Fentanyl Addiction Treatment | Signs & Symptoms | Detox & Rehab Clinic

Fentanyl is a strong painkiller prescribed to those with chronic pain, nerve damage and spinal injuries. It’s thought to be 30-50 times stronger than heroin which makes this drug ripe for addiction.

What is Fentanyl?

Fentanyl is a synthetic opioid and an immensely powerful anaesthetic that is around 30-50 times stronger than heroin and 50-100 times more powerful than morphine.

It is most commonly used with patients who are suffering from chronic or breakthrough pain. Fentanyl works in a similar way to heroin and morphine by binding the body’s opioid receptors, areas in the brain that control pain and emotions. When these are bound, they can increase the dopamine levels in the brain and bring about a state of euphoria and extreme relaxation. It has a rapid onset and effects generally last less than an hour or two.

Fentanyl is available in a number of forms including by injection, as a patch, and in the form of a sublingual tablet or a lolly so that the fentanyl is absorbed through the tissues inside the mouth.

Use and Dosage

Fentanyl is used for the management of chronic pain caused by cancer, nerve damage, back injury or any form of major trauma that sees an individual unable to cope with the level of pain they are experiencing.

When prescribed by a doctor it comes in a number of forms including transdermal patches, lollipops as well as intravenous injection. It should be taken no more than four times per day. Usually, a doctor will start a patient off on a low dosage before gradually increasing the dosage to optimal levels.

Fentanyl transdermal patches work by slowly releasing fentanyl through the skin into the bloodstream over 48 to 72 hours, allowing for long-lasting pain management. The rate of absorption is dependent on a number of factors such as body temperature, skin type, body fat, and placement of the patch.

The different delivery systems used by different makers will also affect individual rates of absorption. Under normal circumstances, the patch will reach its full effect within 12 to 24 hours; thus, fentanyl patches are often prescribed with a fast-acting opioid to handle breakthrough pain.

In terms of palliative care, transdermal fentanyl plays a role in the treatment of;

  • Those already stabilized on other opioids who have persistent swallowing problems
  • Those who are experiencing kidney failure
  • Those who do not tolerate the side effects of other opiate-based painkillers well.

Side Effects

One of the most worrying side effects of fentanyl is that it only takes a very small amount to cause a fatality. As little to two milligrams can cause an overdose in the majority of the population. This means if you do have a history of drug abuse it is strongly advised to inform your doctor and make sure your intake is closely monitored.

Another concern with fentanyl is for those individuals who suffer from slowed breathing or asthma, lung disease or chronic obstructive pulmonary disease. Not only that but taking alcohol alongside fentanyl can cause serious side effects and must be avoided.

Fentanyl’s most common side effects (more than 10% of patients) include diarrhea, nausea, constipation, dry mouth, somnolence, confusion, asthenia(weakness), sweating, and less frequently (3 to 10% of patients) abdominal pain, headache, fatigue, anorexia and weight loss, dizziness, nervousness, hallucinations, anxiety, depression, flu-like symptoms, dyspepsia (indigestion), shortness of breath, hypoventilation, apnea, and urinary retention. Even in optimum circumstances, fentanyl can cause:

  • Mood changes
  • Headaches
  • Coldness
  • Drowsiness
  • Depression
  • Dry mouth
  • Stomach pain
  • Indigestion
  • Back pain
  • Itching
  • Decreased libido
  • Agitation
  • Nausea and vomiting
  • Chest pain
  • Seizures

Overdose and Withdrawal

Fentanyl is also one of the most potent opioids available. It’s intended to be prescribed to patients with chronic pain, particularly from cancer, who are already tolerant to other opioid pain medicines. Fentanyl, like other opioids, is extremely addictive, and there is a high potential for abuse. There is also a high risk of overdose as Fentanyl (brand names include Actiq, Duragesic, and Sublimaze) is 50 to 100 times more potent than morphine.

Fentanyl, like other opioids, works by flooding the brain with dopamine as the drug binds to their opioid receptors, which activates their brain’s reward centres. This creates a euphoric rush. The brain then wants to continue seeking whatever it is that created this feeling, so there is in a sense positive reinforcement to continue using and abusing the drug. After some time you may discover that you have developed a tolerance to the drug and start using more and more to get the same effect. This is incredibly dangerous with fentanyl because of the drug’s potency.

If you are using and abusing fentanyl you are at high risk of overdose. Learning how to recognize the indications of a fentanyl overdose and getting professional help for your addiction may save your life.

Fentanyl overdoses can be fatal. A person overdosing on fentanyl may present with the following overdose signs and symptoms:

  • Weak muscles
  • Dizziness
  • Confusion
  • Extreme sleepiness
  • Loss of consciousness
  • Profoundly slowed heartbeat
  • Very low blood pressure
  • Dangerously slowed or stopped breathing
  • Bluish tint to nails and lips

The effects that a fentanyl overdose has on the user’s heart rate and breathing present the biggest risk of death or permanent damage.


Physical dependency on fentanyl can develop whether you are using prescribed drugs or street drugs. Symptoms of fentanyl withdrawal can include:

  • Sweating
  • Yawning
  • Runny nose
  • Watery eyes
  • Chills, fever or goosebumps
  • Coughing
  • Exhaustion
  • Cognitive problems
  • Memory problems
  • Anxiety
  • Restlessness
  • Insomnia
  • Weakness
  • Aches and pain
  • Adnominal cramps
  • Gastrointestinal problems including diarrhoea, nausea or vomiting
  • Irritation
  • Mood problems
  • Cravings.

People going through withdrawal often experience what can feel like depression, anxiety, and agitation because of how the opioid impacted their dopamine and neurotransmitters. After some time the brain can reset itself and these symptoms should subside.

Withdrawal symptoms from fentanyl usually begin anywhere from 12 to 30 hours after the last dose is taken. Longer if you have a fentanyl patch since it’s an extended release medicine.

Withdrawal would usually start within about a day of removing the patch.

Anywhere from two to four days after the last dose of fentanyl is when the peak effects of withdrawal are often seen. Within about a week, most of the symptoms tail off, though you may experience lingering emotional issues which can be overcome with time and with the development of emotional regulation skills and tools.

Treatment Options for Addiction

If you are suffering from addiction you may benefit from accessing professional help in the form of medication, rehab, or therapy. Or a combination of all three. During your assessment, a treatment provider will try to get as comprehensive a picture as possible to determine which course of treatment will be best for you. You will be asked questions relating to your drug and alcohol use, lifestyle and medical needs. You will also be asked some contextual questions relating to family employment, as well as your mental, emotional and physical health.


Given just how difficult it is to withdraw from fentanyl and the severity of the accompanying side effects, it is necessary to seek professional help when looking to withdraw from this drug. Residential rehab programmes are delivered in a safe and nurturing environment. In rehab you will have access to:

  • Medical detox
  • Expert therapists
  • Cognitive behavioural therapy
  • Dialectical behaviour therapy
  • Individual counselling
  • Group counselling
  • Family groups
  • 12 steps
  • Exercise and fitness programs
  • Healthy eating
  • Educational talks
  • Relapse prevention
  • Aftercare
  • Complimentary therapies
  • Trained and dedicated support staff
  • A community of peers.

In addition to getting clean and sober, rehab can help you with:

  • Stress reduction
  • Anxiety and depression
  • Cultivating peace of mind
  • Self-acceptance
  • Recognizing and understanding our thought patterns
  • Living in the moment rather than worrying about the future and dwelling on the past.

Rehab is designed to be a safe and nurturing environment in which you can deal with your past, present and future in a safe and effective way. In rehab, you can recover with a peer group. You will help others and be helped. You will be able to connect and form genuine, positive relationships.

See our rehab programme for fentanyl addiction.


After being assessed by a doctor you may be prescribed a medicated detox. This assessment will involve questions about your drug or drink of choice, your using history, and any other mental, physical, emotional health issues you may have.

To taper off fentanyl, you may be first switched to another opioid, such as long-acting morphine or methadone. After a person is switched over, these opioids are reduced by about 20-50 per cent each day until the dosage reaches 30 mg/day for methadone or 45 mg/day for morphine. At this point, the dosage can be reduced by 15 mg every 2-5 days for morphine and by 5 mg every 3-5 days down to 10 mg/day. It can then be reduced by 2.5 mg every 3-5 days down to 0 for methadone.


When treating substance abuse, there seems little doubt that therapy is an integral part of treatment and really the only way to ensure that there is no relapse.

Individual Counselling and Group Counselling are two of the core styles of therapy available for addiction:

  • Individual counselling will give you the opportunity to work with the same focal counsellor. In these sessions, you will be able to talk privately and confidentially to your counsellor about whatever you need to work through.
  • Group counselling will be facilitated by a counsellor and will enable peers to learn from one another’s insights and to work on interpersonal and communication skills.

However, that being said there really is no one size fits all option and, instead, it is important to seek advice and see which therapy works best for you. Choices include:

  • Contingency management: A therapy used specifically in the management of substance abuse.
  • Cognitive-behavioural therapy: In this therapy, a therapist will work with you to assess the processes that lead to thoughts, feelings and behaviours the patient wishes or needs to change.
  • Rational Emotive Behavior: This works in a similar way to cognitive behavioural therapy, but places far more emphasis on the views of the individual rather than their behaviours.
  • Person-centred therapy: The foundation of this therapy believes that every person has inner goodness that is waiting to emerge.
  • Motivational interviewing: this was developed specifically for dealing with addiction and encourages patients to find their own drive to stay clean rather than using threats or guilt.
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