How Does Fentanyl Kill You?
Synthetic opioids are substances that are synthesized in a laboratory to stimulate the same areas in the brain as natural opioids such as morphine and codeine. These synthetic substances can be just as dangerous in terms of risk of abuse, addiction, and overdose.
Natural opioids are extracted from the seed pod of a specific variety of poppy plant. Synthetic opioids, on the other hand, are made by scientists in labs using the same chemical structure as natural opioids. The reason that users seek out both opioids and synthetic opioids is often the same, as both drugs act as painkillers or analgesic (pain-relieving) drugs.
What Is Fentanyl Used For?
Fentanyl is an intense synthetic opioid that is similar to morphine but about fifty to a hundred times more potent. Fentanyl is a prescription drug used in extreme cases but also used illegally as a recreational drug. This potent drug is a Schedule II prescription drug, meaning that the substances or chemicals in the drug have a high potential for abuse, with their use potentially leading to severe psychological or physical dependence. As a result, fentanyl is usually only given to patients with severe pain or for pain after surgery. It may be used to treat patients with chronic pain who are physically tolerant to other opioids, but this is rare. When fentanyl is used clinically in these cases, it is in the prescription form, including brand name drugs Actiq®, Duragesic®, and Sublimaze®. When fentanyl is used clinically or prescribed by a doctor, the drug can be administered as a shot, released from a patch placed on a patient’s skin, or sucked from a throat lozenge that is consumed like a cough drop.
Why is Fentanyl So Dangerous?
When fentanyl is used recreationally, people refer to it by street names such as Apache, China Girl, China White, Dance Fever, Friend, Goodfellas, Jackpot, Murder 8, and Tango & Cash. Whatever the name, synthetic opioids, including fentanyl, are currently the most common drugs involved in drug overdose deaths in the United States. In 2017, 59% of opioid-related deaths involved fentanyl compared to 14.3% percent in 2010.
The fentanyl most frequently associated with recent overdoses is made in labs. This synthetic fentanyl is sold illegally and delivered as a powder to be dropped onto blotter paper. The powder is also put in eye droppers and nasal sprays. Fentanyl powder can also be made into pills that mirror the design of prescription opioids.
Fentanyl can also be laced with other dangerous drugs that make a deadly cocktail. For instance, some drug dealers mix fentanyl with other drugs, such as heroin, methamphetamine, cocaine, and MDMA. Many drug dealers lace their fentanyl because it is a cheaper option to make the ratio of fentanyl lower and another drug higher. Using fentanyl from drug dealers is especially risky because users are often exposed to other drugs as a cheap but dangerous additive. This could result in a user consuming stronger opioids than their bodies are used to, resulting in an overdose.
Effects of Fentanyl On the Body
Fentanyl’s effects on the body occur because the chemical components of the drug bind to the body’s opioid receptors. This mechanism is very similar to heroin, morphine, and other addictive opioids. The body’s opioid receptors are located in the brain, where they regulate and control the individual’s feelings of pain and a variety of emotions. When a user has taken opioids numerous times, their brain adjusts to the drug, decreasing its sensitivity and making it difficult to naturally feel pleasure from anything other than the drug. When users become addicted, constant drug-seeking behavior and drug use can take over their lives.
The emotional fluctuations from fentanyl can range from artificially stimulated happiness to depressive thoughts when the drug fades. But fentanyl also affects the physical body. Some of the physical side effects of fentanyl include:
- Drowsiness, fatigue, and lethargy
- Nausea and vomiting
- Sedation, lack of responsiveness
- Difficulty breathing
Fentanyl Overdose and Naloxone
Fentanyl can easily cause a user to die from an overdose. This occurs when the user takes too much fentanyl at once and the drug begins to produce extreme adverse side effects and life-threatening symptoms. If the individual is alone or with someone else who is also under the influence, it makes the situation even more life-threatening. When fentanyl users overdose, their breathing slows and could even stop if no one intervenes with a care plan. This means the user has little to no oxygen reaching their brain. When oxygen is unable to reach the brain, the lack of oxygen could result in a coma, irreversible brain damage, and death. This state is called hypoxia, which is one of the main symptoms of an overdose.
Luckily, there are ways to treat a fentanyl overdose, such as the medication naloxone. Naloxone rapidly binds to opioid receptors and blocks the impact of any opioid drugs consumed. Since fentanyl is much stronger than many other opioid drugs, such as morphine, the user might need multiple doses of naloxone. Medical professionals now encourage individuals whose loved ones suffer from addiction to carry naloxone because it has the capacity to save a life.
Of course, if you are near someone who has overdosed on opioids, the first crucial step you should take is to call 911 so the person can receive immediate medical attention and be taken to the hospital for professional help.
This step is immensely important if you or other bystanders do not have naloxone because medical personnel will administer naloxone immediately if they suspect an opioid drug was involved. Users who are saved by naloxone need to be monitored for up to two hours after the last dose of naloxone to ensure that their breathing does not slow or stop.
Some states have passed laws that allow pharmacists to dispense naloxone without a personal prescription. This allows close friends and family of loved ones with an active addiction to use the auto-injector or nasal spray versions of naloxone to save a user who is overdosing. In addition, individuals who are or know someone at risk for an opioid overdose have the opportunity to get trained on how to give naloxone and can carry it with them in case of an emergency. Naloxone can be carried as an injectable solution with a needle, a hand-held auto-injector called EVZIO®, and a nasal spray called NARCAN® Nasal Spray.
Fentanyl Withdrawal & Treatment
Individuals addicted to fentanyl who are detoxing from the drug will experience severe withdrawal symptoms. Symptoms can emerge as early as a few hours after they last used fentanyl. Withdrawal symptoms can include:
- Muscle, bone, and joint pain
- Sleep problems, nightmares, and vivid dreams
- Diarrhea and vomiting
- Cold flashes with goosebumps; cold sweats
- Uncontrollable leg spasms
- Severe and uncontrollable cravings for fentanyl
Withdrawal symptoms are uncomfortable and make many users resist their recovery. However, there is current research into medications to assist and alleviate some of the symptoms associated with the withdrawal process for fentanyl and other addictive opioids. In fact, the FDA has approved one non-opioid medication: lofexidine. Lofexidine was produced with the sole purpose of reducing opioid withdrawal symptoms. Another device, the NSS-2 Bridge device, is a petite electrical nerve stimulator designed for placement behind the ear in order to ease fentanyl withdrawal symptoms for up to five days during the initial intensive withdrawal phase.
In December 2018, the FDA also approved a mobile medical application called reSET® to make opioid use disorder treatment less unpleasant for individuals in detox experiencing withdrawal symptoms. Interestingly enough, reSET® is an application that is prescribed as cognitive behavioral therapy. This form of therapy should be used along with a care plan that includes buprenorphine and contingency management.
From outstanding data throughout the years, medication in combination with behavioral therapies has been shown to be effective in treating people with all forms of mental illness, including fentanyl addiction.
Some medications that may be prescribed during this process include buprenorphine and methadone. These drugs work by binding to the same opioid receptors in the brain as fentanyl, diminishing cravings, and withdrawal symptoms. Another medicine, naltrexone, blocks opioid receptors and prevents fentanyl from having an effect.
Recovery From Fentanyl Addiction
It is best to discuss addiction treatment options and come up with a personal care plan with your health provider. Behavioral therapies for addiction to opioids like fentanyl alongside medication can provide a space for the individual to change their attitude and develop a willingness to change their old ways of life.
At Boardwalk Recovery Center, private sessions with therapists and physicians, along with group therapy sessions, allow our clients to adjust their attitudes and behaviors related to drug use, introduce healthy life habits, and adapt to life without drugs.