Fentanyl is a powerful, synthetically produced opioid that can be more potent than morphine by up to 50 to 100 times, according to the National Institute on Drug Abuse. It is sometimes prescribed for treating severe pain but has become more widely known for its illicit use.
The U.S. has been experiencing an epidemic of opioid addiction and overdose deaths that are primarily caused by fentanyl. An estimated 80,816 fatal overdoses were caused by synthetic opioids in 2021 alone.
Fentanyl works by binding to opioid receptors in the brain. It not only eliminates or at least drastically reduces pain, but it also creates a feeling of euphoria. This euphoric experience drives people to abuse the substance and eventually develop an addiction.
As the body adapts to opioids, it takes larger and more frequent doses to achieve the desired effect. However, fentanyl is so potent that even a small amount can cause a lethal overdose.
The timeline for withdrawal varies for each person and can be influenced by an individual’s history of drug use. People with profound, long-term addictions may experience more severe symptoms.
However, the process of fentanyl detox and withdrawal can be unpredictable, even if the period of drug use was short or doses were low. Further, if a person has developed a dependency on the drug, their body has not only adjusted to the substance but has come to rely on it to function. When they stop taking it, the body goes through a period of adjustment that includes mild to severe physical and psychological symptoms.
The detox process includes three stages, which are frequently referred to as withdrawal, detox, and recovery. Detox stages can also be described as acute, stabilization, and long-term.
The Withdrawal Stage (Acute)
Withdrawal is the most difficult stage with severe physical symptoms. Accepting that you cannot use fentanyl or other opioids anymore is also a very difficult psychological hurdle to overcome. Common symptoms during withdrawal include:
While the withdrawal stage can be very uncomfortable, it is brief. Most of the symptoms will peak within three to five days and then start to improve.
The Detox Stage (Stabilization)
During detox, your body starts to cleanse itself of fentanyl and other substances. You might continue to experience some of the same symptoms from stage one but at a more manageable level.
If an individual begins using fentanyl as a way to self-medicate other mental health concerns, those symptoms will become more apparent during this phase and may require the care of a mental health professional. Strong cravings for fentanyl may also be experienced during this stage.
The Recovery Stage (Long-Term)
Cleansing the physical body of fentanyl is only the first part of the withdrawal process. The psychological process of recovery must also be considered, during which feelings of regret, guilt, self-loathing, and other negative emotions may begin to emerge.
Cravings to use opioids can continue for many months or even years. However, at this point, the cravings are psychologically based and not physical. Remaining active in a recovery program, understanding the triggers that tempt you to relapse, and developing a strong support system are integral to maintaining recovery.
Relapse is the most dangerous symptom of fentanyl withdrawal because it can lead to a fatal overdose. Relapse can happen during any stage of withdrawal and is equally dangerous at any time. Once a person begins to break their physical dependency on a drug, their tolerance for it is lower. Only a very small dose is needed to produce the same effect as a large dose once did.
Individuals can accidentally overdose because they no longer know what a “safe” amount is for them. Due to the wide variance in the potency of fentanyl, no dosage should ever be considered safe unless it is being prescribed by a medical professional.
One study in the National Library of Medicine found that 91% of a surveyed group reported relapse after completing an inpatient treatment program for opioid use disorder. A majority of those relapses happened within the first week after treatment. Nonparticipation in aftercare services is considered partially to blame for the high relapse rate.
The idea that a person “should” suffer through detox alone and rely on their willpower to get through it is outdated and punitive. Detoxing can be dangerous, and addiction is about much more than personal willpower. Receiving medical help keeps patients safe and comfortable as they detox and increases their ability to participate in treatments that will help them maintain recovery.
Medications used during medically assisted detoxification include:
When they are used for managing detox, these medications are prescribed for short-term use and are tapered off when no longer needed.
A type of long-term opioid treatment known as medication-assisted treatment (MAT) involves the combination of medications, behavioral therapy, counseling, and other modalities to treat addiction. Methadone and buprenorphine are also used to reduce cravings after detox. Some of the other medications commonly used in MAT include:
Patients may continue in MAT for many months or even years as they regain their physical and psychological health.
Taking fentanyl is extremely dangerous. It is possible to die from an overdose even the first time you use the drug. Though fentanyl detox is uncomfortable, and the risk of relapse is high, it is not the most dangerous substance to detox from. Alcohol, benzodiazepines like Xanax, and barbiturates are considered more dangerous. Symptoms of withdrawal from these substances can cause:
Without medical assistance, the withdrawal symptoms of alcohol, benzodiazepines, and barbiturates can be deadly.
Because the process can be unpredictable, it is not recommended that you attempt to detox from fentanyl or any other type of opioid without medical supervision.
Professional detox treatment provides the best possible chance to end fentanyl addiction once and for all. While symptoms may not be life-threatening, the risk of relapse is. The strong cravings experienced during detox are both physical and psychological. They can be so severe it is almost impossible to resist relapse without assistance.
Benefits of medically assisted detoxification include:
Receiving medical assistance during fentanyl detox and withdrawal is not the “easy way out.” There is nothing easy about detoxing from a highly dangerous and potent drug. Medically assisted fentanyl detox is responsible medical care that gives those seeking to heal from opioid use disorder a better chance at complete and lasting recovery.
If you or a loved one is suffering from an addiction to fentanyl, reach out to the Lakeview Health team today at: 866.704.7692.