Recently explosions in overdose deaths have reached numbers never before seen in the United States. The worst part is most individuals that have fallen victim to these overdoses aren’t even aware of the drug they’re consuming.
Narcotics marketed as heroin flooding our borders contain deadly levels of fentanyl and hardly any heroin at all. Individuals seeking to avoid the side effects of opiate withdrawal often have no idea they’re consuming the deadly drug fentanyl.
It’s been a well-known fact that heroin has caused deadly overdoses among users for decades. However, these numbers are dwarfed by those of fentanyl.
What Is Fentanyl?
Fentanyl is a full-synthetic, lab-made opioid similar to morphine. However, the potency of fentanyl is approximately 80 to 100 times stronger than the latter.
Originally manufactured as a remedy for terminal cancer patients, fentanyl was released as a transdermal patch applied to the skin. Later it was marketed in the form of lollipops, and finally, even an inhaler hit the market.
Around 2007, law enforcement officials began noticing random spikes in overdoses and connected them to batches of heroin containing fentanyl. The DEA traced these batches to a single clandestine fentanyl lab in Mexico and shut it down.
Assuming the problem was isolated, law enforcement let their guard down. However, in 2012, overdose cases began to spike again. This time, the problem wouldn’t go away.
Since then, overdose deaths have continued to rise, breaking records along the way. In 2021, it was estimated that nearly 90,000 overdose deaths were attributed to fentanyl.
What makes this drug so deadly? How does it affect the brain in ways that other opiates and opioids don’t?
How Does Fentanyl Affect the Brain?
Fentanyl affects the brain in a unique way. All opiates and opioids attach themselves to the opiate receptors in the brain, causing pain-relieving properties and euphoria. In high quantities, these drugs can cause respiratory depression, which is what leads to death in an overdose.
In the case of fentanyl, the respiratory depression caused by this drug triggers brain hypoxia and hyperglycemia. This leads to changes in brain temperature and affects metabolic brain activity.
Because of the potency and dangerous nature of fentanyl, getting someone help who has a dependency on this drug is vital. However, to achieve this, you must be aware of the signs of fentanyl dependence.
Signs of Fentanyl Dependence
There are several signs of fentanyl dependence. However, it’s difficult to decipher if an individual is dependent on fentanyl or another form of opioid. Symptoms are typically uniform across the board with most of these medications. Most users will display the following signs and symptoms:
- Noticeable periods of nodding off or falling asleep
- Long periods of sleeping
- Noticeably smaller pupils
- Overall look of intoxication (slurred speech, staggering)
- Noticing certain periods where the individual seems sick (withdrawal)
Understanding and having the ability to identify these signs can save an individuals’ life. The risk of overdose on fentanyl is incredibly high, and receiving help as soon as possible reduces those risks.
Risks of Overdose on Fentanyl
Because of the potency of fentanyl, the risk of overdose is much greater when compared to those of heroin, morphine, and other opiate medications. In 2021, we witnessed a spike in those overdoses that led to nearly 90,000 deaths.
On the east coast and in the Midwest, fentanyl is primarily found in bags of powder mixed in with heroin. Lately, drugs seized by law enforcement officials actually contained little to no heroin at all.
The west coast has a more insidious problem when it comes to fentanyl. Pills marketed as oxycodone, hydrocodone, and other pain relievers, are actually pressed forms of pure fentanyl.
Illegal manufacturers buy their own dyes and pill presses and create counterfeit pills. These pills have led to record numbers of overdoses in California as well.
The most frightening part of this epidemic is the fact that drugs even stronger than fentanyl have been surfacing in isolated locations. Carfentanil, a synthetic opioid 100 times more potent than fentanyl, has been found in batches of narcotics seized across the United States.
Carfentanil is used as a tranquilizer for large animal species such as elephants. A dose of only two milligrams can be deadly for individuals with no tolerance.
In fact, this synthetic opioid is so deadly that it’s been used in terrorist attacks as a biological weapon. In 2002, a hostage crisis in Moscow included the use of gas that contained carfentanil.
Chechen rebels stormed a theatre and took over 800 hostages. Russian troops deployed a gas meant to incapacitate the rebels. However, it ended up killing 120 of the hostages because the gas contained carfentanil.
The thought that substances like this are being consumed regularly is extremely alarming. The extreme potency of these synthetic opioids often makes withdrawal symptoms more severe. The following section will outline the most significant fentanyl withdrawal symptoms.
Fentanyl Withdrawal Symptoms
Fentanyl withdrawal symptoms, although similar to other opioids, may be more severe and take less time to kick in. Symptoms of fentanyl withdrawal include:
- Frequent yawning
- Water eyes
- Muscle aches
- Stomach cramps
- Increased heart-rate / blood pressure
Luckily, there are several medications used to treat fentanyl withdrawal. The medications used to treat fentanyl withdrawal are highlighted in the section below.
Medications Used to Treat Fentanyl Abuse Disorder
There are several options for treatment for individuals suffering from fentanyl abuse disorder. Most of these treatment options include the use of medications.
Suboxone vs. Sublocade
Suboxone and Sublocade both contain the drug buprenorphine. Buprenorphine is used in the treatment of opiate abuse disorder, calming the symptoms of withdrawal.
The biggest differences between the two include:
- Suboxone is placed under the tongue in the form of a strip. Sublocade is taken in the form of an injection.
- Suboxone is taken daily, while Sublocade is taken once per month.
- Suboxone contains buprenorphine and naloxone. Sublocade contains only buprenorphine.
Sublocade can only be given to individuals who have started treatment on Suboxone. There should be a clear understanding of whether an individual can tolerate buprenorphine first, hence the initial regimen of Suboxone.
Both of these medications are considered forms of maintenance. This means the body is still dependent on some form of opiate or opioid, and ceasing the use of Suboxone and Sublocade means experiencing withdrawal.
However, individuals that have already fully experienced detox may want a solution for post-acute withdrawal symptoms and cravings. There are also solutions for this issue.
Probuphine vs. Vivitrol
Probuphine is a form of Suboxone. It contains buprenorphine and is also used as a form of maintenance. However, Vivitrol may be an appropriate option for individuals that have already experienced detox.
Vivitrol must be administered after an individual has fully detoxed from fentanyl. This means all traces of the drug must be out of the system before Vivitrol is administered.
Taken as a once-per-month injection, Vivitrol is effective at eliminating cravings associated with post-acute withdrawal symptoms. However, before Vivitrol is an option, individuals must plan for detox.
Two options exist for detoxification from fentanyl. These options include at-home fentanyl detox and medically supervised detox.
Risk of At-Home Fentanyl Detox
Going through fentanyl detox at home presents significant risks for individuals who suffer from fentanyl abuse disorder. The following are the most dangerous risks of making this choice:
- There’s no access to medical staff
- Withdrawal symptoms can lead to dangerous spikes in blood pressure and heart rate, and not measuring vitals could be a problem.
- Individuals have no options for prescription medications that may provide relief.
- Hookup to IV fluids may be necessary to prevent dehydration. This isn’t possible during at-home detox.
If you’re considering detoxing from fentanyl, medically-supervised detox may be the better option.
Benefits of Medically Supervised Detox
There are several benefits when choosing medically supervised detox. Individuals choosing this method have much higher chances of successfully detoxing from fentanyl.
- 24/7 monitoring by medical professionals.
- Access to IV liquids to avoid dehydration
- Quiet, comfortable environment
- Support from mental health professionals
- Access to prescription medication that may reduce the most severe symptoms of withdrawal
Some of the medications that may be helpful in assisting the detox process include:
- Antianxiety medications such as Xanax and Valium
- Blood-pressure medicine such as Clonidine
- Anti-depressants, muscle relaxers, and stomach medication may also be useful.
Regardless of the specific route of detox you choose, it’s vital that you come up with some type of treatment planning for fentanyl use.
Treatment Planning for Fentanyl Use
Treatment planning for fentanyl use takes careful thought and crafting the most vital steps in the correct order. The following is an example of one of the most effective treatment planning for fentanyl use.
Decide On a Detox
Deciding on the most efficient detox process is the first important step in crafting a treatment plan. Medically-supervised detox is normally the most effective course of action.
When individuals choose medically-supervised detox, the odds of successfully completing the entire process are much higher. At-home detox, besides posing several physical risks, increases the odds of relapse as individuals battle the most intense symptoms of withdrawal.
After successfully completing detox, a treatment program must be selected. Inpatient and outpatient rehab programs are usually the two most effective options.
Inpatient vs. Outpatient Rehab
Inpatient rehab includes clients staying for a period of 30, 60, or 90 days. In some cases, treatment times may be extended, depending on the specifics of the recovery plan.
Clients who participate in inpatient rehab receive the following benefits:
- Access to mental health professionals for one-on-one counseling. Dual-diagnosis treatment may also be an option, as underlying issues and accompanying mental health issues must be identified and treated.
- Individuals will have a well-crafted diet that provides the nutrition needed to promote physical and mental wellness successfully
- Physical activities and holistic approaches are also an option. Yoga and other alternative methods are available in some inpatient rehab programs.
- Group counseling with peers that are also participating in the treatment is available. These counseling sessions are similar to NA and other 12-step groups.
- Family counseling sessions are also available. This is when individuals in treatment participate in counseling with family members and loved ones.
- Resources are also available for post-treatment options. This includes continued treatment and appointments with mental health professionals.
Outpatient rehab, while having some benefits, also presents several risks associated with relapse. It takes a high level of willpower and a strong support system to successfully navigate outpatient treatment.
It’s possible to maintain a normal job and home life with an outpatient treatment program. However, individuals are required to travel to a treatment center daily, which could be a lengthy drive.
There are also environmental risks that may trigger a relapse. Family members and other participants in the support system must hold the individual accountable for remaining sober and completing treatment.
Long-Term Recovery from Fentanyl
Long-term recovery from fentanyl is possible with the treatment options listed above and continued services. Aftercare is incredibly important for long-term recovery. Continued attention to mental health and addressing underlying conditions is crucial.
Primary care and regular mental health counseling should be a staple in the life of an individual seeking long-term recovery. Additionally, group sessions like Narcotics Anonymous and other programs are also effective.
There are multiple online support groups that accommodate social distancing. Peer counseling and engagement are available through online platforms and certain forums. Social media is another great place to seek peer engagement for substance abuse therapy.
If you’re seeking treatment for fentanyl abuse disorder, Icarus Behavioral Health is waiting to hear from you. We have experienced staff members and counselors that have assisted countless clients in navigating a successful recovery.
Contact our admissions specialists if you have any questions regarding our treatment and inpatient rehab program following detox. They’ll be happy to address any of your concerns.
Nobody should go through detox and recovery alone. If you or someone you know is suffering from substance abuse disorder, contact Icarus Behavioral Health today.