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Fentanyl Addiction, Withdrawal, Side Effects, Alternatives, Tapering

Last Updated on December 15, 2023 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD

Alternative to Meds Center provides Fentanyl withdrawal treatment that doesn’t just substitute one addictive drug for another.

Fentanyl addiction has risen to epidemic levels in the US and elsewhere. Many who died from fentanyl may not have known that is what killed them. As a powder or liquid, or scraped from a pain patch it can be easily combined with other drugs. It is a cheap drug to manufacture and it is deadly.

There are Better Options than Fentanyl for Pain!

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Alternative to Meds has been an opiate withdrawal help authority for over 17 years. We have published evidence regarding our success. After an addiction to opiates, we aim to help the body get back to balance by addressing many factors that support healing. There is a way back to vibrant health. Addiction to pain medication as well as recreational use of opiates can be overcome if you go broad enough and deep enough in your healing journey. We are here to help.
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Fentanyl Withdrawal Symptoms

Fentanyl withdrawal symptoms are similar to heroin and other opiate drugs. Dehydration caused by loss of bodily fluids is of particular concern during withdrawal from opiates of any kind. Withdrawal symptoms have been described as unbearably harsh, hence the strong craving phenomena connected with both natural and synthetic opioids.

Fentanyl withdrawal symptoms include:
  • Dysphoria, general malaise
  • Drug cravings
  • Runny nose
  • Clammy skin, excessive sweating
  • Diarrhea
  • Yawning
  • Irritability
  • Weakness
  • Cramping, particularly in the stomach or abdomen
  • Vomiting
  • Restlessness
  • Restless legs*
  • Intense aches and pains, muscle spasms, deep bone pain
  • Chills, goosebumps
  • Fever
  • Insomnia

*Data released on “restless legs” by the NHS in the UK suggest a link between nerve damage and resulting low levels of dopamine.

Like all opioids, fentanyl has an extremely fast onset of effects. The half-life is also extremely short. Intravenously, Fentanyl’s half-life was clocked at around 13 minutes in a clinical trial on patients undergoing oral surgery. When administered through a nasal atomizer, the half-life was approximately 6.5 minutes.

Withdrawal symptoms emerge when the drug has been significantly metabolized, about 12 to 30 hours after the last opioid dose. If the drug is not re-administered, these effects will intensify over a number of days, and then begin to ease.

Without restorative support and a thorough health overhaul, It may take several months to start to feel normal again. There is more information on a thorough program for fentanyl withdrawal and addiction treatment below. We provide methods to significantly accelerate the healing period while softening the discomforts of fentanyl withdrawal.

Fentanyl Side Effects

Fentanyl side effects include:
  • Euphoria
  • Seizure
  • Slowed respiration, low blood pressure, decreased circulation, death* 
  • Difficulty swallowing
  • Changes in mood (i.e., exhilarated, depressed, irritated)
  • Pains and aches (i.e., headache, muscle cramps, chest pain, stomach pain, back pain)

*Fatal fentanyl overdoses rose over 500% between 2000 and 2016.8

Other side effects are common such as skin reactions such as burning, itching, hives, rashes, numbness, tingling, and swelling (especially around the site of a fentanyl patch) the skin can become red and itchy.

Other drug effects include these:
  • Drowsiness, groggy feeling
  • Loss of appetite
  • Insomnia, trouble staying asleep
  • Dry mouth, hoarseness
  • Diarrhea
  • Weakness
  • Dizziness
  • Sexual dysfunction, loss of libido
  • Menstrual changes
  • Indigestion
  • Feeling cold
  • Tremors, uncontrolled shaking (i.e., in the hands or legs)
  • Difficult or painful urination
  • Swelling of the eyes, mouth, tongue, ankles, or other body parts

Some side effects of fentanyl can be extremely severe, requiring medical intervention at once. Call for help, by ambulance if necessary, if the following symptoms appear:

  • Difficulty breathing, shallow breathing (the chest does not rise)
  • Hallucination
  • Fainting, syncope, weakness
  • Fever accompanied by tachycardia, sweating, vomiting, and mental confusion
  • Stiff or rigid muscles, twitching muscles, loss of balance or coordination

What Is Fentanyl Used for?

Fentanyl is a pain medication designed for use in specific types of scenarios:

  • As a potent pain reliever where rapid relief is necessary for severe pain
  • When morphine or other opioids no longer work for chronic pain
  • In cancer patients over the age of 18 who are opioid-tolerant
  • Treatment for patients with post-surgical pain
  • Recreational use to bring about feelings of euphoria and relaxation

Fentanyl, when used for recreational purposes, is commonly mixed with other opiates or illicit substances. Mixing alcohol or any other depressant drug significantly compounds the likelihood of overdose and fatality as it compromises the central nervous system. Because of the effects on the respiratory system and heart, and the unknowns related to drugs manufactured in illegal labs and sold on the street, the risk for injury and death due to overdose is exceptionally high.

fentanyl is deadlyMany deaths from fentanyl occur in first-time users, or those using it for only a short time, as they are unaware of the drug’s powerful depressant effects. Illicit drug use comes with many risks. For example, there is no way of knowing whether heroin purchased contains fentanyl, knowing its strength or concentration, or if fentanyl is present as a lacing agent. Fentanyl pills often come from unregulated labs. Apart from the deaths due to overdose from pure fentanyl, a high percentage of fentanyl deaths are traced to the dangerous additive effects of laced heroin or when combined with other drugs.

A comprehensive 10-year review of all drug-related deaths in British Columbia revealed that fentanyl deaths are on the rise. Toxicology post-mortem in 2012 showed fentanyl at 5% of all illicit drug deaths. Toxicology reports showed that 85% of all drug fatalities from 2021 and 2022 involved fentanyl and that high concentrations of fentanyl are increasing year over year, revealed in post-mortem testing.12

In the US, the National Center for Health Statistics shows the same trends, which worsened even more during the recent global pandemic.13,14

Fentanyl Alternative Names and Slang

Fentanyl is the generic name for a synthetic opioid medication developed in the 1960s. Brand names include Duragesic (transdermal patch), Actiq (lollipops), Fentora (effervescent buccal tablets), and Abstral. There is a nasal spray under the brand name Lazanda. Other brand names include Matrifen, Haldid, Onsolis, Instanyl, Durogesic, and innumerable others in the US and across the globe.6

Names for fentanyl or drugs laced with fentanyl include China White, China Girl, Tango, Cash, Goodfella, Friend, Murder 8, Jackpot, TNT, Apache, Dance Fever, Heroin Popcorn, Fenny, and for the transdermal form, patch, sticky, sticker, strips.2

Fentanyl and various derivatives such as acetyl fentanyl come from clandestine sources and are less powerful than fentanyl. Sometimes referred to as designer drugs, these have been identified and put on the US Drug Enforcement Agency (DEA) list of Schedule 1 drugs. These are linked to many recreational drug overdoses that occur outside of clinical settings.5

Hundreds of tons of fentanyl are brought into US ports of entry from other countries each year, only a fraction of which are intercepted, though customs officers are using spectrographic devices and other extremely high-tech means of detection. The sheer volume of fentanyl successfully brought in illegally makes the problem difficult to overcome.

Fentanyl Withdrawal Process

In a hospital or clinical setting, fentanyl intake can be gradually reduced but must be done when careful monitoring is in place. In addition, the withdrawal process must be managed by physicians or caregivers who are licensed and trained in the proper administering of fentanyl.

This is also important when the patient is being bridged over to other opiates or other medications, known as MAT or medication-assisted treatment. The risk for respiratory collapse or other injury is HIGH, if drug tapering is done outside the scope of recommended dosages and timelines.

The same cautions would apply to someone using fentanyl illicitly. Often the danger of dehydration is overlooked in opiate withdrawals. It is possible for dehydration to lead to an increased risk of death due to rapid or continuous fluid loss through sweating, diarrhea, and vomiting.

Alternative to Meds Opiate Recovery

Seek qualified help to avoid the risks that can accompany incorrect or too-rapid opioid tapering procedures.

The Alternative to Meds Center can help using holistic and drug-free recovery once past the fentanyl tapering stage–contact us for more information today and continue reading below for more information on fentanyl and related topics.

Fentanyl FAQs

Fentanyl is one of the most deadly drugs ever to have developed a street presence. To prevent a loved one or you from being exposed unwittingly to this medication, we recommend becoming as knowledgeable as possible to help avoid any chance of addiction, accidental injury, or death.

Fentanyl comes in various forms, including transdermal patches, dissolving tablets, lollipops, injectable liquid, oral spray, and a nasal spray version.

In the event that you’d like to return unused fentanyl products, bring them to your pharmacy to prevent environmental damage and contamination as they will be disposed of safely. Never flush or release fentanyl or other leftover medication into your community water system.4

What is Subsys (Fentanyl)?

Subsys is a sublingual form of fentanyl that should be prescribed only to patients who have become opiate-tolerant. Subsys is placed under the tongue, where the tablet dissolves allowing the drug to enter the bloodstream quickly. Due to the number of accidental deaths of children related to fentanyl products, the drug must be securely stored where children cannot reach it.

What is Fentora (Fentanyl)?

Fentora is the name for an effervescent lozenge form of fentanyl that is dissolved in the mouth (not for use under the tongue). As the tablet dissolves, it reacts with saliva and creates bubbles of carbon dioxide, thought to enhance the speed of delivery. It is only to be prescribed to cancer patients age 18 or over who have become opioid-tolerant on round-the-clock doses of morphine or other pain medications for breakthrough pain.10

What is Abstral (Fentanyl)?

Abstral was initially FDA approved in 1968. Abstral is a form of fentanyl in a citrate-based tablet (fentanyl citrate) placed under the tongue where it dissolves. It is prescribed for breakthrough pain in cancer patients over the age of 18 who have already become tolerant to opioid medication during treatment.11

What is Buccal (Fentanyl)?

Buccal refers to the oral cavity, or mouth, but does not include under the tongue. Buccal Fentanyl is an effervescent (fizzing) form of fentanyl in a dissolving tablet that is placed on the inside of the cheek. It is prescribed to cancer patients over the age of 18 who have already developed opioid tolerance. Buccal Fentanyl acts quickly in treating breakthrough pain.

Treatment for Fentanyl Addiction

When powerful drugs like fentanyl become entwined and embedded into every segment of life, yours or a loved one’s, solutions can seem out of reach and the sense of hopelessness in the face of such chaos can seem overwhelming. It may help to understand how opiates can have such a devastating effect emotionally, physiologically, and mentally, eliminating everything that may have once held meaning and value.

fentanyl addiction holistic withdrawal treatmentsA starting point to healing may be found in the knowledge that it is possible to overcome addiction and become free of its imprisonment. The Alternative to Meds Center program is structured to provide these strategic tools.

Fentanyl addiction is killing thousands daily, fast or slow, and the death rates seem to climb at a rate we have never seen before. To understand the immenseness of fentanyl and its full weight of destruction, just a small dose can knock out a full-sized elephant. Imagine what it does to the human mind, body, and soul.

Naloxone has served as a life preserver in a dangerous ocean of addiction. But because of the massive number of opioid receptors captured by fentanyl, a larger dose is needed to bring a person out of a fentanyl overdose. Naloxone, properly administered in a life or death emergency, is only a temporary way to open the door to recovery, and true healing will take additional steps back to life without the burden of addiction.15

Holistic Pain Management

Holistic pain management has defaulted in many clinical settings to substituting one drug for another. This is a short-sighted view. There are many innovations in this field that can attain relief without continuing to solely rely on pharmaceutical products.16

People are gifted with a natural, magnificent system for internal pain control. Two primary neurotransmitters for this function are called endorphins and enkephalins.7 The pharmaceutical opiates have been designed to mimic these. They are synthetic analogs to our naturally produced chemicals (also called hormones, neurotransmitters, endorphins, enkephalins, peptides, etc.).

Our natural pain control chemicals are designed to be powerful pain blockers. These natural chemicals also have a function of emotional responses, such as pleasure and the sense of reward.

holistic pain management sedona arizonaClinically, we see that people suffering from pain also may be burdened emotionally. However, without the interference or blocks that drugs temporarily provide, both the emotional and painful feelings we experience could be perceived as guideposts to help us navigate more successfully through the trials of life. Though not always pleasant, fears and emotional or physical pains could be compared to warning signals that alert us to threats, danger, or something to avoid. And created with perfect balance, feelings of joy, happiness, physical touch, etc., also shine a light that beckons toward the pleasures in life, the positive connections, goals, and experiences that are available to us.

When emotional or physical suffering becomes chronic, as in PTSD conditions, a person is placed in the precarious position of spending all available reserves of these precious natural commodities. As the situation goes on, they are struggling with a chronic and worsening condition, existing in a deficit.

When the body responds to the presence of fentanyl or other opioids, it shuts down its own natural chemical production, further compounding the deficit. There is another equally important change that occurs; the body, sensing a need to defend itself, instinctively begins building new pain receptors in an attempt to continue to maintain its built-in warning system.

As a result, natural endorphins are in low supply and we are at a disadvantage on every count. Additionally, painful situations become more excruciating, not less. Joyful or happy experiences become less so, as we are unable to positively respond or feel any appreciation for them. This might describe a day in the life of an opiate user. The supply of natural pain-blocking chemicals has been cut off. And the number of newly created pain receptors is off the chart. So when the artificial analog, i.e., fentanyl, is withdrawn, there is no buffer or defense, and there is also a greatly magnified sensation of pain, including emotional pain.

The temporary solution to this situation is to procure more fentanyl in a desperate attempt to stop the emotional and physical pain. Fentanyl cravings left untreated, impact and pervade the entire body with magnified, aggressive, and intolerable withdrawals. However, addressing basics such as diet and supplementation to provide the deficient body with the raw materials it needs for natural endorphin support is essential, and one of many fundamental parts of treatment at Alternative to Meds Center.17,18

Our Drug Treatment Facility

fentanyl addiction Sedona drug rehabThere are many safe and proven ways to provide relief and hope for a better future. There are bridge medications that can temporarily provide a way out of the pain that is driving the addiction. And there are ways to help the body regenerate adequate endorphins and tolerance to pain. Many other holistic pain management strategies are used at Alternative to Meds Center to support healing on the journey back to vibrant health. There are ways to help assuage and soothe emotional pain and release it through various genres of therapy offered here. Life choices can be re-examined in a safe and nurturing setting with the help of a trusted and compassionate Life Coach or CBT counselor, for example.

There is much, much more to learn about the mechanics of healing from fentanyl addiction. At Alternative to Meds Center, we incorporate education as a foundational part of understanding, accelerating the ability to regain strength and health in very practical and pragmatic ways. Examples of services available for addiction treatment include IV + NAD treatment, therapeutic massage, acupuncture, holistic detox, physical exercise, nebulized glutathione, colon hydrotherapy, neurotoxin removal, neurotransmitter rehabilitation, co-occurring disorders therapy, and much more. Please take a moment to review our services overview pages for more details on services offered at the center.

Contact us for more information about how our fentanyl addiction treatment programs including fentanyl alternatives might provide the path for you or a loved one to successfully navigate back to life and the natural joy that comes with having control of your natural, mental health.


1. Fentanyl DrugFacts National Institute on Drug Abuse, [2016 Jun 3] [cited 2022 Aug 9] 12].

2. Fentanyl National Institute on Drug Abuse, [2016 Jun 6] [cited 2022 Aug 9]

3. Ramos-Matos CF, Bistas KG, Lopez-Ojeda W. Fentanyl. [Updated 2022 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: [cited 2022 Aug 9]

4. Opioid Pain Medications FAQs Health Canada [cited 2022 Aug 9]

5. Postmortem Toxicology Findings of Acetyl Fentanyl, Fentanyl, and Morphine in Heroin Fatalities in Tampa, Florida NCBI, National Institutes of Health 2015 Dec 5 [cited 2022 Aug 9]

6. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Fentanyl. [Updated 2019 Apr 25]. [cited 2022 Aug 9]

7. Enkephalins Encyclopedia Britannica [cited 2022 Aug 9]

8. Manchikanti L, Sanapati J, Benyamin RM, Atluri S, Kaye AD, Hirsch JA. Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic. Pain Physician. 2018 Jul;21(4):309-326. PMID: 30045589. [cited 2022 Aug 9]

9. Foster D, Upton R, Christrup L, Popper L. Pharmacokinetics and pharmacodynamics of intranasal versus intravenous fentanyl in patients with pain after oral surgery. Ann Pharmacother. 2008 Oct;42(10):1380-7. doi: 10.1345/aph.1L168. Epub 2008 Aug 26. PMID: 18728103. [cited 2022 Aug 9]

10. FDA Info Letter, Transmucosal Immediate Release Fentanyl (TIRF) Medicines 12/29/2020 [cited 2022 Aug 9]

11. FDA label Abstral (sublingual fentanyl tablets) Approval 1968 [cited 2022 Aug 9]

12. BCCS Illicit Drug Toxicity Report to May 2022 [cited 2022 Aug 9]

13. National Health Statistics – Drug Overdose Deaths in the US Top 100,000 Annually [released Nov 2017] [cited 2022 Aug 9]

14. AMA Advocacy Resource Center Brief – Nation’s drug-related overdose and death epidemic continues to worsen [published May 12, 2022] [cited 2022 Aug 9]

15. Moss R, Carlo D, Higher doses of naloxone are needed in the synthetic opioid era BMC Journal 18 Feb 2019 [cited 2022 Aug 10]

16. Kress HG, Aldington D, Alon E, Coaccioli S, Collett B, Coluzzi F, Huygen F, Jaksch W, Kalso E, Kocot-Kępska M, Mangas AC, Ferri CM, Mavrocordatos P, Morlion B, Müller-Schwefe G, Nicolaou A, Hernández CP, Sichère P. A holistic approach to chronic pain management that involves all stakeholders: change is needed. Curr Med Res Opin. 2015;31(9):1743-54. doi: 10.1185/03007995.2015.1072088. Epub 2015 Aug 20. PMID: 26172982.[cited 2022 Aug 10]

17.; Matsumura S, Eguchi A, Okafuji Y, Tatsu S, Mizushige T, Tsuzuki S, Inoue K, Fushiki T. Dietary fat ingestion activates β-endorphin neurons in the hypothalamus. FEBS Lett. 2012 Apr 24;586(8):1231-5. doi: 10.1016/j.febslet.2012.03.028. Epub 2012 Mar 23. PMID: 22575661. [cited 2022 Aug 10]

18. Jeynes KD, Gibson EL. The importance of nutrition in aiding recovery from substance use disorders: A review. Drug Alcohol Depend. 2017 Oct 1;179:229-239. doi: 10.1016/j.drugalcdep.2017.07.006. Epub 2017 Aug 4. PMID: 28806640. [cited 2022 Aug 10]

Originally Published Sep 13, 2018 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Michael Loes, M.D.


Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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