Fentanyl Addiction Treatment

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What is Fentanyl?

Fentanyl is a painkiller prescribed for acute, chronic or long-lasting pain. Fentanyl is an opioid, meaning it is a synthetic compound that mimics the effects of opiates, derived from the opium poppy flower. Known as one of the most powerful opioid substances in use, fentanyl can be 10,000 times stronger than morphine. In fact, a very similar substance called Carfentanil is used as an anesthetic for elephants and other large animals. Misuse of fentanyl and other prescription opioids can result in dependency, abuse and addiction. It can be prescribed as an adhesive skin patch, as a sublingual spray, as a dissolvable lozenge or in pill form. Duragesic, Actiq and Fentora are some of the brand names for prescription fentanyl.

Fentanyl is a controversial medication for its role in the recent and ongoing opioid epidemic. Fentanyl is often prescribed to patients dealing with difficult chronic pain problems for around-the-clock pain management, however, it should only be prescribed for acute pain in non-cancer pain patients. If the correct dosage of fentanyl has not yet been discovered by one’s doctor, its pain-relieving effects could wear off and leave the patient in pain, presenting the risk of self-medicating with additional doses. Fentanyl is a Schedule II controlled substance for its highly addictive properties, so any use of it outside of a doctor’s instructions is dangerous and even fatal.

Unfortunately, fentanyl is sold on the street to those who can no longer get a prescription, under names such as Apache, China girl and Goodfella. Fentanyl has also been produced synthetically outside of pharmaceutical companies, often in laboratories in China. This illicit fentanyl is smuggled into the US, sometimes even by mail, because just a few micrograms can have the same effect as several grams of heroin or morphine. Other opioids are sometimes cut with fentanyl or even carfentanil to create more potent effects, which has led to devastating numbers of overdoses and deaths.

Fentanyl side effects and dangers

When treating chronic pain with fentanyl, there are common side effects even when taking it correctly. Fentanyl side effects include:

  • Nausea
  • Vomiting
  • Drowsiness
  • Dizziness
  • Insomnia
  • Constipation
  • Excessive sweating
  • Fatigue
  • Loss of appetite

Fentanyl use crosses the line into abuse and addiction when it is misused. One of the most important aspects about this prescription is its purpose for treating chronic pain around-the-clock for a defined period. It is never meant to be taken “as needed.” If your current fentanyl dosage is not providing effective relief, it is important to talk to your doctor about what to do, instead of self-medicating with additional doses.

There are serious risks to fentanyl misuse. Sharing, giving away or selling fentanyl is against the law because of its dangerous medical consequences. Prescriptions are filled for specific doses tailored to specific people, and this can have adverse reactions in others. Taking too much fentanyl can result in almost immediate overdose and death.

Fentanyl overdose symptoms include:

  • Difficulty breathing
  • Sleepiness progressing to stupor or coma
  • Cold and clammy skin
  • Constricted pupils
  • Fluid in lungs
  • Low blood pressure
  • Partial/complete airway obstruction and atypical snoring
  • Death

These symptoms can be deadly if not treated immediately.

The path to serious misuse and abuse of fentanyl can begin when the desired effect is the high produced by the drug. People seeking a fentanyl high may snort or inject the tablet’s contents for more immediate effects. Users of the fentanyl patch may increase its effects by heating the patch site (patients are advised against direct sunlight or saunas) or by chewing the patch. Any of these methods can result in fentanyl overdose, especially when the prescription was filled for a different person with different medical needs.

If a person seeking fentanyl is still unable to access the drug, they may buy them illegally from drug dealers. Because this fentanyl is not controlled by a pharmacy, it frequently contains unknown and harmful ingredients. Fentanyl is cheaper and more potent than heroin, and people who buy heroin and other opiates may unknowingly be purchasing substances laced with fentanyl.

Fentanyl abuse and addiction signs

Any use of fentanyl outside of a doctor’s instructions is considered drug abuse. This includes tampering with fentanyl pills by chewing, crushing, cutting or dissolving them in order to ingest, snort or inject a higher dose than prescribed. Other examples include heating or chewing the fentanyl patch. Even if the fentanyl prescription not tampered with, taking more fentanyl than prescribed is also abuse of the drug.

Fentanyl addiction signs include:

  • Taking more than the prescribed dosage
  • “Doctor shopping” for multiple prescriptions
  • Tampering with fentanyl before taking it
  • Taking fentanyl in any way other than as prescribed

Opioid withdrawal symptoms and treatment

It is possible to develop a physical dependency on opioids like fentanyl, which should be discussed with your doctor. A physical opioid dependency occurs when the body adjust to the presence of the medication and depends on that medication to function normally. A fentanyl prescription can include dosing instructions from your doctor to taper off the dosage to reduce and eliminate this physical dependency. This type of medication management is important those who are physically dependent on fentanyl will experience withdrawal symptoms if they stop their fentanyl prescription too suddenly. If the withdrawal symptoms are extreme, they could drive the patient to continue using the substance despite significant harm – the definition of addiction.

Opioid withdrawal symptoms can include:

  • Restlessness
  • Yawning
  • Sweating
  • Tearing eyes
  • Runny nose
  • Chills
  • Muscle and back aches
  • Nausea
  • Loss of appetite
  • Vomiting
  • Diarrhea
  • Irritability, anxiety
  • Dilated pupils
  • Increased blood pressure, heartbeat, or breathing

These problems vary in severity and duration depending on the specific fentanyl dose and duration of use.

Opioid withdrawal stabilization, also known as detoxification or detox, is usually done in a similar way as other opiate treatment. In general, the opioid withdrawal stabilization procedures resemble those used for withdrawal from sedatives: longer-acting opioids are substituted for shorter-acting ones and the patient is stabilized on the longer-acting opioid medication, such as Suboxone. The patient will be most uncomfortable during the first one to three days of the opioid withdrawal phase, so a combination of clonidine (an alpha-adrenergic agonist), a sedative such as phenobarbital, and a nonsteroidal anti-inflammatory such as Motrin (generic name ibuprofen) is frequently combined with the longer-acting opioid to help make the patient more comfortable for the first two to three days of the conversion to Suboxone. Usually after day three of the correct dose of Suboxone, a patient’s opioid withdrawal symptoms and cravings have almost completely subsided.

Opioid addiction treatment options

Most opioid users need help getting clean and require residential drug treatment. Few people can safely stop using without a certified detoxification and evidence-based addiction treatment program.

Withdrawal and recovery from opioid addiction is most effectively accomplished under the supervision of board-certified medical professionals, who are able to assist with the intense cravings for the drug, along with dangerous withdrawal symptoms, such as disturbed sleep patterns, high blood pressure, abnormal heart rate, nausea, vomiting and diarrhea, muscle aches and flu-like symptoms.

Typically, opioid addicts go through a detoxification program – or opioid withdrawal stabilization – before beginning a long-term treatment program. Patients can be prescribed anti-addiction medications to lessen the opioid withdrawal symptoms.

The drug and alcohol detox process alone is not a cure for opioid addiction. A comprehensive, personalized addiction treatment program, like the program at Enterhealth, is crucial for a successful recovery. A combination of therapeutic and pharmacological addiction treatment can help those with opioid addiction regain a stable and productive life and address the underlying issues creating the desire to use. Research shows that integrating both types of treatment is the most effective approach to restoring a degree of normal function to the brain – and provide a more positive, life-long outcome.

Effective behavioral treatments for opioid addiction can be administered in a residential or outpatient setting after withdrawal stabilization. A treatment plan may include:

  • Individual counseling
  • Group therapy
  • Family therapy sessions
  • Intensive Outpatient Programs (IOP)
  • Wellness, nutritional and stress management treatment services

Anti-addiction medications approved for the treatment of fentanyl addiction work through the same opioid receptors in the brain that fentanyl affects. Medications such as Suboxone (buprenorphine) and Vivitrol (naltrexone), block the effects of opioids, reduce cravings and allow healing to continue. These medicines treat opioid addiction through the same receptors as the addictive drug, but are safer and less likely to result in addiction.

Opioid addiction recovery with Enterhealth

People suffering from opioid addiction may feel hopeless, but they are not alone. Enterhealth Ranch and Enterhealth Outpatient Center of Excellence can help you or a loved one begin recovery at our 43-acre residential opioid addiction treatment center just north of Dallas-Fort Worth in Texas, and our outpatient opioid addiction treatment center located in the Preston Center area of Dallas.

At Enterhealth, our goal is to treat the whole person for a lifetime. We offer a better chance to recover through our advanced, evidence-based treatment approach, designed and administered by board-certified addiction psychiatrists, physicians and other experts, that is proven to be more effective than traditional twelve-step approaches.