The Centers for Disease Control and Prevention (CDC) have declared that the abuse of opioid painkillers is contributing to a national epidemic, resulting in increased deaths due to drug overdose.
This is happening across the country, to people from all walks of life, including women and men, the young and old, and rural and urban citizens.
Fentanyl is one of the more recently recognized elements of this epidemic – a potent drug that is also highly dangerous.
Fentanyl: A Synthetic Opioid and Target of Abuse
News Medical explains that fentanyl is a synthetic opioid drug used in treatment of chronic or acute pain, and as a supplement to anesthesia for surgery.
The National Institute on Drug Abuse states that fentanyl is 25-50 percent stronger than heroin and 50-100 percent stronger than morphine. This makes it highly useful for treating some of the worst kinds of pain from surgery, severe chronic pain, and acute injury or other extreme circumstances that cause pain. For this reason, it is a popular medical and surgical medication.
Developed in the late 1950s, fentanyl is not new to the opioid market. However, it has made recent headlines as a powerfully addictive drug that has become part of the illicit drug market, with high levels of nonmedical use. Illicitly, it is often used to lace other drugs to enhance their high. It has been used illicitly in combination with heroin, other drugs such as benzos, and, infamously, as a “date rape” drug. With continued abuse, the drug can quickly become addictive.
Fentanyl Statistics and Facts
According to the US Drug Enforcement Administration (DEA), there were 6.64 million legal prescriptions of fentanyl dispensed in 2014. The same year, there were more than 3,300 reports of illicit fentanyl use – more than three times the number reported in the previous year of 2013. Fentanyl is generally diverted for nonmedical, illicit use through theft from pharmacies, faked prescriptions, and illegal distribution by patients or doctors.
Fentanyl is sometimes manufactured by organizations or individuals for distribution without the knowledge of authorities. These versions of the drug can be even more dangerous, as the user may not know all of the ingredients in the drug. As a result, some of the ingredients that are used to make the drug are now regulated by the DEA.
According to the CDC, between 2013 and 2014, deaths attributable to synthetic opioid use, including use of fentanyl, increased by 80 percent. Most of this increase can be traced to both illicit and legitimate use of fentanyl.
How to Tell if Someone Is Abusing It
Signs of opiate addiction or abuse include:
- Heavy focus on obtaining and using the drug
- Relationship issues based on substance use
- Inability to keep up with daily responsibilities
- Involvement in dangerous activities while using
- Loss of control over use of the drug, along with cravings
- Continuing to use the drugs even when negative consequences occur
- Loss of interest in favorite activities
Abuse may also be recognized if there are missing pills from a prescription, the prescription runs out earlier than expected, the person does not properly follow the doctor’s instructions, or prescriptions are obtained from multiple doctors or pharmacists.
As with many opiates, physical and psychological symptoms of abuse include:
- Digestive upset and changes in eating
- Depressed respiration
- Fatigue and changes in sleep
- Confusion and inability to focus
- Withdrawal symptoms, such as anxiety, nausea, and sweating
How Fentanyl Addiction Starts
Fentanyl abuse often starts as legitimate, prescribed use of the drug to treat pain. A person who uses this drug for a long period of time may develop tolerance, which, as described by the National Institute on Drug Addiction (NIDA), may result in the person using the drug more often or in larger amounts. If tolerance develops, and the person keeps increasing use, the process can lead to a feedback loop, ultimately resulting in an inability to stop using the substance and subsequent addiction.
Alternately, the individual may obtain fentanyl specifically for nonmedical use to get high.
Fentanyl is one of the fastest growing street drugs, and it is often used on the club scene.
One of the biggest dangers of fentanyl abuse is the common practice of combining it with other drugs, as described in the NIDA article. Because it is such a powerful opioid, it can have profound effects on the user’s ability to breathe. When compounded with other depressant drugs like heroin, benzodiazepines, or alcohol, this can result in respiratory arrest and death. Fentanyl is also often combined with stimulants like cocaine, which can result in heart issues.
One of the challenges of this addiction is the fact that the drug is used to treat pain. Even in individuals who are known to be at risk of addiction, pain management needs sometimes require it to be used. For these individuals, efforts to continue managing pain while avoiding dangerous addiction can be a problem.
Another problem can arise if an individual has a co-occurring mental health disorder such as depression or anxiety, and uses the drug to self-medicate for that condition. This can increase the potential for a legitimate prescription of fentanyl to become a target of abuse and contribute to the development of an addiction.
Fentanyl has a number of effects similar to those of other opiates. According to NIDA, long-term issues can include:
- Drowsiness and sedation
- Digestive issues
- Confusion, lack of focus, and sedation
- Damage to the heart, lungs, and other organs
- Brain damage due to lack of oxygen from suppressed breathing (hypoxia)
- Extreme withdrawal symptoms if the drug is stopped
Because of the high potency of this drug, the biggest risk of abusing fentanyl is overdose and death. This risk markedly increases if the person develops tolerance, meaning that larger doses are necessary to achieve the same effect. Increases in dosage of this powerful drug can quickly prove fatal.
Intervening in Fentanyl Abuse
Fentanyl use and abuse can be very difficult to halt, based both on its intensity as a pain-relieving drug and its high addiction potential. In many cases, the individuals who are addicted to this drug may be extremely hesitant to stop use because of pain issues or fear of extreme withdrawal symptoms. For this reason, careful planning to support detox and treatment for fentanyl abuse should be undertaken when preparing for an intervention.
Reputable treatment programs can provide advice and support, including references to experienced intervention personnel, to help confront a loved one about suspected fentanyl abuse. With this support, family and friends can be prepared to help their loved one enter treatment and support the individual in avoiding relapse after treatment is over. These treatment programs often also provide therapy for the family to deal with the emotional upset and practical realities of supporting a loved one who is struggling with drug abuse or addiction.
Getting the Right Treatment
In order to get the kind of treatment that is most likely to result in recovery and long-term abstinence from opioid abuse, the treatment center should be experienced in:
- Medically supported detox and withdrawal
- Behavioral therapies that motivate and instruct the individual on avoiding relapse
- Treatment of co-occurring disorders, as needed
- Motivational techniques and support for continued abstinence
- Peer support and 12-Step treatment during and beyond rehab
- Aftercare that helps the person readjust to life after rehab
These elements are provided through research-based treatment programs that include trained, certified addiction treatment specialists. For severe addiction like what can occur with fentanyl, long-term treatment is recommended to provide the most support and opportunity to achieve long-term recovery.
Fentanyl is highly useful medically; however, it is also a powerfully addictive drug that requires close monitoring to prevent abuse and the complications that may arise from long-term, chronic use.
Because of the risks and dangers of abuse or addiction, it is important to get help if addiction to this drug is suspected. By doing so, an individual who may be trapped in a cycle of fentanyl abuse can achieve recovery for the long-term and avoid the possibility of overdose and death.