What Is Fentanyl?
Fentanyl addiction is a serious condition that affects more Americans than one would think. Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States. According to the National Institute on Drug Abuse, in 2017, 59.8 percent of opioid-related deaths involved fentanyl compared to 14.3 percent in 2010.
Fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine typically used to treat patients with severe pain, especially after surgery.
It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. Tolerance occurs when you need a higher and/or more frequent amount of a drug to get the desired effects. In its prescription form, fentanyl is known by such names as Actiq®, Duragesic®, and Sublimaze®.
When prescribed by a doctor, fentanyl can be given as a shot, a patch that is put on a person’s skin, or as lozenges that are sucked like cough drops.
The illegally used fentanyl associated with recent overdoses is made in labs. This synthetic fentanyl is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.
Some drug dealers are mixing fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl, making it a cheaper option. This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive. They might be taking stronger opioids than their bodies are used to and can be more likely to overdose.
As sudden discontinuation of the drug may induce fentanyl withdrawal, individuals may instead choose to slowly taper off the drug. Tapering is the slow removal of fentanyl over a set period, and it is also called weaning off the drug. This must be performed under the direction and watchful eye of a medical professional who can set up a tapering schedule that may be able to keep fentanyl withdrawal symptoms from manifesting by keeping some of the opioid drugs in the system. By slowly removing the drug and not stopping “cold turkey,” Fentanyl withdrawal may be managed.
To taper off fentanyl, a person may be first switched to another opioid, such as long-acting morphine or methadone, as reported in the Tapering and Discontinuation of Opioids published by the U.S. Department of Defense (DoD) and the Department of Veterans Affairs (VA). After a person is switched over, these opioids are reduced by about 20-50 percent 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.
Tapering may not be the same for everyone, and different schedules may need to be adopted. Several factors may require the schedule to be modified, such as:
- Level of dependence on fentanyl: The more significant the dependence, the slower the taper may need to be.
- Addiction to or abuse of fentanyl: Someone using fentanyl for nonmedical purposes, or who suffers from compulsive drug-using behaviors, may benefit best from a residential detox program where substance abuse and addiction are addressed in tandem with withdrawal.
- Co-occurring disorders: Someone suffering from a medical or mental health disorder may take medications that need to be properly managed during a tapering schedule.
- Length of time taking fentanyl: Typically, the longer someone has been taking an opioid like fentanyl, the slower the taper may need to be to manage withdrawal.
- Abuse of other drugs or alcohol: Other mind-altering substances can interact with fentanyl and may increase the level of dependence on both substances and/or create a cross-tolerance that may need to be managed differently than usual.
A doctor, substance abuse professional, or another medical professional can help people to set up an individualized tapering schedule to wean off fentanyl safely while minimizing withdrawal symptoms.
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Fentanyl Withdrawal Timeline
Fentanyl withdrawal usually begins within 12-30 hours of the last dose of the drug, the National Library of Medicine (NLM) reports. Fentanyl, in patch form, is an extended-release medication with effects that may continue to increase for the first 12-24 hours of wearing it, lasting up to 72 hours total, according to the labeling information provided by the U.S. Food and Drug Administration (FDA) for Duragesic. With a half-life of around 17 hours after removal of the patch, withdrawal likely begins around a day or so after taking it off.
Withdrawal Symptoms of Fentanyl
The FDA reports the following as potential side effects of the opioid withdrawal syndrome that occurs when Duragesic (fentanyl) leaves the bloodstream:
- Tearing up
- Runny nose
- Stomach cramps
- Pain in joints and/or muscles
- Body hair standing on end, or bristling
- Muscle weakness
- Nausea and/or vomiting
- Elevated heart rate
- Increased respiratory rate
- Pupil dilation
Fentanyl withdrawal syndrome likely peaks in the first few days and levels off within a week or so.
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What Is a Fentanyl Detox?
The method of removing fentanyl from the body safely is called detox, which is the removal of toxic substances from the bloodstream.
This process is usually performed in a specialized substance abuse treatment center. Detox can be part of either an outpatient or an inpatient program, depending on the specific needs of the individual. Typically, residential detox is called medical detox, as it includes medical and mental health support provided by highly trained professionals around the clock. Vital signs are monitored to ensure each individual’s safety, and medications are also often used to manage physical and emotional withdrawal symptoms. A residential detox is usually recommended for fentanyl withdrawal as it is such a powerful opioid.
What is Safe During Detox?
To begin a safe detox, be sure to consult with a medical professional, preferably one with addiction treatment or withdrawal management experience. This specialist can provide a thorough assessment of your status and risks.
In determining an appropriate treatment plan for you, he or she may ask you questions about:
- The type or types of substances you use regularly and whether you are currently intoxicated.
- The frequency, dose, and duration of your use.
- Any preexisting and concurrent mental health symptoms.
- Your physical health/medical history.
- Previous withdrawal and detox attempts.
- How much support do you have at home.
Your answers to these questions will help to determine an appropriate level of care. In very limited instances, natural (or “cold turkey”) detox may be an option for a healthy person with no significant physical dependence or with a history of use of a substance not typically associated with dangerous withdrawal symptoms (e.g., hallucinogens, some inhalants).
What Isn’t Safe During Detox?
Detoxing at home or otherwise without appropriate withdrawal management may not be safe with some types of substance dependence. In certain cases, and with certain substances (such as alcohol), abruptly quitting without medical withdrawal management can be risky.
In the event you experience progressively severe withdrawal symptoms and/or complications without medical care or assistance, detoxing at home can be dangerous. For example, left unmanaged, detox from alcohol can bring about withdrawal symptoms such as seizures or delirium tremens that can lead to death. Also, the chance for relapse could increase if a person is subjected to an unpleasant withdrawal and has no plan for medical assistance.
Completing detox from drugs and alcohol at home is only a viable option for substances that don’t produce particularly dangerous withdrawal symptoms. Remember, however, that while there may be relatively few common medical dangers, some unexpected dangers may arise. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), several medical complications can occur during detox, such as nausea and vomiting.
Particularly in scenarios where an altered level of consciousness is a factor, it’s possible individuals may aspirate on their vomit, which can be fatal. Both the uncomfortable nature of withdrawal symptoms and the presence of accompanying substance cravings can contribute to relapse or return to drug or alcohol use when withdrawal symptoms aren’t managed. Drug cravings can be immensely difficult to resist when withdrawal feels too uncomfortable to handle. Getting professional support can make a big difference in preventing relapse and making it to the next step of treatment.
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How to Detox Fentanyl?
Fentanyl detox is the process of weaning someone off of a fentanyl dependency. It allows members of centers like We Level Up to recover healthily. While an uncomfortable withdrawal from fentanyl is unavoidable, it doesn’t have to be unbearable.
The substance itself is highly addictive, so individuals struggling with misuse can’t quit abruptly. Instead, licensed clinicians at addiction treatment centers swap one out for another. In other words, a medication to relieve withdrawal symptoms is often necessary. Some of the medications are:
- Buprenorphine (aka Subutex)
These FDA-approved drugs are also opioids (minus Naloxone). They’re not as addictive as fentanyl per se, but people can develop an addiction without professional supervision. Licensed substance use specialists are essential to recovery. They will gradually reduce the dosage of these opioids. Then, once a clinician feels a treatment center member is physically ready they will stop its administration.
In this way, members at treatment centers avoid an unbearable withdrawal. The opioid cravings are minimized, which can prevent an overdose. Since synthetic opioids are responsible for most drug overdose cases, this is important. Around 30,000 Americans died from a synthetic opioid overdose in 2018.
Fentanyl Detox Treatment
Detoxification and withdrawal are difficult for patients to go through and often need medical and specially trained personnel. This is where detox centers come in. Fentanyl detox centers can help those suffering from addictions such as fentanyl misuse overcome their dependence without coming to harm. They also provide a safe setting where patients can focus on their detox and recovery until they’re ready to rejoin the outside world.
Most rehab facilities address all types of addictions including fentanyl dependencies. Such facilities are equipped to provide physical and psychological support to their patients by providing a complete range of services that are geared towards patients’ recovery:
- Patient community
- Wellness support
- Treatment of underlying medical conditions
- Medical services
- Behavioral services
- Social services
With professional doctors, counselors, and therapists available 24/7, your overall wellbeing and holistic healing are given top priority in these facilities.
What Is a Medically Assisted Fentanyl Detox?
A fentanyl medical detox is a process of weaning someone off from fentanyl by using medication to stabilize fentanyl withdrawal symptoms. During a medically assisted fentanyl detox, you will also be constantly monitored by a medical team and trained professionals who can assist you should your symptoms escalate.
They will also monitor your progress and ensure that you don’t become addicted to the medication you’re using to manage your withdrawal. You need to complete the medical detox and follow through on your recovery by going to fentanyl rehab. This is because detox is just the beginning of your journey to recovery. It should ideally be followed with ongoing support and treatment to help you remain drug-free once you leave the detox facility. This follow-on treatment is recommended by the Substance Abuse and Mental Health Services Administration (SAMHSA).
In some instances, fentanyl may be replaced with a different opioid agonist during detox. Buprenorphine products are commonly used to aid in opioid withdrawal. Buprenorphine is a partial opioid agonist that is FDA-approved to treat opioid dependence. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports the brand names Bunavail, Suboxone, and Zubsolv all contain buprenorphine as well as the opioid antagonist naloxone, and buprenorphine can be found in transmucosal products like Subutex.
Buprenorphine acts on opioid receptors in the brain like other opioids but to a much lesser degree. This action can help reduce withdrawal symptoms without producing the euphoric “high” that opioid narcotics like fentanyl are known to produce. Naloxone, on the other hand, has the opposite effect and blocks opioid receptors from receiving opioids. The naloxone component of these opioid dependency medications remains dormant unless they are altered or abused, and then, if activated, can cause withdrawal to come on full force. Combination medications may be reserved for post-detox after fentanyl and other opioids are completely out of the system.
Adjunct, or supplementary, medications are helpful during medical detox too. Antidepressants can help with depressive symptoms; antihistamines can assist with insomnia or restlessness; medications to ease gastrointestinal distress can address nausea, vomiting, cramps, and diarrhea; and nonsteroidal anti-inflammatory agents can soothe muscle aches, Pain Treatment Topics reports. The blood pressure medication clonidine is also a popular adjunct medication used off-label to treat opioid withdrawal symptoms, as it can help regulate heart rate, blood pressure, and body temperature.
Medical detox can be highly beneficial in helping to safely and smoothly remove fentanyl from the body and achieve a healthy physical balance. When it is followed with a substance abuse treatment program that uses both therapeutic and pharmaceutical tools, cravings and other negative psychological and behavioral symptoms of substance abuse and addiction can be improved and managed on a long-term basis.
Fentanyl Detox Timeline
In a medical fentanyl detox facility, your withdrawal symptoms can be treated real-time and your treatment adjusted accordingly. They can also provide emergency medical intervention if necessary. You’ll be able to employ their expertise in managing and reducing withdrawal symptoms. The pain and discomfort of the detox will still be there, but it’s more manageable thanks to the medical team and the treatment they’ll be prescribing.
They’ll also create a treatment plan that addresses your fentanyl use, medical history, and physical and mental condition. The treatments that medical detox facilities provide are holistic and can involve programs and activities like counseling, meditation, group therapy, and yoga.
While fentanyl addiction is common, every individual is different and can benefit from a medically assisted treatment plan that takes their different needs into account. This sets you up for better, safer, and more long-term recovery than if you were to do it on your own.
People also undergo different symptoms during each phase of fentanyl withdrawal. There are three main stages of withdrawal: early, peak, and long-term effects.
Early Symptoms (2 to 4 Hours After Last Dose)
The earliest symptoms of fentanyl withdrawal involve slight bodily discomforts, such as constant yawning, aches, and chills. Physical symptoms may come with feelings of anxiety, restlessness, and an intense craving for drug use.
Peak Symptoms (24 to 36 Hours After Last Dose)
Peak symptoms may last up to about a week after the last dose. Symptoms may include an increase in earlier withdrawal effects. Individuals may also experience additional symptoms that require medical care and attention, such as fever and vomiting.
How Long Does Fentanyl Detox Take?
Fentanyl detox can last up to several weeks or longer depending on how your body responds to the medication being used to relieve withdrawal symptoms. The greater the amount of fentanyl used, the larger the dose of medication needed to control and manage symptoms — meaning your detox period may be longer. In some instances, medication may be used for a lifetime to help you stay abstinent from fentanyl and other opioids.
Don’t try detoxing from fentanyl on your own since doing so comes with life-threatening consequences. Fentanyl is a short-acting opioid, which means withdrawal symptoms can begin anywhere between 8 and 24 hours after the last use and may last between four and 10 days.
Fentanyl withdrawal symptoms include the following:
- Hot and cold flashes and sweating
- Tearing eyes and runny nose
- Muscle stiffness and aches
- Nausea, vomiting, and diarrhea
- Insomnia and anxiety
Fentanyl Detox Near Me
Fentanyl addiction is a condition that can cause major health problems such as an overdose. We Level Up rehab treatment & detox center can provide you, or someone you love, the tools to recover from this with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition and give you clarity about issues like the fentanyl withdrawal symptoms. Our specialists know what you are going through. Please know that each call is private and confidential.
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