Fentanyl Addiction: Signs, Effects & Treatment

Last Updated: December 13, 2023

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Article Overview:

  • Fentanyl is an opioid that is 80 to 100 times more powerful than morphine.
  • Fentanyl is available in skin patches, injections and oral dosage forms. 
  • Fentanyl side effects include euphoria, drowsiness and sedation.
  • Using fentanyl in ways not recommended by a doctor, seeking multiple medical opinions to obtain it, dishonesty about symptoms, or devoting substantial time and resources to fentanyl may indicate fentanyl misuse and the potential for addiction.
  • Fentanyl addiction is best treated with a medical detox and inpatient, residential treatment.

What Is Fentanyl?

Fentanyl is an exceptionally strong opioid, placed in Schedule II for prescription drugs. Primarily, it treats severe pain, often after surgery or in cancer patients. It’s much stronger than morphine, about 80 to 100 times more potent. On the streets, it hides under aliases like Apache, China Girl or China White. Illicit fentanyl often mixes with heroin, forming a dangerous blend that can lead to overdose in very small amounts.

Doctors usually prescribe fentanyl as injections or skin patches. It can also come in lozenge form. However, a significant number of fentanyl overdoses occur due to illegal production, where it becomes a dangerous powder or is applied to blotter paper.

Understanding Fentanyl Addiction

Addiction is a complex issue. It forces people to continue using a substance, like fentanyl, even when it harms them. Trying to quit can be incredibly tough due to addiction’s grip.

Fentanyl, like other opioids, affects the brain’s mu-opioid receptors and the central nervous system. It impacts the parts of the brain that handle emotions and pain. When fentanyl hits these receptors, it triggers the brain’s reward system, causing a flood of dopamine. This is why people get addicted—it’s like chasing a feeling of euphoria, starting a cycle that’s tough to break.

Fentanyl can also create physical dependence. This happens when the body gets so used to fentanyl that it can’t function normally without it. When someone who’s physically dependent stops taking it, they experience withdrawal symptoms.

The Risk of Fentanyl Patches

Medical professionals use fentanyl patches to provide controlled pain relief. These patches stick to the skin and release the drug gradually. But they can lead to addiction, too.

Abusing fentanyl patches comes in various forms, each riskier than the last. Some people apply multiple patches, change them too often, chew or swallow them, insert them rectally, inject the gel or turn them into a potent tea. These methods deliver a large dose at once, leading to a high risk of overdose.

Fentanyl’s impact is felt nationwide and is not geographically limited to one area. Between May 2020 and April 2021, the Midwest experienced a 33.1% increase in fentanyl deaths.

Recognizing Signs of Fentanyl Use 

Spotting fentanyl use in someone you care about can be alarming. Some common signs include:

  • Euphoria, an initial burst of happiness followed by drowsiness, confusion and sometimes depression
  • Drowsiness, slurred speech and confusion
  • Sedation, leading to weakness, coordination issues and walking difficulties
  • Pinpoint pupils and slowed breathing

Fentanyl’s Effects

Even when used as prescribed, fentanyl isn’t without side effects. Common ones include:

  • Sweating
  • Fatigue
  • Drowsiness
  • Confusion
  • Dizziness
  • Swelling in extremities
  • Dehydration
  • Loss of appetite
  • Constipation
  • Nausea and vomiting

Using fentanyl patches can also cause skin irritation and itching at the application site.

Spotting Fentanyl Misuse

Fentanyl misuse often shows side effects similar to those of regular use. However, signs of misuse are more evident because those who misuse the drug often take dangerously high doses. Look out for these signs of fentanyl misuse:

  • Using fentanyl differently than prescribed, like taking too much or too often
  • Trying to get multiple fentanyl prescriptions by visiting different doctors
  • Making up or exaggerating symptoms to obtain a prescription
  • Breaking fentanyl patches to swallow, inject or brew into a tea
  • Obtaining fentanyl without a prescription, often from the streets
  • Facing financial or legal problems while trying to acquire more fentanyl

Symptoms of Fentanyl Addiction

Doctors diagnose fentanyl addiction using specific criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). To receive a fentanyl addiction diagnosis, a person typically must display at least two of these signs and symptoms over the past year:

  • Taking larger fentanyl amounts for longer than intended
  • Failing to reduce or control fentanyl use despite trying
  • Spending a significant amount of time obtaining fentanyl
  • Devoting substantial time recovering from fentanyl’s effects
  • Experiencing intense cravings for fentanyl
  • Struggling to meet responsibilities due to fentanyl use
  • Continuing to use fentanyl despite recurring problems
  • Giving up on activities because of fentanyl
  • Using fentanyl in risky situations
  • Needing more fentanyl for the same effect
  • Experiencing withdrawal when stopping fentanyl

Treating Fentanyl Addiction

Fentanyl addiction is severe due to the drug’s incredible potency. In many places, the top choice for fentanyl addiction treatment is inpatient, residential centers. Here’s why:

Inpatient treatment provides a holistic approach, addressing the complex nature of opioid addiction, including physical withdrawal and psychological effects.

Fentanyl isn’t usually the first drug people become addicted to. They may turn to fentanyl because other prescription opioids or heroin no longer suffice, or they might use fentanyl alongside other substances. Polysubstance addictions require specialized treatment.

Moreover, many individuals grappling with fentanyl addiction also contend with untreated or undiagnosed mental health issues. Dual diagnosis treatment facilities, like The Recovery Village Indianapolis Drug and Alcohol Rehab, can identify and address mental health problems alongside fentanyl addiction, leading to better recovery chances.

At a fentanyl addiction treatment center, the journey begins with a detox plan, ensuring safety and comfort during opioid withdrawal. Following detox, a personalized treatment plan unfolds.

Fentanyl Rehabilitation

Fentanyl addiction is a chronic condition for many. Hence, residential and inpatient rehab programs are often considered the best choice. However, alternatives such as outpatient rehab exist, particularly suitable for those who’ve already completed inpatient treatment.

Whether inpatient or outpatient, fentanyl rehab combines behavioral therapies with medical interventions as needed. Therapies encompass group, individual and family sessions.

Coping with Fentanyl Withdrawal

Fentanyl withdrawal symptoms align with those of other opioids. For most people, initial symptoms surface within hours of their last fentanyl use, with the worst discomfort appearing within about 24 hours. Generally, fentanyl withdrawal concludes within ten days of the last use. For individuals using multiple drugs, like heroin and fentanyl, withdrawal symptoms may persist slightly longer, up to ten days.

Initial fentanyl withdrawal symptoms include:

  • Chills and goosebumps
  • Insomnia
  • Leg jerking movements
  • Intense cravings
  • Muscle or bone pain
  • Diarrhea
  • Vomiting

Some may experience extended psychological and mood-related withdrawal symptoms, such as ongoing anxiety and insomnia.

Timeline of Fentanyl Withdrawal

Fentanyl withdrawal timelines vary, but here’s a general overview:

  • Stage one lasts up to 10 days, beginning within 24 hours after the last use. It involves the most severe symptoms, including anxiety, insomnia, sweating and body aches.
  • Stage two, which may span up to six months, entails reduced well-being and strong cravings.

Fentanyl Withdrawal After Short-Term Use

Regardless of the duration of fentanyl use, medical oversight is crucial during withdrawal. Fentanyl withdrawal treatment often involves tapering down or abrupt cessation. Tapering entails gradual dose reduction or the use of medications like suboxone to ease withdrawal symptoms. Going “cold turkey” can be intensely uncomfortable and lead to problems like dehydration and constipation. Consult with a doctor to determine the best tapering schedule.


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Drug Enforcement Administration. “Fentanyl.” Accessed December 10, 2023.

Drugs.com. “Fentanyl.” April 19, 2023. Accessed December 10, 2023.

Kuczyńska, Katarzyna; Grzonkowski, Piotr; Kacprzak, Łukasz; Zawilska, Jolanta B. “Abuse of fentanyl: An emerging problem to face.” Forensic Science International, June 2, 2018. Accessed December 10, 2023.

American Psychiatric Association. “Opioid Use Disorder.” December 2022. Accessed December 10, 2023.

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National Institute on Drug Abuse. “Fentanyl DrugFacts.” June 2021. Accessed December 10, 2023.

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