vital component of this therapy is that the client must want to want to change and improve their lives.

These behavioral treatment approaches are effective at treating opioid addiction, especially when used in combination with medication. You can learn more about addiction therapies at Laguna Shores here.

Fentanyl is a highly potent prescription medication that comes with a high potential for abuse. Overdose is an increasingly common occurrence with synthetic opioids like fentanyl. At Laguna Shores, we understand how hard it can be to get off this addictive drug. Call us today at (866) 229-9923 to change your life.