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Fentanyl is an opioid drug that is available by prescription only. Unlike natural and semi-synthetic opioids that are derived from the opium poppy, fentanyl is an entirely synthetic opioid, meaning that it is produced in a lab. Despite being synthesized using artificial means, fentanyl retains the chemical structure and psychoactive properties of traditional opioids. Opioids, including fentanyl, work by activating naturally occurring opioid receptors in the brain, spinal cord, and gastrointestinal tract. 

When opioid receptors are activated, pain signals are blocked and dopamine is released. Due to the pain-blocking effects of opioids, they are generally prescribed as analgesics, a medical term for pain relievers. However, since fentanyl is a particularly powerful opioid, with effects 50-100 times more potent than morphine, its use is limited to severe circumstances. Given this potent drug’s potential for off-label abuse, doctors prescribing fentanyl generally exercise a great deal of caution.

Fentanyl Uses

Given fentanyl’s potency, this prescription opioid analgesic is generally prescribed for cases of severe and chronic pain. Different dosages and routes of administration can be used to achieve different effects. A vast array of products exist to meet the needs of individuals suffering from distinct types of extreme pain. Fentanyl can be prescribed for a variety of circumstances, including:

  • Anesthesia. A fentanyl citrate injection is a powerful tool during major surgeries when general anesthesia is required. Doctors frequently combine it with a sedative-hypnotic and a muscle relaxant.
  • Chronic pain. Fentanyl doses can be delivered at a steady rate via a transdermal fentanyl patch. The fentanyl patch is worn on the skin for 48 to 72 hours and provides a consistent and regular dose. Cancer patients suffering from the side effects of chemotherapy are often prescribed the fentanyl pain patch, which goes under the brand name Duragesic.
  • Breakthrough pain. Sublingual formulations of fentanyl, such as fentanyl pills, fentanyl tablets, and the fentanyl lollipop provide quick-acting doses of fentanyl to individuals who need immediate pain relief.
  • Combat medicine. Combat medics with the United States Air Force use fentanyl to treat injuries sustained in active combat. The fentanyl lollipop is generally used to deliver a quick-acting dose of fentanyl.
  • Childbirth. Fentanyl also plays a role in obstetrics. It can reduce the pain associated with childbirth when it is injected intrathecally (directly into the spinal canal).

When Fentanyl Becomes a Problem

Fentanyl can be extremely effective for individuals suffering from severe and chronic pain. However, prescription fentanyl has a variety of side effects that certain individuals are more prone than others to experience. Side effects of fentanyl include:

  • Confusion
  • Drowsiness
  • Gastrointestinal problems, including nausea and constipation
  • Extreme happiness
  • Difficulty breathing
  • Sedation
  • Unconsciousness

The greatest risk of fentanyl use and abuse is overdose. Like all opioids, fentanyl can cause overdoses when people take doses higher than they can tolerate. Given fentanyl’s potency and the unpredictability of illicitly produced fentanyl, it can be very difficult for non-medical professionals to measure the correct dosage. 

Additionally, drug dealers frequently add fentanyl to other drugs. Heroin cut with fentanyl can cause overdoses even among hardened drug users who have built up a tolerance to heroin. Drug interactions dramatically increase the risk of overdose. When an overdose occurs, an individual experiences respiratory depression and can die in a matter of minutes.

Doctors often avoid prescribing fentanyl to individuals who are more susceptible to experiencing these deleterious side effects. These individuals include:

  • People with adrenal gland problems
  • People with kidney or liver problems
  • People with enlarged prostates
  • People with low blood pressure
  • People who are pregnant, breastfeeding, or trying to conceive
  • People who suffer from arrhythmia (irregular heartbeats)
  • People with respiratory problems, such as asthma
  • People who have suffered or head injury
  • People who regularly experience seizures
  • People who have had an allergic reaction to opioids previously
  • People who suffer from a substance use disorder or abuse alcohol and/or drugs

The last category, those who suffer from a substance use disorder, is particularly vulnerable to the harmful effects of fentanyl. While many people think of prescription drugs as entirely safe because they are legal, the reality is that all opioids lead to physical dependency, and fentanyl is so potent that even people who take their medications as prescribed can develop addictions. Fentanyl misuse and abuse can lead to an opioid use disorder. In an effort to satisfy their addictions, they may continue to seek out and abuse synthetic opioids like fentanyl. 

Individuals suffering from fentanyl addiction can buy fentanyl online or purchase it on the streets. Much of the fentanyl available on the black market is produced illicitly in labs run by criminal organizations, and it is therefore of dubious quality. Those suffering from opioid addiction may also turn to other drugs. In fact, research shows that 80% of people who use heroin first used prescription opioids like fentanyl. To avoid addiction and the harmful consequences that follow, it is crucial for people to only take fentanyl exactly as prescribed and to reach out to their doctor with any concerns.

When Fentanyl Becomes a Problem

If a person who is being prescribed fentanyl has developed a physical dependency or addiction, it is important to inform one’s doctor. Medical professionals can help find an alternative solution for pain treatment that does not involve addictive opioids. Beyond that, it is crucial to withdraw from opioids and begin a process of addiction treatment. Addiction treatment is a process that takes time; research indicates that people who continue to pursue addiction treatment in the months subsequent to fentanyl withdrawal have a higher chance of avoiding relapse and maintaining their sobriety.

Design for Recovery, a structured sober living home in West Los Angeles, offers young men a way of rebuilding their lives while recovering from an opioid use disorder. Working together as a community, residents strengthen their social support systems, examine the underlying causes of their addictions, and develop new tools and coping strategies for avoiding relapse. At Design for Recovery, young men aim not only to avoid the drugs they were addicted to, but to create new lives for themselves in sobriety that are happy, joyous, and free.

It’s never too late. If you are ready to make a change, reach out today.

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Edited by: David Beasley

David Beasley - Design for Recovery

David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen

Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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