Fentanyl Addcition

Fentanyl is used legitimately under strict medical supervision. Doctors prescribe it in cases where patients experience severe pain that is unmanageable with other painkillers. It is often administered through patches, lozenges, or injections. Due to its rapid onset and effectiveness, it is a crucial tool in palliative care and in managing pain for patients who are tolerant to other opioids.

Fentanyl is also produced and sold illegally, often mixed with other substances like heroin, cocaine, or counterfeit pills. This illegal production is done without any quality control, leading to unpredictable and often deadly dosages. People use illicit fentanyl for its intense euphoric effects, which are far more powerful than other opioids. Unfortunately, because of its potency, even a slight miscalculation in dosage can result in overdose and death.

Fentanyl is highly addictive. Its potency means that it binds quickly and strongly to opioid receptors in the brain, leading to a rapid and intense release of dopamine, the brain’s pleasure chemical. This creates a powerful high, which can quickly lead to physical and psychological dependence. As the body becomes accustomed to the presence of fentanyl, higher and more frequent doses are needed to achieve the same effect, fostering a cycle of addiction.

Common symptoms of fentanyl withdrawal include:

Early onset symptoms:

Later symptoms:

Fentanyl withdrawal symptoms typically start within a few hours after the last dose and can last for several days to weeks, depending on the duration and level of use. Medical supervision is recommended to manage symptoms of withdrawal effectively and reduce the risk of relapse.

Physical symptoms:

Behavioural signs:

Psychological symptoms:

Synthetic opioids like fentanyl are extremely dangerous due to their potency, high risk of overdose, and their prevalence in the illicit drug market. The withdrawal from fentanyl can be severe, but with proper medical care and treatment, individuals can safely navigate the detox process.

Carfentanil: One of the most potent synthetic opioids, primarily used as a tranquiliser for large animals like elephants. It is about 100 times stronger than fentanyl and is extremely dangerous for human consumption.

Methadone: A synthetic opioid used in medication-assisted treatment (MAT) for opioid addiction. It helps reduce cravings and withdrawal symptoms without producing the same euphoric effects as other opioids.

Buprenorphine: A partial opioid agonist used in MAT as well. It has a ceiling effect, meaning its effects plateau, making it safer than full opioid agonists like fentanyl.

Tramadol: A synthetic opioid often prescribed for moderate pain relief. It has a lower risk of addiction compared to stronger opioids but can still be dangerous when misused.

Oxycodone (semi-synthetic): While derived from natural opioids, oxycodone is semi-synthetic and is often prescribed for pain management. It carries a high risk of addiction and abuse.

Extreme potency: Synthetic opioids, especially fentanyl and carfentanil, are incredibly potent. Fentanyl is about 50-100 times more potent than morphine, and carfentanil is 100 times stronger than fentanyl. Even small doses of these drugs can cause fatal overdoses, as users might not realise how much they are taking.

Risk of overdose: Due to their potency, synthetic opioids suppress the respiratory system quickly. Breathing slows down or stops altogether in cases of overdose, leading to hypoxia (lack of oxygen in the brain), coma, or death.

Illicit production and contamination: Much of the fentanyl available illicitly is manufactured in illegal labs. It is often mixed with other substances like heroin, cocaine, or counterfeit pills. Because the dosage is not regulated, users may take a much higher dose than intended, leading to overdose.

Rapid addiction: Synthetic opioids produce a strong euphoric effect, which can lead to rapid physical and psychological dependence. As the body builds a tolerance, users require increasingly higher doses to achieve the same effect, heightening the risk of overdose.

Difficulty in detecting presence: Synthetic opioids, especially fentanyl, are often mixed with other drugs without the user’s knowledge. Someone may believe they are using heroin or cocaine, but a small amount of fentanyl could be present, leading to an unintended overdose.