One of the objectives of advancing technology and our continuous breakthroughs in medical science is to help sick people manage their pain. It’s difficult coping with the effects of medical treatments and diseases. Any prescription drug that can make patients more comfortable is, therefore, a welcome improvement.
However, most medications have side effects. It’s up to you and the medical team behind you to weigh if comfort – at least for the time being – is worth the potential side effects.
It’s not a win-win situation for sick people, but there are situations where painkillers are a necessary reprieve. Unfortunately, they can also become an addiction. This is sadly the case for many users of fentanyl, a prescription painkiller that is 50 to a hundred times more potent than morphine.
What is Fentanyl?
Fentanyl is a synthetic opioid used to treat advanced pain in adults with cancer. It is extremely effective in dulling physical discomfort when taken correctly.
This synthetic drug is also used by patients who have developed a tolerance for opioids and people whose pain cannot be managed by other available medications. Some of its brand names are Sublimaze, Duragesic, and Actiq.
How does fentanyl work? Fentanyl targets your brain and alters how your body reacts and responds to pain. It blocks your pain receptors and promotes the production of dopamine, the body’s feel-good hormone.
Unfortunately, it is also being sold as a street drug because of its powerful euphoria-inducing effects when taken in large quantities. Some of the street names of fentanyl are China White, China Girl, TNT, Dance Fever, and Crush.
The illegal purchase and use of fentanyl almost always result in an overdose.
This drug is prescribed in the following forms:
- Buccal tablet – a tablet that you melt between your gums and cheek
- Injectable – administered by a healthcare professional with a syringe
- Oral lozenge – a pastille that can be melted in the mouth
- Nasal spray – a fentanyl solution sprayed into one’s nasal passages
- Sublingual spray – a fentanyl solution that is sprayed under the tongue
- Sublingual tablet – a tablet that is dissolved under the tongue
- Transdermal patch – a medicated adhesive patch placed on the skin
While it’s a powerful tool for pain management, this opioid analgesic is potentially habit-forming and can cause an unhealthy dependence. As your tolerance builds, higher and higher dosages lead to a potential overdose which then requires tapering off.
Fentanyl Withdrawal Symptoms
How do you know if you’ve become too dependent on fentanyl? You’ll know you’ve built an unhealthy dependence on the drug when it starts becoming hard for you to function normally without it.
Suddenly stopping fentanyl can cause withdrawal symptoms. The gravity of withdrawal-related side effects depends on how long you’ve been using it and in what doses.
Most people taking fentanyl for legitimate reasons use it to numb the pain from their illness. When the withdrawal symptoms kick in and the discomfort from the disease returns, they continue taking it. This is the beginning of a potentially dangerous cycle.
Here are some fentanyl withdrawal symptoms:
- Agitation
- Anxiety
- Cold flashes
- Depression
- Diarrhea
- Dilated pupils
- Excessive yawning
- Goosebumps
- Feelings of helplessness
- Incoherence
- Insomnia
- Mouth sores
- Muscle and bone pain
- Nausea
- Restlessness
- Runny nose
- Tearing
- Uncontrollable leg movements
- Unusual thinking
- Vomiting
The symptoms of fentanyl withdrawal are excruciating both physically and psychologically, but they are not fatal.
The risk with these symptoms is they can trigger other existing medical conditions. This is when the situation can become life-threatening.
Fentanyl Patch Withdrawal Symptoms
Fentanyl transdermal patches are available as brand name and generic drugs. Naturally, the generic ones are more affordable than the branded ones, but both can be purchased in varying strengths and forms.
Usually, fentanyl patches are used as part of an existing therapy or treatment that can be used safely with other prescriptions.
When you become dependent on these patches and stop using them, you may experience one or several of the patch withdrawal symptoms such as:
- Abdominal cramps
- Agitation
- Diarrhea
- Flu-like symptoms like runny nose, colds, and body pains
- Nausea
- Profuse sweating
- Tachycardia
Fentanyl Withdrawal Timeline
Fentanyl withdrawal is classified into phases that can last from four to ten days.
First Phase
The first phase of fentanyl withdrawal starts between the first until the third day of stopping intake. This stage can cause flu-like symptoms like body pains, fatigue, and a runny nose. During this time, the craving for fentanyl in any form is strong, and patients will feel restless and distressed.
Second Phase
Phase two of fentanyl withdrawal includes a different set of symptoms from physical to psychological ones. Nausea, cramps, and diarrhea are common because your body has begun the natural process of detoxification to rid itself of fentanyl residue in your system.
As uncomfortable as it may be, you have to let it take its course. This stage happens from the fourth day you stopped taking fentanyl and can last for three to five days.
Third Phase
The last stage of fentanyl withdrawal causes less damage physically but it’s still a psychological battle. You are at your most vulnerable mentally during this phase. The entire withdrawal process can leave you feeling down, alone and depressed due to the sudden absence of synthetically produced dopamine.
Unfortunately, this last hurdle can take longer depending on you and your mental state. Some struggle with depression and the constant craving for fentanyl. There’s a strong tendency for relapse during the third phase.
The Risks of Fentanyl Withdrawal
Fentanyl withdrawal isn’t usually fatal, but all medical processes have risks. The primary danger of fentanyl withdrawal is dehydration since the second phase includes diarrhea and sometimes bouts of vomiting. These two symptoms can cause you to lose a significant amount of body fluids leading to dehydration.
It is critical to increase your water intake during the detox process to adequately replenish your liquids until you are weaned off the drug.
This is when a medical detox becomes practical. Any adverse reactions or potentially harmful effects like dehydration can be managed before they become worse. Should dehydration occur, medical professionals will quickly hook you up to intravenous liquids to manage it. The medical, emotional, and physical support from a detox facility is invaluable to the process.
A More Serious Risk: Overdose
Dehydration, however, is just the tip of the iceberg. The more serious risk of fentanyl withdrawal is overdose. You may wonder: how can stopping fentanyl intake result in taking too much of it?
It’s important to understand that your tolerance decreases when you stop taking it regularly so when you return to the drug for whatever reason, you may feel that the standard dose has zero effect on you. You then end up taking more (and too much) of it.
If you try to take the same amount of fentanyl while detoxing, there’s a good chance you’ll end up overdosing. You need to understand that your body can no longer handle the “old” doses once you’ve begun the detoxification process.
Fentanyl Withdrawal Symptoms Treatment
Fentanyl withdrawal symptoms are a struggle to live through. For many, the battle against its withdrawal symptoms requires all their strength and will. Because of this, medicines and devices have been developed to help fentanyl withdrawal symptoms.
Here are some of the treatments used to help manage fentanyl withdrawal symptoms:
Enrolling in a Rehabilitation Program
Detox is merely the start of the hard road ahead. This is why most of the time, patients need to decide if they want to continue their recovery inside an inpatient facility or opt for outpatient treatment after detoxing.
Inpatient Rehabilitation
Inpatient rehabilitation entails staying inside a dedicated facility that provides 24/7 monitoring with trained medical staff, counselors, and therapies to give you physical, emotional, and psychological guidance.
Inside the facility, you are encouraged to form healthier habits and participate in therapies and group discussions to help you handle your withdrawal symptoms. This becomes an avenue for you to realize that your fentanyl addiction is not the only way to ease your pain.
Depending on your readiness, confidence, overall mental health, and ability to control your symptoms, you can stay for 30, 60, or 90 days inside the facility unless your health professional recommends otherwise.
Outpatient Treatment
The cost of inpatient care is a massive deterrent for a lot of people which is why many prefer outpatient treatment. However, while support from home is critical at this point, not all homes provide a conducive environment for patients struggling with substance abuse.
When you opt for outpatient treatment, you need to regularly go to the clinic or rehab facility to get holistic treatment. Your commitment to regular visits will help you form alternative ways to manage pain and illness without resorting to fentanyl.
Medical Assisted Treatment or MAT
The greatest challenge to getting off fentanyl completely is the detoxification process. It can be depressing and frustrating at the beginning. Without complete commitment, you may find yourself relapsing.
This is when MAT is used as an intervention process. There are particular remedies that your doctor can give you to better manage and recover from fentanyl’s withdrawal symptoms.
Buprenorphine-Based Medications
Buprenorphine-based drugs like Suboxone are one of the best MAT treatments. This medication can manage moderate to severe withdrawal symptoms.
Another buprenorphine-based drug is Zubsolv which can control your symptoms and decrease your fentanyl cravings. By easing your withdrawal symptoms, these drugs help you stay away from fentanyl and prevent a relapse.
The dosage of these drugs is in direct proportion to your fentanyl dosage. The higher the fentanyl dose, the higher your prescription for buprenorphine. Therefore, it’s important to be honest with your healthcare provider to ensure that you receive the right doses.
Methadone
The success rate of methadone is high, but it is not the primary course of treatment because the potential for abuse is also high. However, as long as it is prescribed by your doctor, methadone can significantly reduce fentanyl withdrawal symptoms.
Another reason why this is only prescribed in exceptional and thoroughly studied cases is because its side effects can cause complications and other medical issues. It should not be given if you have Crohn’s disease, respiratory issues, liver problems, and alcohol dependence.
Lofexidine
A non-addicting drug, the FDA has approved the use of lofexidine to manage fentanyl abuse withdrawal symptoms. This non-addicting drug is not a treatment in itself, but health professionals usually prescribe it as part of a treatment program.
Lofexidine works by blocking the release of norepinephrine, a hormone similar to adrenaline that aggravates fentanyl withdrawal symptoms. Like all drugs, this too has side effects. Lofexidine can impact your blood or heart vessels and cause them to slow down.
Because of its serious side effects, activities requiring your full attention like driving and operating heavy machinery should be avoided. If you experience any symptoms like dizziness and high blood pressure, you should advise your physician right away.
NSS-2 Bridge
Another method to help treat fentanyl withdrawal symptoms comes in the form of a percutaneous nerve field stimulator (PNFS) called the NSS-2 Bridge.
This small device is placed behind the ear to reduce the symptoms of fentanyl withdrawal. It can help ease symptoms anywhere between five days to one month.
This hearing-aid-like device works by sending painless electrical pulses from your skin to your cranial nerve system, the region in your brain that regulates fear and is a primary factor for reward-seeking addiction-related behaviors.
Accelerated Fentanyl Detox
Accelerated or rapid fentanyl detox relies on removing fentanyl from the brain receptor under sedation. While sedated, the patient receives an opiate blocker to mitigate the discomfort of withdrawal. Once the patient is free from withdrawal and fentanyl, doctors administer a blocker to keep any opiates from re-entering the brain.
This method has a high success rate and is preferred by some patients because it allows them to detox without the pain and discomfort of withdrawals, although this method doesn’t necessarily come as part of a treatment plan and can be less effective long-term.
reSET-O Mobile App
Cleared by the FDA in December 2018, reSET-O is a mobile app that you can download on your phone after receiving a prescription from your doctor.
The app is designed to support you while you are undergoing an outpatient treatment program. It diligently monitors, trains, and reminds you and your health provider of the essentials and guidelines of being in a treatment plan.
A compliance reward system integrated into the app can motivate you to be consistent in your treatment regimen.
Since this is prescribed cognitive behavior therapy, you can have other ongoing programs in conjunction with this app like medical prescriptions.
Frequently Asked Questions
Are withdrawal symptoms and side effects the same for fentanyl?
There are similarities between fentanyl withdrawal symptoms and its side effects when used. The shared side effects of fentanyl use and its withdrawal symptoms are vomiting, nausea, dizziness, and headaches.
Because of the dangers of fentanyl use, the only time your doctor will prescribe it to you is when he or she is confident that you can manage the side effects of the drug.
How long does it take to get addicted to fentanyl?
There is no specific timeline for getting addicted because it all depends on your tolerance to the drug.
As one of the most potent opioids, fentanyl use can quickly transition to addiction without your awareness. If you find yourself increasing your dosage because the current one is “not working” or “doing the job right,” then you might have built a tolerance for it leading you to take more than necessary.
Is fentanyl overdose possible?
Yes, you can overdose on fentanyl. In the worst-case scenario, fentanyl can cause your breathing to slow down or stop altogether. When this happens, your brain is deprived of much-needed oxygen, a condition called hypoxia. If it isn’t effectively addressed within the first several minutes, it can lead to brain damage, coma, and even death.
Is there a way to taper off the use of fentanyl without going through withdrawal?
Suddenly stopping fentanyl can be an overwhelming experience for you and your body. Not everyone can successfully manage its withdrawal symptoms so another option is to taper off the drug gradually. This method relies on the measured removal of fentanyl over a fixed period. By weaning you off fentanyl slowly, you avoid experiencing the full force of its withdrawal symptoms.
If you choose this method, you need to make sure that you’re under the supervision of a medical professional who will assess the situation and create a timeline for weaning you off the drug. During treatment, your doctor may also switch you to another opioid for pain management as your dosage is gradually reduced.
Before putting you on this type of treatment, your attending physician will evaluate your level of fentanyl dependence, comorbidities, and the length of time you’ve been dependent on fentanyl among other factors.
Afterthoughts: Kicking the Fentanyl Habit
Fentanyl addiction is real and so are its withdrawal symptoms. Since it’s much more potent than heroin, this opioid is extremely addictive. Plenty of people who take fentanyl for legitimate medical reasons find themselves inadvertently struggling with getting off the drug.
If you’ve become dependent on fentanyl, know that you’re not alone. While the withdrawal symptoms outlined here may sound extreme and scary, there are resources available to help you through it. The professional team and treatment programs at Divine Detox can help you kick the fentanyl habit, reach out today and we’ll help you achieve lasting sobriety.
Though difficult, getting your life back on track is worth the struggle!