What Is Fentanyl Used for?
Fentanyl is a pain medication designed for use in specific types of scenarios, including:
- 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 through the underground and sold on the street, the risk for injury and death due to overdose is exceptionally high.1
Many deaths from fentanyl occur in first time users, or those using for only a short time, as they are unaware of the drug’s powerful depressant effects. However, drug use comes with risk. 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 from laced heroin or when combined with other drugs.
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 oromucosal 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 devises and other extremely high tech means of detection. The sheer volume of fentanyl successfully brought in makes the problem difficult to overcome.
Fentanyl Addiction Side Effects
Fentanyl is a pain reliever with euphoric, relaxation and other effects.3
Some of these can include:
- Slowed respiration, difficulty breathing
- Difficulty swallowing
- Changes in mood (i.e., exhilarated, depressed, irritated)
- Pains and aches (i.e., headache, muscle cramps, chest pain, stomach pain, back pain)
Skin reactions such as burning, itching, hives, rashes, numbness, tingling, swelling (especially around the site of a fentanyl patch the skin can be red and itchy)
- Drowsiness, groggy feeling
- Loss of appetite
- Insomnia, trouble staying asleep
- Dry mouth, hoarseness
- Sexual dysfunction, loss of libido
- Menstrual changes
- 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, chest does not rise, shallow breathing
- Fainting, syncope, weakness
- Fever accompanied by tachycardia, sweating, vomiting, and mental confusion
- Stiff or rigid muscles, twitching muscles, loss of balance or coordination
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 may range from mild to severe, and can include:
- Dysphoria, general malaise
- Drug cravings
- Runny nose
- Clammy skin
- Bone pain
- Cramping, particularly in stomach or abdomen
- Restless legs
- Aches and pains, muscle spasms
- Chills, goose bumps
- Insomnia, interrupted sleep
These effects tend to begin about 12 to 30 hours after the last opioid dose taken. These effects will intensify over a number of days, and then begin to ease. It may take several months to start to feel normal again. There is more information on this topic below in the Treatment section. Find ways to accelerate the healing period significantly through proper support.
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 great, 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.
Seek qualified help to avoid the risks that can accompany incorrect opioid tapering procedures.