Understanding Fentanyl’s Fierce Health Risks and How to Help

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By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

Authored By: Joe Gilmore

Table of Contents

  • Often people overlook the ominous effects of the Opioid Epidemic under the innocent guise of prescription medication. The opioid epidemic has taken countless lives across the United States.

In part, this crisis keeps  because there are always new types of drugs hitting the streets. Among these new drugs, the worst offender is fentanyl, heroin’s synthetic cousin.

With heroin, 30mg is a fatal dose. Just 3mg of fentanyl, by contrast, is enough to kill the average adult male. This is a shocking picture to imagine when something so small could take the life of something so huge.

According to the CDC, fentanyl is up to 100 times more potent than morphine, and many magnitudes stronger than heroin.

Today, then, we’ll be highlighting how this powerful painkiller works and why it’s becoming more commonly abused, both in the US and worldwide.

What is Fentanyl and How Does It Work?

Fentanyl is a prescription drug and a powerful synthetic opioid usually used during surgery. It’s also sometimes used to treat severe chronic pain symptoms in patients with a physical tolerance to opioids.

The drug is available in the following forms:

  • Patch: You place this transdermal patch on your skin
  • Sublingual tablet: You dissolve this tablet on your tongue
  • Buccal tablet: You dissolve this tablet between your cheek and your gums
  • Oral lozenge: You suck on this lozenge until it dissolves
  • Nasal spray: You spray this directly into your nose
  • Injectable: Healthcare providers can inject you with fentanyl

In the case of the transdermal patch, this is commonly sold under the brand name Duragesic. The patches are also available in generic form. These, as you would expect, typically cost much less than the branded drug. 

Fentanyl patches are often used as a component of combination therapy, meaning you’ll also be using other medications alongside.


Whatever the application, when you take fentanyl, it binds to the opioid receptors in your body. This causes a spike in dopamine levels in the CNS (central nervous system). Resultantly, you experience a state of euphoria and relaxation, while your perception of suffering and pain is reduced.

This drug also depresses your cough reflex and constricts your pupils. The drug will affect everyone slightly differently, though. Your size, weight, and general level of health all influence the effects you feel. Other relevant factors include the amount of fentanyl you take, whether you are taking any other drugs alongside, and whether you have a tolerance to opioids.

Fentanyl kicks in very quickly, relieving pain and sedating within minutes. The duration of effects is short-lived at anywhere from 30 to 90 minutes.

Fentanyl is a schedule II prescription narcotic and analgesic. 

So, how is fentanyl mainly used today, and why is it so dangerous?

How Do You Use Fentanyl?

Fentanyl is only legally used in medical settings. These include: 

  • Anesthesia: Fentanyl is often used for patients undergoing heart surgery and for those with weak heart function.
  • Pain management in cancer patients: The drug can be effectively used to manage breakthrough cancer pain experienced by patients already receiving opioid medication for persistent pain.
  • Pain management for chronic pain: Fentanyl is often administered to patients with persistent, chronic pain calling for the continuous delivery of opioids.
  • Other types of pain management: Patients taking narcotic analgesics or opioid-tolerant patients may benefit from injections of fentanyl.

The danger from fentanyl doesn’t come from its use in these clinical settings, though.

Most of the illegally-used fentanyl associated with the recent glut of overdoses is illicitly manufactured in labs. The synthetic fentanyl is sold in powdered form, formed into pills that resemble prescription opioids, put into eye droppers or nasal sprays, and dropped onto blotter paper.

Unfortunately, some unscrupulous drug dealers are also mixing fentanyl with other drugs like cocaine, heroin, meth, and MDMA. Fentanyl is used as a bulking agent because so little is required to deliver an intense high that it becomes a cost-effective route for dealers looking to maximize profits.

Now, this becomes especially risky when users are unaware they are taking fentanyl. Even if the person is tolerant to opioids or accustomed to taking other narcotics, the danger of overdose with fentanyl is significant and potentially lethal.

When did this unsavory practice start, then?

Fentanyl Use

Although it wasn’t considered particularly newsworthy at the time, the substance abuse of fentanyl started around the late 1970s. It’s only over recent years, though, that this trend has started becoming more noticeable. 

Street fentanyl is either diverted from a legitimate medical source, or illicitly manufactured in underground labs. The fentanyl analogs produced in these illegal laboratories can be a hundred times more powerful than street heroin. This form of the drug is also known to produce dramatically more respiratory depression. 

When drugs like heroin or cocaine are cut with fentanyl, the end user is normally unaware of this. As a result, using the same amount of the drug as normal could easily trigger an overdose. 

Used illegally, fentanyl can be smoked, snorted, injected, or taken orally. None of these methods can be considered safe. 

Fentanyl goes by an ever-changing roster of names on the street, including: 

  • Apache
  • China girl
  • China white
  • Dance fever
  • Drop dead
  • Goodfella
  • Jackpot
  • Murder 8
  • Percopop
  • Serial killer
  • Shine
  • TNT 

Our advice to you is simple. If you are thinking about using fentanyl as a recreational drug, think again. We’ll highlight the laundry list of negative effects you could experience right below. If you use drugs like heroin, cocaine, meth, or MDMA and you have not yet attempted to discontinue use, try to establish whether or not the drug contains fentanyl so you can better protect yourself. 

What could go wrong if you take fentanyl, then?

Fentanyl Side Effects

Fentanyl can trigger mild and serious side effects.

You should always speak with your healthcare provider if you are using this drug under medical guidance if you experience any of these side effects. 

Here are some of the more common forms of blowback from fentanyl:

Common Side Effects

  • Constipation
  • Diarrhea
  • Dizziness
  • Feeling cold
  • Headache
  • Increased sweating
  • Loss of appetite
  • Nausea
  • Redness and irritation of the skin
  • Tiredness
  • Trouble sleeping
  • Vomiting

Most of the above side effects should subside within days or weeks. If not, or if they become more severe, you should speak with your healthcare provider for further guidance.

Serious Side Effects

Here are some of the more serious side effects you can expect when using fentanyl:

  • Adrenal insufficiency
  • Androgen deficiency
  • Back ache
  • Chills
  • Diarrhea
  • Dilated pupils
  • Fast breathing rate
  • Fast heart rate
  • Increased blood pressure
  • Loss of appetite
  • Muscle ache
  • Nausea
  • Physical dependence and addiction
  • Serious breathing problems
  • Severely low blood pressure
  • Stomach cramps
  • Sweating
  • Trouble sleeping
  • Vomiting
  • Withdrawal when discontinuing use

Aside from these issues, constipation is a routine side effect of fentanyl that’s unlikely to disappear without intervention. Your doctor can suggest dietary changes, stool softeners, or laxatives.

Note: After the initial dose of fentanyl and whenever your dose is increased, you may notice a drop in your blood pressure. Make sure you monitor this until it normalizes.

So, now you can see what to expect if you take fentanyl, how do those side effects translate in terms of risk?

Risks of Fentanyl

As with all opiates, fentanyl carries a risk of tolerance, dependence, abuse, and addiction.

In the case of physical dependence, withdrawal symptoms set in when the drug is abruptly stopped. These symptoms usually begin 12 hours after the lose dose and endure for a week or more.

Withdrawal symptoms include:

  • Agitation
  • Anxiety
  • Chills
  • Diarrhea
  • Dilated pupils
  • Goosebumps
  • Hot or cold flashes
  • Insomnia
  • Severe and generalized pain
  • Vomiting

Tolerance to fentanyl builds quickly. This means that much more of the drug is needed to achieve the same effect.

The continual use of opioids often results in addiction. Addiction is a chronic and relapsing disease encompassing more than simple physical dependence. Fentanyl addiction is characterized by uncontrollable drug-seeking behaviors regardless of the negative consequences. Obtaining and using the drug becomes the fentanyl addict’s primary purpose. 

Just like any opioid use disorder, the treatment for fentanyl addiction depends on the severity of the problem. We’ll guide you through some of the most common and effective methods of treatment right below. 

Treatment is always advisable due to the significant risk of fentanyl overdose…

Fentanyl Overdose Symptoms

Even a single dose of fentanyl can be fatal, especially if it’s taken other than as prescribed, or taken incorrectly.

 Here are the most common markers of a fentanyl overdose:

  • Cold and clammy skin
  • Confusion
  • Dizziness
  • Feeling faint
  • Problems walking and talking
  • Severe sleepiness
  • Slow heartbeat
  • Slow, shallow breathing
  • Unresponsiveness

Pure fentanyl powder is awkward to properly dilute, resulting in potent mixtures that can be lethal even for those with a high tolerance for opioids. 

Death from fentanyl overdose can be so quick that users are sometimes found with needles in the injection site.

It’s also possible to overdose on fentanyl simply from being exposed to the contents of transdermal patches. The FDA issued a warning that these patches should always be prescribed at the lowest dose needed, and never to treat short-term pain. These patches should also be folded with the sticky sides together after use before being flushed down the toilet. 

Naloxone should be used immediately to treat a fentanyl overdose. This medication is an opioid antagonist that will block the effects of the drug. Due to the potency of fentanyl, more than one dose of naloxone is often required. 

Fentanyl also comes with some boxed warnings. These are the most serious of the warnings issued by the FDA. 

These warnings include: 

  • Addiction and misuse
  • Heat exposure
  • Decreased breathing
  • Opioid withdrawal in newborns

How Is Fentanyl Addiction Treated?

Just like any opioid addiction, fentanyl addiction is best treated using a combination of proven behavioral therapies and medication to mitigate withdrawal.

Counseling can help you to change your attitudes and behaviors toward drug use. You’ll also learn how to improve your life skills.

Examples of the therapies used include:

  • Cognitive behavioral therapy: CBT helps you to modify your expectations and behaviors while also learning to effectively manage triggers and stressors that could otherwise lead to relapse
  • Contingency management: This is a rewards-based therapy where you’ll receive incentives for healthy living
  • Motivational interviewing: With this patient-centered counseling, you’ll address your feelings toward change

In terms of medications, both methadone and buprenorphine can be used effectively. These medications work by binding to the same opioid receptors in your brain that fentanyl does. Naltrexone is another option. This medication blocks the opioid receptors and negates the effects of fentanyl.

Fentanyl Addiction Treatment with Renaissance Recovery

Whether you feel a loved one has a problem with fentanyl or you’re struggling with opioid addiction yourself, you don’t need to do this alone.

Get in touch with the friendly team here at Renaissance Recovery and we’ll walk you through your best options to get back on track. Call us right now at 866.330.9449.

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Joseph Gilmore

Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country