What Is Fentanyl?
Fentanyl is a synthetic opioid drug, manufactured in a lab, instead of being derived from a natural source, such as a herb or a plant.
Fentanyl was originally designed to be an effective pain killer for chronic pain, resulting from serious illness.
It’s commonly used in combination with other pain-killing drugs, in the treatment of cancer, and serious illnesses.
However, professionals typically avoid Fentanyl use for regular aches, pains, or minor conditions, as its addictive qualities are well established.
In the operating room, Fentanyl can be used intravenously or regionally.
Usually, only anaesthesiologists are allowed to inject this drug in specific amounts, in certain parts of the body.
Sadly, illegal Fentanyl use is increasing rapidly, due to its very high potency in comparison to other opiates, and comparatively cheap production costs.
Overdose deaths from Fentanyl are increasing, especially in the United States.
Fentanyl is up to 100 times more potent than heroin, and delivers a very rapid, short-lived, spike in euphoria levels, followed by a quick “crash” phase, leaving users quickly seeking more. Fentanyl binds to opioid receptors in the brain, simulating the effects of other opiate drugs. Repeated use of the drug down-regulates the brain’s production of normal levels of feel-good neurotransmitters, as the body becomes dependent on an external source.
- As a synthetic opiate, Fentanyl is cheaper to produce than organic relatives such as heroin, and can be produced at scale, quicker.
- Fentanyl typically has far higher potency than heroin, and can be mixed, even in small quantities, to increase the euphoria achieved from street heroin alone.
- Some versions of the drug are so potent, that emergency recovery teams in the US are finding their normal Naloxone kits, used to reverse opiate overdose, are not powerful enough to combat the effects of Fentanyl in the brain.
For these reasons, Fentanyl is extremely addictive, and even a few episodes of use will usually result in either (i) ongoing addiction issues or (ii) overdose.
Forms of Illegal Fentanyl
Street Fentanyl is commonly found in the following forms:
- Powder mixed into heroin (cheaper and more powerful than heroin alone)
- Powder mixed into cocaine
- Combined with other opioid drugs, such as oxycodone, hydrocodone, or methadone.
- Combined with alprazolam (an anti-depressant)
- Diversion of Fentanyl Transdermal Patches (FTP) to illegal distributors
- Extracting the drug from patches, then injecting, inhaling through the nose, or inhaling vaporised fumes
Since Fentanyl is extremely potent, people often misjudge the amount used, and overdose becomes more likely.
Naturally, street drugs mixed with heroin do not undergo a standard process.
The amount of Fentanyl mixed with street heroin is unpredictable, and will vary dramatically, in each individual situation.
Using heroin and Fentanyl in combination is like playing Russian roulette. Sadly, some drug users even see this as an added thrill.
Fentanyl + Diazepines = Deadly Combination
Diazepine drugs and Fentanyl taken together can be a fatal combination.
Benzodiazepine drugs include:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Clonazepam (Klonopin)
- Lorazepam (Ativan)
- Temazepam (Restoril)
- Chlordiazepoxide (Librium)
Benzodiazepines are usually prescribed for people who have depression or mood disorders.
Opiates taken in combination with Diazepines act to suppress breathing, and can result in potentially fatal respiratory arrest.
Fentanyl Withdrawal Symptoms
Fentanyl floods opioid receptors, and after sustained exposure to the drug, the body and mind must find equilibrium again. Fentanyl withdrawal symptoms mean that the body is trying to break free from its dependence on the drug. The body and brain are re-balancing levels of neurotransmitters and other chemicals, to function normally again, without external chemical input from Fentanyl.
Withdrawal symptoms can start within hours of the last dose of the drug, and ceasing Fentanyl use, without controlled detox, means withdrawal symptoms may include:
- Anxious feelings
- Irritable mood or mood swings
- Tired feelings, i.e. wanting to give up
- Runny nose
- Increased heart rate (tachycardia)
- Muscle pains or cramps
- Stomach pains, nausea and vomiting
- Fever and chills
- Blood pressure variations
- Tremors and twitches
The unpredictable potencies of street drugs can mean that unassisted (“cold turkey”) Fentanyl withdrawal is at best, very uncomfortable, or at worst, fatal.
Completing assisted detox, typically under supervised care in a residential facility, usually offers a safer and more personalised detox option. It avoids the negative associations which can accumulate, as a result of repeated unsuccessful detoxes, undertaken alone. Quitting the recovery process because of undesirable experiences during detox is a lot like quitting the race during the warm-ups.
Because we were not properly equipped and informed about what we were about to go through, we got scared and stayed away.
Residential rehab care for Fentanyl withdrawal usually provides:
- Initial assessment of physical and mental health, with a view to prescribing for withdrawal symptoms
- Personalised detox regimen.
- Addiction specialist staff available 24/7 for assistance
Subject to their discretion, an attending professional during a residential detox may offer alternatives to offset the effects of the withdrawal symptoms opioid drug users may experience, such as:
- Anti-anxiety drugs
- Medicines for diarrhoea and nausea
- Mild pain relievers for stomach aches
- Nonsteroidal Anti-Inflammatory Drugs for fever and chills
However, detox does not equal rehabilitation.
Physical recovery from withdrawal symptoms alone does not mean we’re now adequately equipped to tackle the same psycho-social issues we faced during active addiction.
The mental health issues which were present before the substance abuse began, are still present, and detox itself should be part of a bigger program of Fentanyl addiction recovery, the foundation of which, is usually rehab.
If achieving a stable physical state is the focus of detox, a drug rehab programme should help us to identify and begin to address, the underlying reasons behind Fentanyl substance abuse. Active addiction is usually borne out of a life structure that is chaotic, unstructured, and out of balance. Secondary mental health issues, such as depression and anxiety, usually co-exist alongside active patterns of addiction.
Getting help for substance abuse means accepting in advance, that a life of abstinence, is the most likely route towards long term recovery.
As well as therapeutic progress, any course of rehabilitation should include a rebalance of life’s priorities, and a focus on:
- Improved self-care (eating balanced meals, exercising and having good sleeping habits)
- Effective ways to deal with Fentanyl cravings
- Enabling independence (emotional, mental and physical), and a move away from co-dependent relationships and associations
- Setting and achieving personal goals
- Developing appropriate relationship management skills
- Contributing positively to family, and the wider community
At Abbeycare, the Fentanyl detox and rehab programme incorporates the 12 Step Approach, Cognitive Behavioural Therapy, individual work, and group therapy.
A personalized treatment plan is better than a one-size-fits-all scenario, where a person’s needs tend to be overlooked. An individually-assigned case manager can oversee your progress throughout treatment, from beginning to end.
An addiction treatment programme that prioritises personalisation and consistency provides:
- A measurement of success
- Insight around which approaches work for you personally, and which don’t
- Accountability for both case manager and client
- Rapport, friendship and trust
- Continuity of care
Individual Step Work & Keywork
Individual, one-to-one sessions provide an opportunity to progress through 12-step work, and manage progress toward care-plan goals, with an individually assigned case manager.
Sessions 2-3 times per week are personalised, but typically include:
- Care plan management
- Agreeing treatment goals, and desired outcomes
- Identifying areas of progress, with greatest potential for improvement
- Progressing toward completion of Step One
- Acknowledging insights and gains from treatment so far
- Recognising aspects of treatment which can be used as part of aftercare planning and goals for the future
- Discussing concerns and questions in a supportive setting
Small group therapeutic sessions utilise Cognitive Behavioural Therapy, to better understand the events, thinking, feelings, and behaviours which have contributed toward our addiction over time. Exercises identifying life events, or our addiction history, help us understand what prompted dependence on Fentanyl to develop, and improve our motivation to recover.
Common activities may include discussions around triggers, cravings, self-care techniques, and coping with stressful environments.
Group therapy can also include the positive and negative influence of others in our lives, and how they may have supported our addiction – usually unknowingly. Lessons learned from individual and group work can be utilised in aftercare planning.
Rehab programmes that prioritise a client’s long-term well-being will include a rehab aftercare plan.
Components of a sound rehab aftercare plan include:
- Practical supports, and resources to turn to, when feeling triggered
- A detailed schedule of how life will look, sound, and feel, after rehab
- An accountability partner (i.e. a sponsor)
- Strategies on how to redirect energy and time into positive activities, after Fentanyl is removed from life.
Fentanyl Addiction Rehab Programmes
Fentanyl addiction needs to be tackled with a comprehensive treatment approach, addressing issues at all levels in an individual’s life. Success in recovery means entering a full rehab programme that usually consists of:
- Supervised Fentanyl detox – to begin the recovery process by rebalancing body and mind
- 12 Step Programme and Cognitive Behavioural Therapy – to identify and address underlying addictive thoughts and behaviours
- Therapeutic input specifically for addiction – to help us deep dive into the issues that led to our addiction
- Rehab aftercare planning – for relapse prevention planning, and providing support for long term recovery.
Public .v. Private Fentanyl Detox & Rehab
As a form of recreational substance misuse, Fentanyl addiction does not typically attract detox or drug rehab services which are free for public use.
NHS drug/alcohol services are usually co-ordinated by local DAT teams for each area.
Approaching NHS services re Fentanyl use could take the following path:
- Referral via GP to local specialist team (2-3 months)
- Assigned DAT team worker
- Initial paperwork
- Usage diary to be kept (3-6 months+)
- Referral onward for care for physical needs
- Referral onward towards an opioid drug substitute program such as Methadone
- Long term maintenance on substitute program, often with increasing prescription levels
- Scheduled follow up appointments with worker
This approach is usually time consuming, and on an outpatient basis, is difficult to manage quality and continuity of care.
Importantly, any deficit in Fentanyl treatment in public care is of course not through intention, or design, but rather simply lack of funding, and demand for treatment outstripping available resource.
In comparison, private rehab clinics usually:
- Can admit quickly
- Offer a range of options and treatment durations
- Provide consistency and continuity of primary care under one roof
- Undertake a personalised and specialist approach to treatment with addiction-specific staff
Fentanyl Detox & Withdrawal – Treatment At Abbeycare
At Abbeycare, we provide a detox and structured rehab programme founded in the abstinence-based model of addiction recovery.
The clinical program includes supervised detox, structured cognitive therapeutic assistance, and a strong foundation of aftercare for future support, as well as onward referral for more specialist future care needs.
Through experience, we’ve found this provides the strongest possible foundation for positive long term recovery outcomes.
Our program includes holistic therapy, opportunities to exercise and relax, and our clinics are located in spacious, private grounds.
An individually assigned case manager assists you in the transition from detox to rehabilitation, and in to aftercare planning.
The programme includes accountability and continuation of care.
Progress in the programme and aftercare plan are professional and peer reviewed, to ensure the best possible recovery outcomes.
For personalised help for Fentanyl addiction, please ring us direct on 01603 513 091.
- What happens if mixing Fentanyl and alcohol use?
Both Fentanyl and alcohol slow down breathing. Taking Fentanyl while drinking alcohol is dangerous because it can cause respiratory arrest.
- Can Fentanyl use be deadly?
Synthetic opiates are usually more concentrated, and potent, than their organic equivalents. This means, the opiate receptors in the brain can become overwhelmed with the influx of chemicals. These receptors, and others affected by opiate use, also regulate critical functions in the autonomic nervous system such as breathing, and regulation of heart-beat.
Overdosing on Fentanyl usually results in:
- Slowed breathing
- Reduced brain function – the person enters a state very similar to a person under anaesthesia
Together, slowing down of breathing or “respiratory depression” and sedation, make it more difficult to get a response from a person who has overdosed from Fentanyl.
- How long does withdrawal last?
Fentanyl withdrawal symptoms typically begin 6-12 hours after the last dose, and peak around day 2-3 of withdrawal. Depending on how much Fentanyl is regularly used, symptoms usually alleviate after 5-7 days.
- How quickly can I get access to rehab programme?
We understand the urgency to arrange detox quickly. The typical time frame between our initial phone conversation and being admitted for treatment can be as little as 24-48hrs. The duration of your stay will depend on your current status, frequency, recency, and duration of usage, and other factors we can during the initial call. Contact us for advice personalised to your needs.
- How much does rehab cost?
For Fentanyl use, choose the option for “Other Opiates” to get a personalised price guide for your needs. Please note that all pricing is subject to agreement from both our Admissions and Clinical teams.
- Where do you provide rehab programmes?
- How do I prepare to admit to rehab?
First, know how much time you will be away from work, home, and other obligations. Make a plan for people to follow. Put in detail who will be responsible for the usual tasks you foresee. Next, pack your essentials. These include clothing, toiletries, your mobile device, etc. You’ll receive a full checklist of what to bring, by email, when admitting to Abbeycare.