Opioids are driving the current addiction crisis. Specifically, fentanyl has caused a recent spike in lethal overdoses. Fentanyl is a powerful opioid that’s used as a medicinal drug, and it’s common in the illicit drug trade. As a recreational drug, it’s cheap, potent, easy to transport, and frequently lethal. In 2017, 29,406 people died as a result of an overdose on synthetic opioids, most of which were related to fentanyl.
Fentanyl is more powerful than most of the prescription and illicit opioids you might encounter. It’s so powerful that it can cause an overdose in tiny amounts. The drug is used in hospital settings because it’s effective and fast-acting, which is a desirable quality in a pain reliever. However, it’s also a popular substance among drug dealers and black market traders.
This potent drug can be transported in small, yet profitable packages that are harder to detect. A small amount of fentanyl can make a heavily diluted supply of heroin seem purer and more expensive. In fact, the principle has been applied to other drugs, and fentanyl has even been found in cocaine.
One of the biggest problems is that it’s hard to tell the difference between drugs that have been mixed with fentanyl and ones that haven’t. It’s also difficult for untrained drug dealers to mix this highly potent chemical into their drug supplies without creating deadly concoctions. So, people end up taking deadly amounts of fentanyl, thinking they were just taking cocaine or heroin.
However, treating substance use problems like opioid addiction can help you avoid encountering a deadly fentanyl overdose. By learning to spot the signs of fentanyl addiction, you can get the help you need as soon as possible.
Mainly used as a pain reliever, fentanyl is a powerful synthetic opioid that’s around 80 to 100 times more powerful than morphine. In the U.S., around 6.5 million fentanyl prescriptions were given out in 2015. Compared to other opioids, it’s relatively fast-acting, and it can work in as little as five minutes. This quality makes it useful in emergency situations, such as an epidural during labor. Other opioids can take up to an hour to start working.
Fentanyl is also used as a recreational drug. It’s made in clandestine laboratories and sold on the black market. It often makes its way into the U.S. via transnational criminal organizations. Since it’s cheap, easy to make, and easier to transport than heroin, it’s sometimes shipped in small boxes similar to smartphone packages. (To ship the equivalent amount of heroin, you’d need a box 50 times that size.)
Addiction is a serious disease. It’s characterized by compulsive drug use that continues even if serious consequences follow. While addiction is a chronic disease with no known cure, it can be treated and prevented. As a substance use disorder becomes more severe, it’s often preceded by warning signs.
The first sign that opioid use is becoming a problem is a growing tolerance. Do you increase the dosage if you feel like the drug is getting weaker? If so, you may have developed a tolerance. If you continue to use it anyway, you may start developing a chemical dependency, which is when your body starts getting used to the presence of the drug and adapts your brain chemistry to the presence of the foreign chemical. If you stop using it, you’ll start feeling flu-like withdrawal symptoms.
Fentanyl is one of the most dangerous drugs facing the U.S. today. Other substances are more inherently toxic, but fentanyl’s danger comes from its power and ubiquity. It’s strong enough to lead to a fatal overdose after ingesting a tiny amount, and all kinds of drugs are being laced with it, including heroin and cocaine.
According to the U.S. Drug Enforcement Administration, fentanyl is about 100 times more powerful than morphine and up to 50 times more potent than heroin. Only 2 mg (milligrams) of fentanyl can cause a fatal overdose in the average person.
Fentanyl is mixed with heroin to give users the impression that the heroin is purer and more expensive. It can also mask heroin that has been heavily adulterated with inert substances, such as caffeine, sugar, and procaine. However, a lethal dose of fentanyl is so small that it’s difficult for untrained drug dealers to add a dose that’s small enough to be effective without putting the user in danger.
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When someone takes a dangerous amount of the drug, it can slow down their nervous system to the point of causing respiratory depression. In other words, your breathing will slow down or stop, which can cause oxygen deprivation, brain damage, and death.
Illicit opioid use can also lead to other consequences, including the contraction of intravenous diseases and the increased likelihood of being involved in criminal activity.
Fentanyl addiction isn’t as common as addiction to other opioids. The drug is so potent that it’s likelier to cause a fatal overdose than encourage reuse. However, someone could become addicted if they had a high tolerance and took low doses of fentanyl. Plus, people who are addicted to opioids may eventually come across fentanyl when using illicit drugs.
Opioid addiction is a serious disease that’s officially classified as a severe substance use disorder. Though it’s difficult to overcome, it can be treated with the right therapy options and a lifelong commitment to sobriety.
When you first enter an addiction treatment program, you’ll go through an intake and assessment process that’s designed to determine your immediate needs, the level of care that can help you, and a treatment plan. Therefore, you may go through an assessment called a biopsychosocial, which helps your therapist understand your biological, psychological, and social needs.
Treatment often starts with medical detox, the highest level of care in addiction treatment. It’s designed to treat people with pressing medical needs, especially people who might experience dangerous withdrawal symptoms.
Opioid withdrawal causes symptoms that mimic the flu, including high body temperature, sweating, nausea, vomiting, diarrhea, body aches, and fatigue. However, severe cases can result in dangerous dehydration, so the safest way to go through withdrawal is via medical supervision.
It’s especially important to go through medical detox if you’ve used other substances in addition to opioids. The simultaneous use of multiple drugs is called polydrug use, and it’s very common. In fact, more than 30 percent of opioid overdoses involve benzodiazepines (prescription sleep aids). Benzodiazepines and alcohol can increase the effects of opioids, which leads to respiratory depression and death and causes life-threatening withdrawal symptoms.
After medical detox, clinicians will help connect you to the next level of care that can address your needs. If you finish with medical detox, you no longer need 24/7 medically managed care, but you may still need medical monitoring or clinically managed care. If so, you may go through an inpatient program or residential programs to treat any ongoing medical complications or conditions.
If you’re able to live on your own without significantly risking your safety or sobriety, you might go through an intensive outpatient (IOP) or a partial hospitalization program (PHP). IOP offers more than nine hours of clinical services every week. In PHP, you may have access to as much as 12 hours of treatment every day, but you’ll be able to live independently.
As you progress, you may move down to outpatient (OP) treatment, which offers fewer than nine hours of clinical services per week. OP often works as a helpful step between highly intensive care and complete post-treatment independence.
DEA. (n.d.). Fentanyl. Retrieved from https://www.dea.gov/factsheets/fentanyl
DEA. (2018, October). Fentanyl (Trade Names: Actiq®, Fentora, Duragesic®). Retrieved from https://www.deadiversion.usdoj.gov/drug_chem_info/fentanyl.pdf
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
Nathanson, M. (2019, June 28). 'Crisis': Surge in cocaine mixed with fentanyl has communities and law enforcement on edge. Retrieved from https://abcnews.go.com/US/crisis-surge-cocaine-mixed-fentanyl-communities-law-enforcement/story?id=63846815