Dum-Dums of the 21st Century; Fentanyl Lollipops

Medical prescription

What is Fentanyl?

Fentanyl is an opioid that is available legally via prescription. Opioids are a class of drugs that activate naturally occurring opioid receptors in the brain and throughout the body. When these receptors are activated, the result is a significant lessening of pain signals and an increase in feelings of euphoria. 

Fentanyl Lollipops, and other prescription opioids, are used as analgesics, otherwise known as pain-relievers. While most opioids have historically been derived from the opium poppy plant, fentanyl is a lab-produced synthetic opioid. As such, it is significantly stronger than natural and semisynthetic opioids.

 In fact, fentanyl is 50-100 times stronger than morphine. For this reason, a fentanyl prescription is intended only for people with severe and chronic pain. Unfortunately, this addictive substance is currently heavily overprescribed, resulting in high rates of fentanyl abuse throughout the United States.

Fentanyl Lollipops

While the transdermal fentanyl patch is the most frequently prescribed type of fentanyl, the fentanyl lollipop is also common. While the fentanyl patch is used to release steady doses of fentanyl over the course of a day, the fentanyl lollipop, which contains flavoring as well as fentanyl citrate, is a quick-acting form of fentanyl. 

Users hold it in their mouth and absorb the fentanyl rapidly under their tongues. This form of the medication is often utilized to treat breakthrough chronic pain. It is also the form of fentanyl most widely used by military medics to treat injuries and trauma.

Fentanyl lollipops are available by prescription under the brand name Actiq. However, they are also frequently produced in illicit labs. While fentanyl lollipops are less widely available than fentanyl patches, they are in higher demand as recreational drugs, due to the ease with which they can be abused. 

Abusing a fentanyl patch generally requires scraping off the psychoactive sticky substance and taking the time to make that palatable. However, fentanyl suckers require no such tampering. Fentanyl lollipop street prices range from $15 to $40 per sucker. 

However, many people who regularly abuse fentanyl lollipops do so using perfectly legitimate prescriptions, in part due to illegal marketing practices by pharmaceutical companies. These marketing practices have resulted in skyrocketing prescription rates, with many doctors offering heavy duty fentanyl lollipop prescriptions when a far less potent (and less risky) painkiller would be sufficient.

Fentanyl Abuse: Risks of Fentanyl Lollipops

Fentanyl lollipops release high doses of fentanyl during a very short period of time. The result is that recreational users and prescription-takers alike experience feelings of euphoria, known as a “high.” Aside from euphoria, however, fentanyl side effects include drowsiness, constipation, nausea, confusion, and sedation. 

Unfortunately, the high doses that people experience on a fentanyl lollipop are also more likely to lead to the development of physical dependence and addiction. When people are physically dependent on fentanyl and other opioids, stopping use very quickly results in fentanyl withdrawal, an experience that can be excruciatingly painful.

Most suffering from dependence and addiction are willing to do anything to avoid fentanyl withdrawal, resulting in the desperate behavior that is characteristic to addiction. Fentanyl lollipop abuse can over time cause people to experience significant interpersonal problems, economic hardship, and health issues. The greatest risk of fentanyl lollipop abuse, however, is fentanyl overdose.

Signs and Symptoms of Fentanyl Addiction

People who develop fentanyl addictions suffer from a condition known as an opioid use disorder. The DSM-V, the manual that psychiatrists use to diagnose individuals with disorders, defines opioid use disorders by listing 11 distinct symptoms that are associated. Addiction manifests itself via different symptoms for every person, so not everyone suffers from every single one of the best symptoms of opioid addiction. Fentanyl addiction is best thought of as a spectrum disorder. People who become addicted to fentanyl lollipops are likely to experience the following symptoms:

  • Taking more fentanyl, or spending more time taking fentanyl, than originally intended
  • Having a strong ongoing desire to stop abusing fentanyl or cut down on use, but being unable to do so
  • Spending a significant portion of one’s time, energy, and money to obtain fentanyl, abuse fentanyl, or recover from fentanyl use
  • Experiencing strong urges or cravings to use fentanyl
  • Due to ongoing fentanyl abuse, being unable to adequately meet obligations at work, home, or school
  • Despite the fentanyl abuse causing problems, continuing to abuse fentanyl
  • Withdrawing from work, social, recreational, or other opportunities in order to abuse fentanyl
  • Continuing to abuse fentanyl despite an awareness of being in danger, such as driving under the influence of fentanyl
  • Continuing to use fentanyl even when it is causing or exacerbating a physical or psychological problem
  • Developing a tolerance to fentanyl, whereby a person needs greater quantities of the drug in order to experience the high to which they are accustomed
  • Suffering from withdrawal symptoms when fentanyl use stops or the dosage is decreased

The Greatest Risk: Fentanyl Overdose

Due to the quick-release nature of fentanyl lollipops, users are particularly susceptible to opioid overdose. Since 1998, when the fentanyl lollipop was released on the market, the rates of opioid overdoses have dramatically increased in the United States. In 1999, 3,442 people died as a result of synthetic opioid abuse. 

That number has multiplied since then. In 2017, synthetic opioids were responsible for 17,029 deaths. When people abuse the fentanyl lollipop, it can be difficult to determine if they are getting a dose they can withstand. 

This is particularly true for illicitly produced fentanyl lollipops, which often have no dosage labels or proper testing protocols in place. Because fentanyl suckers are so quick-acting, the effects of overdose set in rapidly, resulting in life-threatening respiratory depression. When fentanyl lollipops are combined with other substances, such as heroin or methamphetamine, the risk of overdose increases

Signs of Fentanyl Overdose

People who take higher doses of fentanyl lollipops than they are prescribed, or those who take them for purely recreational reasons without a prescription, are at a high risk of overdosing. Fentanyl is an extremely potent opioid, and because fentanyl lollies are so quick-acting, the symptoms of a fentanyl overdose can occur quite rapidly. Individual can identify a fentanyl overdose by looking out for the following signs and symptoms:

  • Frequent vomiting
  • Significant confusion, delirium, or acting drunk
  • Intermittent loss of consciousness
  • Extreme sleepiness, or the complete inability to wake up at al
  • Pinpoint pupils
  • Breathing problems, such as slowed or irregular breathing
  • Respiratory arrest (no breathing at all)
  • Cold, clammy skin
  • Bluish or discolored skin, especially under the fingernails or around the lips

The greatest danger of overdosing is respiratory depression. Because fentanyl is a central nervous system depressant, when a person takes too high of a dose, their central nervous system becomes inhibited. It is important to keep in mind that the central nervous system is responsible for maintaining automatic life-preserving bodily functions, such as breathing and heartbeat. After consuming too high a dose of a fentanyl lollipop, breathing can stop entirely. This is known as respiratory depression. Respiratory depression can prevent oxygen from reaching the brain and other vital organs, such as the heart and kidneys, which can cause permanent damage. More concerningly, it can be life-threatening if not immediately treated.

Fentanyl Withdrawal

When a person is overdosing on a fentanyl lollipop or any other form of opioid drug, they can be saved by being given naloxone, a drug that rapidly reverses the effects of opioid overdose. Giving a person naloxone sends them into immediate withdrawal, however, which presents its own set of difficulties.

Fentanyl withdrawal also occurs while a person is actively abusing fentanyl. Whenever they are unable to access a fentanyl lollipop prescription or even when they try to cut down or stop abusing fentanyl, the result is opioid withdrawal. These symptoms can be so debilitating and excruciatingly painful that many people find it impossible to stop using fentanyl lollipops on their own.

The symptoms of fentanyl withdrawal include restlessness, sweating, chills, runny nose, backache, stomach cramps, musical and joint pain, muscle weakness, nausea and vomiting, diarrhea, elevated heart rate, high blood pressure, fast breathing, anxiety, and an inability to sleep.

Because these symptoms are so painful, people who survive overdoses often return to abusing fentanyl dum-dums as soon as they can.

Fentanyl Recovery Resources

It is essential that anyone experiencing an overdose or suffering from addiction be given proper care. While medical assistance is generally helpful during the height of a personal crisis, long-term addiction care is the best course of action for someone suffering from an opioid use disorder.

Ultimately, achieving long term sobriety requires more than just ceasing to abuse fentanyl lollipops. Addiction is a complex medical condition with a variety of underlying causes, including trauma, economic hardship, and untreated mental health conditions. Addressing these underlying issues is essential, as is developing a new set of skills and tools for coping with life.

Design for Recovery, a structured sober living home in Los Angeles, California, offers a safe space for young men to develop the skills they need to avoid relapse over the long term. At Design for Recovery, staff understand that abstaining from fentanyl is only the beginning of recovery. 

Residents at Design for Recovery work daily to develop a strong social support system and to rebuild their lives from the ground up. By the time they graduate, residents who enrolled only a few months prior in a state of abject hopelessness are thriving in their newfound sobriety.

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