Fentanyl Withdrawal, Detox, and Treatment Options
For a long time, the most commonly abused opioid in the United States was heroin, but fentanyl has become more popular and much more recognized as a highly potent and dangerous substance. Fentanyl is currently one of the strongest opioids on the planet. While it creates intense highs, it can also very easily lead to overdose and death. On top of that, many street drugs are laced with fentanyl because it’s cheap and leads to strong feelings, but when street dealers put in too much, the results can be fatal.
If you find yourself using fentanyl or other substances that are commonly laced with fentanyl, such as heroin, cocaine, or ecstasy, then you might be wondering what fentanyl withdrawals are like. We will cover that along with overdose symptoms, detox procedures, treatment options, and more.
Fentanyl Compared to Heroin
Many people recognize heroin as a very powerful substance that is highly addictive and very potent. Both heroin and fentanyl are opioids. This means they are substances derived from poppy flowers and used as powerful painkillers.
The major difference between them is potency. Fentanyl is about 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin. Not only that, but it takes incredibly low doses to feel the effects of fentanyl. This is what often leads to overdose deaths, as only a tiny bit of fentanyl can be dangerous to the body.
What Is Fentanyl Used For?
Unlike heroin, which has no accepted medical use, fentanyl is used by doctors for its potent painkilling abilities. Unlike other painkillers, like Oxycontin and Percocet, fentanyl is only used for very severe pain. It must also be used under intense medical supervision, as using even a bit more than prescribed may have dire consequences.
While a doctor’s discretion will determine when fentanyl is used, it is most commonly prescribed for patients with intense nerve damage, a difficult recovery following major surgery, serious injuries with chronic pain or pain management due to cancer.
Street fentanyl is usually a whitish powder that easily mixes into other substances, but that’s rarely how medical fentanyl is administered. Medical fentanyl is most commonly administered as:
• An injection or IV bag
• A transdermal skin patch that transfers through skin contact
• An oral lozenge
You should ensure that your doctor knows all the medications you’re on, and any medical conditions you may have as fentanyl can have intense interactions.
Fentanyl Withdrawal Symptoms
Withdrawal symptoms occur with many substances and medications. Your body may feel uncomfortable or develop certain symptoms as it tries to regulate without the substance. This largely occurs because your body develops a dependence on the substance. Withdrawal symptoms for most substances tend to be relatively short, but the level of discomfort might make it very difficult to endure.
One thing you should know is that fentanyl withdrawal can occur whether you’re using the street or medical variety. If you are using fentanyl under medical supervision, then your doctor should create a tapering schedule that helps you reduce your use with little or no withdrawal symptoms. At the same time, this largely depends on how your body reacts. If you are using the street version without a doctor watching over you, then abruptly stopping your use can cause uncomfortable symptoms.
The most common fentanyl withdrawal symptoms include:
• Runny nose
• Anxiety or restlessness
• Mood swings and irritability
• Increased sensations of pain
• Goosebumps and sweating
• Diarrhea, vomiting, or nausea
• Stomach pain
• Muscle and joint pain
• Rapid heartbeat
• Difficulty sleeping
• Spasms and tremors
Please note that just because a withdrawal symptom is common doesn’t mean it’s not concerning. Be sure to tell your doctor about any withdrawal symptoms you’re facing, even if it’s not on the list. This will help guide the tapering schedule. For example, your doctor might slow down the taper if your withdrawal symptoms or cravings are more intense than expected.
Risk of Overdose
Another potential withdrawal symptom that deserves its own section is the risk of overdose. As stated above, withdrawal symptoms can be highly uncomfortable, and many people are taking fentanyl to alleviate pain. This may cause you to start using fentanyl again. If you are addicted to fentanyl, then there is a good chance that you might take even larger amounts than before to get relief.
Taking a larger dose puts you at risk for overdose. Not only that, but your body may have developed a tolerance during your use. Your tolerance level rapidly decreases, so going back on your original dose could lead to an overdose.
Common fentanyl overdose symptoms include:
• Intense sleepiness or drowsiness
• Difficulty breathing
• Slow and shallow breaths
• Inability to wake up or respond
• Smaller pupils
Due to the potential for overdose, many doctors give clients naloxone. This is an injectable medicine that is able to counteract overdose symptoms. While it would be ideal if you could administer it yourself, overdose often leads to an inability to respond. It would be best to tell nearby friends and family members about the naloxone so that they know how to respond if needed.
Naloxone should be administered immediately, and then it’s important to call 911. Naloxone only stops the withdrawal symptoms temporarily, so additional doses might be needed before help arrives. Be sure to ask the dispatcher about this to know if another dose should be administered.
Helpful Tips While Experiencing Withdrawal Symptoms
You will likely experience at least some mild withdrawal symptoms while you discontinue the use of fentanyl. While this is an uncomfortable time, there are some helpful tips that can make it easier to get through.
It can be good to lean on social supports such as friends or family members. If you find this difficult, either because you are lacking in social supports or they don’t understand your struggles, then consider attending therapy or self-help groups such as Narcotics Anonymous.
Drinking more water and keeping up your nutrition can be helpful. Find ways to relax throughout the day by listening to music, reading, watching something you enjoy, or anything else that helps remove stress. Mild exercise can be helpful, but you may want to avoid anything too strenuous. Positive self-talk can be very helpful as well. Tell yourself that you can get through this and that the symptoms are only temporary.
Fentanyl Detox Procedure
Like with many other substances, a proper fentanyl detox involves tapering the substance. This is normally easier if you were taking it under medical supervision before, as the dose would be smaller and more manageable, but the procedure is largely the same if you were taking street fentanyl.
Unlike some medications where the taper only takes two or three weeks, fentanyl detoxing might take many weeks or months. This depends on numerous factors. The first factor is your current dose. The higher the dose, the longer the taper will likely be. Another factor is how your body reacts. If you feel intense cravings for fentanyl or have more severe withdrawal symptoms, then the doctor will likely slow down the taper.
It is important to listen to the doctor’s recommendation and not use more or less than prescribed. Using less can exacerbate withdrawal symptoms, while using more can prevent your body from detoxing.
Depending on your symptoms and progress, the doctor might prescribe supplemental medications to help you get through the detox. This might involve nonsteroidal painkillers to reduce the feelings of pain without triggering cravings. There are also some medications that help with cravings themselves, such as Vivitrol. Lofexidine is sometimes used as well as it can reduce withdrawal symptoms.
Most doctors will give you some naloxone just in case cravings spike, and you take more fentanyl than you should. This can help in the case of an accidental overdose.
Medication-assisted treatment, or MAT, is quite common when it comes to opioids like heroin and fentanyl. This means that certain medications are used to help reduce cravings and withdrawal symptoms. The most common MAT options include methadone, suboxone and Subutex.
These medications are very helpful. Not only do they make it easier to detox from fentanyl, but they also improve treatment adherence and social functioning. At the same time, some people see this as a controversial option since these medications are also opioids.
The major difference is that they either do not produce a high, or the high is very minimal and won’t be felt by those who have an opioid tolerance. If this treatment recommendation is made, you should know that it can be very useful to get you through the detox process.
Levels of Treatment
Along with a medical detox program, you should know that there are various levels of treatment that can help you recover from fentanyl use. Each level has a different amount of therapy and extra support to help you through the process. Be sure to speak with the treatment team to help get the proper level of treatment for your needs.
The first level of care is outpatient treatment, which can be split into two separate levels. Regular outpatient care involves seeing a therapist on a weekly basis for an individual appointment. This can be very useful for dealing with deeper issues and receiving individual attention.
The next level is intensive outpatient treatment, also known as IOP. This is group therapy that meets three times a week for three hours each time. You’ll be able to talk about your progress, learn about coping skills for getting through discomfort and distress and be around peers going through their own recovery journey.
Above that is a partial hospitalization program, or PHP. This is typically five days a week, and it gives you even more support. Not only can you meet with peers, doctors, therapists, and other staff as needed, but you’ll be able to get away from your stressors for the day. You can then go home and sleep in your own bed at night.
Navigating the proper level of care can be difficult, especially if this is your first time getting treatment. Be sure to communicate your needs in order for the right level to be selected for you.
Here to Help You
We at First City Recovery Center have been helping many clients with fentanyl use and other substances. Located in Kokomo, Indiana, our program offers numerous levels of care that make recovery possible. Each treatment plan is tailored to fit your needs while respecting your decisions and preferences.
If you are having difficulty controlling your fentanyl or other substance use and need help, then reach out. We can give you the extra support you need to get through this.