Fentanyl Addiction and Overdose Deaths

Table of Contents

  1. Introduction

  2. What is Fentanyl?

  3. How is it Used?

  4. Deaths and Other Costs

  5. Fentanyl Effects

  6. Signs and Treatment of Addiction

Introduction

In severe pain cases, physicians prescribe opioid drugs like fentanyl and morphine to help provide comfort and ease suffering. But what makes these drugs so effective is also what makes them addictive and dangerous. If used for a long time or without medical oversight, these powerful pain relievers can result in misuse, addiction, or death.

One of these opioid medications is fentanyl, and in recent years, it's become a significant problem in the opioid epidemic fight. According to the United States Drug Enforcement Agency (DEA), in the county of San Diego alone, the first six months of the year 2020 saw 203 fentanyl overdose deaths.1 That number was more than the fentanyl-related overdose deaths for the county in the entire year of 2019. San Diego's increase in fentanyl deaths isn't isolated. Fentanyl deaths have increased nationwide in recent years.2

What is Fentanyl?

Fentanyl is an opioid medication, similar to drugs like oxycodone, methadone, heroin, and morphine. Opioids are a class of drugs that produce the same pain-relieving and euphoric effects as opiates. Opiates are drugs derived directly from poppy plants, like opium or heroin. Opioids can be produced from the poppy plant or made in a lab to mimic the effects of an opiate.

The dangerous aspect of fentanyl is that it is more potent than other opioids. Fentanyl is up to 80-100 times more potent than morphine, making it a Schedule II drug.3, 4 Schedule II drugs, according to the DEA, are drugs with a "high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous."5

When used for legitimate medical purposes, fentanyl safely controls high levels of pain. Typically prescribed after surgery or to treat cancer pain, it treats some symptoms of pain. Fentanyl is available under the brand names:

  • Abstral

  • Actiq

  • Fentora

  • Duragesic (fentanyl patch)

How Is It Used?

When used legally as prescribed medication treatment, fentanyl comes in several forms, like:

  • Lozenges

  • Fentanyl patches

  • Tablets

  • Injectable liquid

Formulations include:

  • Fentanyl lollipop

  • Spray

  • Buccal film (small film placed between the cheeks and gum)

Illegal uses include the forms the drug is commercially manufactured, like the fentanyl patch and lozenge. However, street uses include snorting it, mixing it with other drugs, or injecting it intravenously. Fentanyl mixed with cannabis, or "fentanyl laced weed," can turn marijuana into a dangerous substance.

When discussing the illegal use of fentanyl, it's essential to include other synthetic opioids in the conversation. Carfentanil is another synthetic opioid. Both drugs are sometimes illicitly mixed with other drugs to create a more potent high. Both synthetic opioids are dangerous and can lead to overdose and death.

Fentanyl is much stronger than most other opioids. Carfentanil is even stronger than fentanyl -- 100 times more potent. This makes carfentanil 10,000 times stronger than morphine. It is so strong that it's not approved for use on humans. Carfentanil is only approved for use on large animals, such as elephants, as a tranquilizer.

Deaths and Others Costs of Fentanyl

Opioids like fentanyl have a unique effect on the central nervous system (CNS), which include the brain, spinal cord, and nerves.6 The opioid receptors in the spine help block pain and cause a "feel good" state known as a "high." Unfortunately, opioids also affect the CNS by slowing down the system, causing:
 

  • Nausea

  • Constipation

  • Drowsiness

  • Depressed breathing

 
If too much of an opioid is administered at once or accumulates in the body, there's a risk of becoming unconscious and stopping breathing, resulting in death.

Street Drugs Lack Quality Control

Misuse can result in a lethal dose of fentanyl. There is no quality control when street drugs are mixed or manufactured, making every dose challenging to gauge. Opioids, as a category of drugs, are an issue because of their addictive properties and ability to stop a person from breathing.7 Because of its strength, when even small amounts of fentanyl are mixed with other opioids, alcohol, or benzodiazepines, it increases the risk of an overdose.

Fentanyl's potency is so concentrated that incorrectly disposing of it can result in a lethal dose of fentanyl. Because the drug comes in many formulations, a lozenge can look like candy, and an old fentanyl patch may look like a food wrapper. People can unknowingly expose themselves to the drug and experience fentanyl side-effects.

Fentanyl\'s Costs

In a 2018 report from the CDC's National Vital Statistics System report, fentanyl was involved in 29% of all overdose deaths in 2016.8 In two-thirds of the fentanyl-related deaths, fentanyl was mixed with one or more other drugs. Misuse costs lives, but there are monetary costs, too. The National Institutes of Health (NIH) reports that the nation's opioid epidemic costs the U.S. $78.5 billion a year in healthcare, addiction treatment, criminal justice, and lost productivity.9

Fentanyl Effects

Opioids, which include fentanyl, have both short term and long term side-effects. Common fentanyl side-effects are:

Fentanyl Short-Term Side Effects

  • Decreased respiratory rate

  • Drowsiness

  • Nausea

Fentanyl Long-Term Effects

  • Memory loss

  • Liver damage

  • Nausea and vomiting

  • Suppressed immune system

  • Abdominal distention

  • Coma

  • Death

Overdose

A fentanyl overdose can occur, whether it's the first dose ever taken or a routine dose. The following are common signs and symptoms of a fentanyl overdose:

  • Slow breathing

  • Shallow breaths

  • Clammy skin

  • Severe drowsiness

  • Bluish appearance to the skin

  • Unresponsiveness

Fentanyl Withdrawal

Fentanyl withdrawal is different for each person. Withdrawal depends on how long and how much of the drug has been used and mental and physical state. Health professionals recommend tapering when withdrawing from an opioid. Tapering helps reduce withdrawal symptoms and make the process more tolerable. Common side-effects of a fentanyl withdrawal include:

  • Anxiety and agitation

  • Joint and muscle pain

  • Rapid heartbeat

  • Tremors

  • Nausea or vomiting

  • Diarrhea

  • Trouble sleeping

  • Chills

  • Sweating

  • Suicidal thoughts

Signs and Symptoms of Addiction

Spotting the signs of opioid addiction can prevent overdose. The signs of an addiction are:

Physical Signs

  • Pinpoint pupils

  • Unusual drowsiness

  • Unconsciousness

  • Loss of weight

  • Confusion

  • Slurred speech

Behavioral Signs

  • Preoccupation with obtaining the drug

  • Needing higher doses for effective pain relief

  • Choosing to forgo activities they used to enjoy

  • Failing to stop using the drug despite negative repercussions of drug use

Fentanyl Addiction Treatment

Seeking treatment for fentanyl addiction, whether inpatient or outpatient, can increase success and recovery chances. Opioids are known for their addictive properties, and the fentanyl withdrawal symptoms that come with long-term use can make stopping fentanyl challenging.

For example, the detox which the body goes through when stopping fentanyl can be painful and uncomfortable. The experience is less traumatic with the constant support of medical and mental health professionals at treatment centers.

Inpatient drug rehab for fentanyl offers 24-hour care amid trained support staff. Along with counseling sessions, therapy, and medical care, clients can also enjoy some leisure activities. Outpatient drug rehabilitation provides treatment for a portion of the day, with the opportunity to return home to other responsibilities.

Rehabilitation treatment facilities offer professional addiction specialists and therapists. These staff help clients develop behavioral interventions like cognitive behavioral therapy (CBT) to modify addictive thought patterns. Most rehabilitation facilities that offer rehab from fentanyl addiction also offer medication-assisted treatment (MAT), along with counseling and behavioral therapies.10 MAT utilizes medications like buprenorphine and methadone to treat addiction and help with fentanyl withdrawal.

Resources

  1. https://www.dea.gov/press-releases/2020/08/06/alarming-spike-fentanyl-related-overdose-deaths-leads-officials-issue

  2. https://emergency.cdc.gov/han/2020/han00438.asp

  3. https://www.dea.gov/factsheets/fentanyl

  4. https://www.drugabuse.gov/drug-topics/fentanyl

  5. https://www.dea.gov/drug-scheduling

  6. https://www.medicalnewstoday.com/articles/314790

  7. https://www.drugabuse.gov/publications/drugfacts/prescription-opioids

  8. https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf

  9. https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates

  10. https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat

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