Fentanyl is a powerful synthetic opioid similar to morphine but is 50 to 100 times more potent.1,2
It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine typically used to treat patients with severe pain, especially after surgery.3 It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids.4 Tolerance occurs when you need a higher and more frequent amount of a drug to get the desired effects.
In its prescription form, fentanyl is known by such names as Actiq®, Duragesic®, and Sublimaze®.4,5.
Synthetic opioids, including fentanyl, are now the most common drugs involved in overdose deaths in the United States. In 2017, 59.8 percent of opioid-related deaths involved fentanyl, compared to 14.3 percent in 2010.
Opioids are a class of drugs naturally found in the opium poppy plant. Some opioids are made from the plant directly, and others, like fentanyl, are made by lab scientists using the same chemical structure (semi-synthetic or synthetic).
When prescribed by a doctor, fentanyl can be given as a shot, a patch on a person’s skin, or as lozenges that are sucked like cough drops.
The illegally used fentanyl most often associated with recent overdoses is made in labs. This synthetic fentanyl is sold unlawfully as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.
Some drug dealers mix fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. It takes very little to produce a high with fentanyl, making it cheaper. Fentanyl is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive. They might be taking more potent opioids than their bodies are used to and can be more likely to overdose. To learn more about the mixture of fentanyl with other drugs, visit the Drug Enforcement Administration’s Drug Facts on Fentanyl.
Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body’s opioid receptors, which are found in areas of the brain that control pain and emotions. After taking opioids many times, the brain adapts to the drug, diminishing its sensitivity and making it hard to feel pleasure from anything besides it. When people become addicted, drug seeking and use take over their lives.
Fentanyl’s effects include:
Yes, a person can overdose on fentanyl. An overdose occurs when a drug produces adverse severe effects and life-threatening symptoms. When people overdose on fentanyl, their breathing can slow or stop. An overdose can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can lead to a coma, permanent brain damage, and even death.
As mentioned above, many drug dealers mix the cheaper fentanyl with other drugs like heroin, cocaine, MDMA, and methamphetamine to increase their profits, making it often difficult to know which drug is causing the overdose. Naloxone is a medicine that can treat a fentanyl overdose immediately. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. But fentanyl is more potent than other opioid drugs like morphine and might require multiple doses of naloxone.
Because of this, if you suspect someone has overdosed, the most crucial step to take is to call 911 so they can receive immediate medical attention. Once medical personnel arrive, they administer naloxone if they suspect an opioid drug is involved.
Naloxone is available as an injectable (needle) solution and nasal sprays (NARCAN® and KLOXXADO®).
People who are given naloxone should be monitored for another two hours after the last dose of naloxone is granted to make sure breathing does not slow or stop.
Some states have passed laws that allow pharmacists to dispense naloxone without a personal prescription. Friends, family, and others in the community can use the nasal spray versions of naloxone to save someone from overdosing.
Read more in Naloxone DrugFacts.
Yes. Fentanyl is addictive because of its potency. A person taking prescription fentanyl as a doctor instructs can experience dependence, characterized by withdrawal symptoms when the drug is stopped. A person can be dependent on a substance without being addicted, but dependence can sometimes lead to addiction.
Addiction is the most severe substance use disorder (SUD). SUDs are characterized by compulsive drug seeking and drug use that can be difficult to control, despite harmful consequences. When someone is addicted to drugs, they continue to use them even though they cause health problems or issues at work, school, or home. A SUD can range from mild to severe.
People addicted to fentanyl who stop using it can have severe withdrawal symptoms that begin a few hours after the drug was last taken. These symptoms include:
These symptoms can be extremely uncomfortable and are why many people find it difficult to stop taking fentanyl. Medicines are being developed to help with the withdrawal process for fentanyl and other opioids. The FDA has approved lofexidine, a non-opioid drug, to reduce opioid withdrawal symptoms. Also, the NSS-2 Bridge device is a small electrical nerve stimulator placed behind the person’s ear that can ease symptoms for up to five days during the acute withdrawal phase. In December 2018, the FDA cleared a mobile medical application, reSET®, to help treat opioid use disorders. This application is a prescription cognitive behavioral therapy and should be used with treatment that includes buprenorphine and contingency management.
1. Volpe DA, Tobin GAM, Mellon RD, et al. Uniform assessment and ranking of opioid Mu receptor binding constants for selected opioid drugs. Regul Toxicol Pharmacol. 2011;59(3):385-390. doi:10.1016/j.yrtph.2010.12.007
2. Higashikawa Y, Suzuki S. Studies on 1-(2-phenethyl)-4-(N-propionylanilino)piperidine (fentanyl) and its related compounds. VI. Structure-analgesic activity relationship for fentanyl, methyl-substituted fentanyls and other analogues. Forensic Toxicol. 2008;26(1):1-5. doi:10.1007/s11419-007-0039-1
3. Nelson L, Schwaner R. Transdermal fentanyl: Pharmacology and toxicology. J Med Toxicol. 2009;5(4):230-241. doi:10.1007/BF03178274
4. Garnock-Jones KP. Fentanyl Buccal Soluble Film: A Review in Breakthrough Cancer Pain. Clin Drug Investig. 2016;36(5):413-419. doi:10.1007/s40261-016-0394-y
5. Drug and Chemical Evaluation Section, Office of Diversion Control, Drug Enforcement Administration. Fentanyl Fact Sheet. March 2015. http://www.deadiversion.usdoj.gov/drug_chem_info/fentanyl.pdf.
6. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108(3):776-789.
7. Drug and Chemical Evaluation Section, Office of Diversion Control, Drug Enforcement Administration.
8. Acetyl fentanyl Fact Sheet. July 2015. http://www.deadiversion.usdoj.gov/drug_chem_info/acetylfentanyl.pdf.
Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.
VOTC, Inc. is NOT a detoxification facility. However, once an individual receives detoxification services and is on MAT (Medically-Assisted Treatment), they can be admitted into one of our Residential SUD Treatment Programs.
If you are struggling with an opiate use disorder, here are our recommendations:
1.) Empire Recovery
2.) Mercy Hospital Bridge Program