After injecting herself with a bag of drugs, Nicki barely had enough time to remove the needle. All she remembers is waking to the sound of paramedics frantically working to revive her. Unbeknownst to Nicki, the bag of heroin she purchased had been cut with a deadly synthetic opioid called fentanyl.
After her overdose — even though she had been addicted to heroin for the past decade — Nicki regrettably came to realize that no other drug could remove the ugly pain of withdrawal with the exception of more fentanyl. And everywhere she looked, it seemed, someone was selling it.
Fentanyl has made America’s opioid epidemic, already the deadliest drug overdose crisis in U.S. history, even deadlier. The U.S. Centers for Disease Control and Prevention reports that drug overdose kills more Americans — 70,000 in 2017, a record — than HIV, automobile accidents and gun violence. The data also suggest that fentanyl has been involved in most of these overdoses. Since 2013, the number of overdose deaths associated with fentanyl and similar drugs has grown to more than 28,000, from 3,000. And deaths involving fentanyl increased more than 45 percent in 2017 alone.
Fentanyl is not only contaminating heroin supplies; the powerful opioid is also showing up in cocaine, methamphetamines, and benzodiazepines while overwhelming county morgues with overdose victims. Its sudden ubiquity has alarmed law enforcement authorities, substance abuse experts, and addicted individuals alike.
Attraction to fentanyl makes somewhat terrifying sense. After all, fentanyl is affordable, more potent, and likewise, addictive. One problem is that fentanyl does not show up in most hospital drug screenings. That means that far too many addicted people are denied the treatment they need at the precise moment they may be ready to seek help.
Considered the most powerful opioid in medical circles, fentanyl is generally used to treat severe pain, especially for cancer patients who need around-the-clock relief. It is also administered as an anesthetic following surgery. Its popularity is due, in part, because it is between 50 to 100 times stronger than morphine, oxycodone, methadone and many forms of heroin.
As people who use drugs move from opioids to more cheaply and potent highs, the illegal use of fentanyl continues to rise. And the young and old are paying for the drug with their lives.
An overdose of fentanyl slows or completely stops breathing. The inability to breathe decreases the amount of oxygen to the brain, creating a condition called hypoxia, which can lead to a coma, permanent brain damage, or death.
For medical purposes, fentanyl is often injected, applied as a patch on the skin or as lozenges or lollipops. When abused, fentanyl is typically swallowed, snorted, or injected as a powder, pill or a piece of blotter paper placed under the tongue. But the danger of fentanyl isn’t just to patients and people in active addiction. Because fentanyl can be absorbed through the skin or accidentally inhaled, the drug can pose problems for anyone who comes into contact with it.
Similar to other opioids, fentanyl attaches to receptors in the brain, but it does so in a much faster fashion and in smaller doses than morphine and heroin. When this connection is made, fentanyl boosts levels of the chemical dopamine, which creates enhanced feelings of reward, pleasure, euphoria, and relaxation.
The longer the exposure to fentanyl, the greater the chance the body will develop a dependency on the drug. When this happens, withdrawal symptoms are likely to surface once the body is deprived of fentanyl. Because fentanyl withdrawal can be both painful and dangerous, consult a doctor on how to stop safely.
What is Fentanyl Withdrawal?
Reducing or eliminating fentanyl from the body after a few weeks or more of consumption can create mental and physical symptoms called withdrawal.
As the brain struggles to recover from the removal of fentanyl from the body, more fentanyl will be needed to prevent withdrawal.
At this point, an individual is considered physically dependent or, in other words, addicted.
This type of dependence can result from either a medical-necessary function or an illicit drug activity. However, the time it takes to become physically addicted depends on the individual.
Once addicted to fentanyl, a craving for more of the drug will be hard to compromise. Other signs of dependence can include:
- Taking more fentanyl than prescribed
- Feeling powerless to stop cravings
- Acting irresponsibly
- Mood swings, irritability, and agitation.
What are Fentanyl Withdrawal Symptoms?
Fentanyl withdrawal can be extremely uncomfortable and painful. Unlike other opioids, fentanyl lingers in the body for a longer time. That means when an individual stops taking fentanyl, withdrawal symptoms may begin 12-24 hours after the last dose. As withdrawal takes over the body, symptoms may include:
- Muscle pain
- Diarrhea
- Vomiting
- Nausea
- Sweating
- Abdominal pain and cramping
- Elevated heart rate
- Difficulty sleeping
- Tremors
- Anxiety
Although fentanyl withdrawal may not be life-threatening, individuals are especially vulnerable to craving and an extreme desire to eliminate the unpleasant symptoms.
What are the Stages of the Fentanyl Withdrawal Timeline?
The timeline and stage of fentanyl withdrawal can vary depending on the individual, genetics, frequency of use and dosage. However, to gain a better understanding of what to expect, a typical timeline might include:
Stage 1
The first signs of withdrawal will surface anywhere within the first eight hours up to two days
Stage 2
The most trying symptoms will begin after the first 36 hours and start to subside after three days.
Stage 3
Individuals should begin to feel some semblance of health after five days; however, in some cases, it may be weeks before individuals get back on their feet again
Stage 4
Physical symptoms including sensitivity to pain may still be present for several weeks or even months. Psychological symptoms, such as cravings, depression, irritability, anxiety and difficulty sleeping may also persist for extended periods
Individuals who use fentanyl for medical purposes will need to find other forms of pain management.
Treatment for Fentanyl Withdrawal
No one chooses addiction; however, there are treatments to assist in recovery. Like any other opioid, fentanyl withdrawal can be treated with methadone, buprenorphine, or naltrexone. A doctor or medical professional can prescribe these medications that are approved by the U.S. Food and Drug Administration, typically in a detoxification facility.
Why Should I Detox?
Fentanyl withdrawal is not easy, but eliminating this deadly opioid from your life is not impossible. Detoxification under the care of doctors and certified medical professionals can manage the acute physical symptoms associated with fentanyl withdrawal in a safe and peaceful environment.
This type of assistance is best found at a hospital or residential treatment facility, where medication can be prescribed to alleviate the discomfort from symptoms, and medical staff can monitor progress and prevent any complications from vomiting, breathing, and dehydration. Detox is a highly recommended first step on a path toward recovery.
What is the Next Treatment Step?
The biggest danger to fentanyl withdrawal is a return to use. Following successful detox, any real chance at sustained sobriety and a life without fentanyl and other opioids will require determination, commitment and an extended stay at a residential treatment center.
Here, you will be fitted with a personalized recovery plan customized to meet your issues and unique circumstances. To strengthen your resistance to relapse and to start feeling good about yourself, you will also be exposed to group therapy, one-on-one counseling, educational lectures and workshops as part of your recovery program.
