Call us today
Fentanyl is a synthetic opiate drug in the same class of drugs like morphine, heroin, methadone, Vicodin, and OxyContin. According to the National Institute on Drug Abuse, all opioid drugs are derivatives of the poppy plant. The majority of these drugs are used in the treatment of chronic pain, and they also have medicinal uses as cough suppressants and treatments for chronic diarrhea.
Fentanyl is a synthetic opioid drug that is far more potent than morphine or heroin. It is marketed under a number of different brand names, including Durogesic and Duragesic. It is commonly used as a transdermal patch applied to the skin but also can be taken as a nasal spray or as a dissolvable lozenge.
The United States Drug Enforcement Administration lists fentanyl as a Schedule II controlled substance, indicating that the drug does have medicinal uses but also has a very strong potential for abuse and the development of physical and psychological dependence. Fentanyl can only legally be obtained with a prescription from a physician.
As fentanyl acts as an opioid agonist, it is believed to have an infinity to bind to built-in receptors in the human brain that are specialized for endogenous neurotransmitters, such as endorphins and enkephalins that naturally alter the subjective experience of pain. Opiate drugs naturally bind of these receptor sites to produce their effects. They also increase the production of dopamine in the brain, which adds to the euphoria and pleasant effects that the drugs produce. Fentanyl’s action makes it a strong candidate for abuse.
According to research from The Journal of Drug and Alcohol Dependence, the abuse of prescription drugs in college students appears to occur from one of three different possible routes. In the study:
All opiate drugs have the potential to cause physical dependence in anyone who uses them for lengthy periods of time. Even people who use the drugs medicinally can develop physical dependence on them, and individuals who abuse the drug are more likely to develop physical dependence because they use it in a manner inconsistent with safe use.
Physical dependence consists of exhibiting both the symptoms of tolerance (the need to use greater amounts of a drug to achieve effects that were once achieved at lower amounts) and withdrawal (a series of negative and often very unpleasant physical, emotional, and psychological effects that occur when one discontinues using the drug or drastically cuts down on the amount being used).
The withdrawal process from opioid drugs like fentanyl is generally well described; however, there can be quite a bit of individual variation associated with withdrawal from opioid drugs. Several factors affect the length of the withdrawal process and the severity of the symptoms that one will experience. According to the book Managing Patients with Chronic Pain and Opioid Addiction, these factors include:
The half-life of a drug refers to the amount of time that normal metabolism in most individuals is able to reduce the original concentration of the drug by half. The half-life of fentanyl is relatively long for the transdermal patch (20-27 hours) and much shorter for sublingual dosages (typically 5-6 hours). This is because the patches release the drugs slowly into the system. A good deal of the abuse of fentanyl occurs by individuals who obtain the patches and extract or use the fentanyl in them. Because the drug is taken in larger doses when abused, the half-life of fentanyl for individuals abusing the drug may typically be closer to 5-6 hours. This means that individuals who abuse fentanyl could potentially begin to experience withdrawal symptoms rather rapidly if they were taking significant amounts of the drug.
Although there will be significant individual variation, the withdrawal process from fentanyl typically occurs over the following timeline:
Even though the withdrawal process can be negotiated without serious aftereffects in most individuals, simply undergoing withdrawal from opioid drugs like fentanyl is not considered to be a method of treatment for a substance use disorder. Individuals with substance use disorders require active participation in a long-term treatment program following the withdrawal management process in order to ensure that they will not relapse.
In addition, individuals attempting to discontinue fentanyl will experience greater success initially if they become enrolled in a physician-assisted withdrawal management program (often referred to as medical detox).
During this process, an addiction medicine physician or psychiatrist trained in addiction medicine will administer a number of medications, including opioid replacement medication such as Suboxone, to the person as they negotiate withdrawal. These medications have the effect of significantly reducing or eliminating the symptoms of withdrawal, and the person can safely go through the process of normal detoxification without significant discomfort. The physician administers these medications on a tapering regime, such that at specific intervals, the dosage is decreased to allow the person to adjust to slowly eliminating the drug from their system. This process takes quite a bit longer than withdrawing from fentanyl without any assistance at all; however, it is much more comfortable, and there is significantly less risk involved. Individuals going through medical detox are at far less risk for relapse and the development of other complications.