Why is Fentanyl Dangerous?
As substances go, fentanyl is known to be one of the most dangerous drugs ever made. The Centers for Disease Control and Prevention (CDC) released a report that indicated opioid-related overdose deaths increased in 2021, going up to 80,816 from 70,029 in 2020.
These opioid-related overdose deaths are primarily attributed to fentanyl, and the staggering death count is making many ask why fentanyl is dangerous to the point of being highly lethal. Most of these overdose deaths, however, are not linked to prescription fentanyl, but to illegally made fentanyl that is either mixed with heroin or falsely sold as heroin.
Prescription fentanyl is a popular painkiller, as it is quite potent. It is estimated to be at least 100 times more powerful as a painkiller than morphine. This substance blocks the pain receptors of the brain and increases the level of dopamine, a chemical that induces euphoria, in the body. Due to the fact that a vast majority of Americans deal with chronic pain on a daily basis, it is not difficult to see why there would be prolific use of potent painkillers such as fentanyl.
The ability of fentanyl to produce sensations of euphoria makes it equally popular as a recreational drug for those who don’t suffer from chronic pain. To put things into perspective, fentanyl is powerful enough to relieve the pain felt by people who had just had surgery. Pain associated with surgery is so agonizing that it is often used as a sensory cue in horror movies, to give the viewers a greater sense of just how excruciating the scene is. Fentanyl is also so powerful that it is used by people who have become tolerant to the effect of other opioids.
What Makes Fentanyl So Dangerous?
Fentanyl is a rapid-acting opioid that kills even severe pain. Add to that the fact that fentanyl induces euphoria, and it really is no wonder that many believe fentanyl is not as dangerous as it really is. Fentanyl could be absorbed by the body in a number of ways, including inhalation, ingestion, or even through the skin, which is why there are fentanyl-based transdermal patches.
The effect of fentanyl to block pain receptors is not the only effect it has on the central nervous system (CNS). Fentanyl works as a potent central nervous system and respiratory depressant. This means that this substance could seriously impair a person’s ability to think, function, and breathe.
This effect is so potent that fentanyl could be used to incapacitate full-grown adults in just a short amount of time. A botched Russian military operation to stop terrorist is proof of this. In an effort to incapacitate the terrorists holding hostages inside a theater in Moscow in 2002, the Russian military reportedly used gas with a fentanyl derivative component to subdue them. This action inadvertently led to the deaths of 127 hostages.
Fentanyl is odorless, and could easily be used to contaminate water, food, or even into the air as an aerosol. People are known to suffer from the adverse effects of fentanyl even from just a single exposure to it. These adverse effects include:
- Cold and clammy skin
- Gurgling sounds while sleeping
- Dry mouth
- Lips and nails turning blue
- Respiratory distress
- Abdominal pain
- Asthenia (general weakness)
- Muscle rigidity
- Urinary retention
- Coordination impairment
- Flu-like symptoms
- Apnea (temporary cessation of breathing)
- Extreme sedation
- Bradycardia (decreased heart rate)
- Warm or hot sensation on the skin
- Death via overdose
Fentanyl use is also known to have long-term effects, including:
- Suicidal thoughts
- Loss of impulse control
- Sexual dysfunction in men
- Irregular menstrual cycles in women
- Severe weight loss
What are the Signs of a Fentanyl Overdose?
As it is quite easy to overdose on fentanyl, it is important to understand what the potential signs of a fentanyl overdose are. The signs and symptoms of a fentanyl overdose include:
- Constricted (very small) pupils
- Severe respiratory depression
- Cold, clammy skin
- Gray, blue, or pale skin
- Blue or purple lips and nails
- Respiratory arrest, or complete cessation of breathing
- Progressive decreases in the level of consciousness
- Limp arms and legs
- Slurred speech
- Inability to speak
- Loss of consciousness
- Making choking or gurgling sounds
Should a person manifest these signs, immediate medical assistance is needed as death is a high probability.
What are the Withdrawal Symptoms of Fentanyl Addiction?
The symptoms that manifest during a fentanyl medical detox are similar to other opioid withdrawal symptoms. The only difference that could be seen would be the duration and severity of the symptoms, which would be completely dependent on the person who used fentanyl. These would include:
- Current health
- Pre-existing conditions
- Length of use
- Frequency of use
The most common withdrawal symptoms that people experience include:
- Disrupted sleeping patterns
- Profuse sweating
- Runny nose
- General irritability
- Chills and goosebumps
- Muscle or joint aches
- Dilated pupils
- Blurry vision
- Hyperventilation (increased breathing rate)
- Abdominal cramps
- Upset stomach
- Tachycardia (elevated heart rate)
- Mood swings
- Memory problems
- Impaired cognition
- Lacrimation (teary eyes)
It should be noted that death during opioid withdrawal is a possibility, mainly due to persistent vomiting and diarrhea. A person who experiences both of these symptoms will most likely succumb to dehydration after a short while unless they are constantly rehydrated. The threat of aspiration, or entry of vomited material into the lungs, is also a possibility during the withdrawal period. This could lead to aspiration pneumonia.
Persistent diarrhea also causes the loss of electrolytes. Unless the person is immediately rehydrated, the massive loss of electrolytes will not only cause severely compromised cognitive function, but it could also cause detrimental changes in heart rate. These changes could lead to circulatory issues and even a heart attack.
What is the Timeline for Fentanyl Withdrawal?
The timeline of withdrawal from fentanyl could vary largely from person to person depending on the person. Typically, it would depend on a person’s general health, and the quality or formulation of the fentanyl taken. Fentanyl bought from street dealers is usually mixed with potentially dangerous substances which could add to the toxicity.
This period is characterized by the initial withdrawal symptoms, and although they appear to be mild at first, they continue to increase in severity and frequency.
The worst withdrawal symptoms begin to manifest during this period, although they don’t typically last very long. Once the symptoms reach their peak, they will begin to decrease in intensity and frequency.
Most people will experience a significant decrease in the withdrawal symptoms during this period, although those who either took fentanyl longer or in greater quantities tend to feel the symptoms past this point.
A few symptoms tend to remain even after the first week, including increased sensitivity to pain, depression, disruption of sleep patterns, irritability, anxiety, and intense cravings. There are also those who experience post-acute withdrawal syndrome, which makes them experience these symptoms for years after the last dosage of fentanyl.
What Treatments are Available for Fentanyl Addiction?
The first step is always the hardest, as it involves the complete stoppage of fentanyl use. For people with a substance abuse disorder, regardless of the substance that they had developed a dependency on, completely stopping is the most difficult in both physical and psychological aspects. It is difficult physically because the body will not only react to the absence of the substance, but it will also react to the slow resumption of normal bodily processes that were affected by the substance abuse. This is why many who undergo medical detox to quit fentanyl also require medication-assisted treatment (MAT).
MAT will not only help the patient curb the massive urge to use fentanyl again, but also help with the most severe withdrawal symptoms. Fentanyl withdrawal is mostly characterized by agonizing pain, as the patient begins to regain the ability to feel pain. MAT helps in dealing with most of the pain felt by the patient without having to resort to the use of other painkillers.
The severity of fentanyl withdrawal symptoms may require being in a facility capable of giving hospital-level care. This is particularly true for those who are in danger of dehydration from the persistent vomiting and diarrhea that come with the withdrawal symptoms. There are also cases where some patients experience flu-like symptoms so severe that every movement they make gives them pain.
Being in inpatient rehab, or residential treatment as others would call it, gives the patient going through fentanyl withdrawal the benefit of being with professionals who know what to do to alleviate their suffering. Being in a facility with these professionals could also be a life-saving benefit should the patient suffer a complication during the withdrawal process. As patients in residential treatment are monitored closely, any change in their condition could immediately be addressed so that it does not worsen or become life-threatening.
LUNA Recovery Can Help You Get Through the Most Difficult Phases of Rehabilitation
The road back to recovery coming from an addiction is never easy. This journey is made even more difficult if the dependency involved a highly dangerous substance, such as fentanyl. This is why it is important to be in a place where the patient could get the proper care and support needed to help them through this arduous process.
This is the kind of attention that patients get here at LUNA Recovery. We do this because we believe that people going through this journey deserve no less, and their success is also our success. Let us help you now because you deserve all the care and support you could get.
Dr. Allaire received his Bachelors of Science in Biology from the University of Houston, as Valedictorian of the College of Natural Sciences and Mathematics, and his Medical Doctorate from Baylor College of Medicine, where he served as Chief Resident. He is the medical monitor for the Physician Counseling Committee of the Harris County Medical Society and the Medical Director of Serenity House Detox. Dr. Allaire specializes in medically assisted detox cases, treating patients in recovery from addiction or other mental health disorders, the medical assessment and monitoring of patients with addictive disorders, medical care related to eating disorders and the medical treatment of patients with mental health conditions.