How to Spot if Someone is Using Fentanyl
Fentanyl is a powerful synthetic opioid 50 times stronger than heroin and 100 times stronger than morphine. First developed in 1960 by Dr. Paul Janssen, the founder of Janssen Pharmaceuticals, fentanyl is prescribed to treat post-operative pain or severe chronic pain.
Because of its high potency and potential for abuse and addiction, the drug is classified as a Schedule II controlled substance by the Drug Enforcement Administration (DEA).
If you have concerns that someone you know may be using fentanyl, it’s essential to be aware of which fentanyl symptoms to look for to help you determine if they are indeed in danger.
Different Forms of Fentanyl
Pharmaceutical-grade fentanyl is available by prescription under several brand names. Three of the most common are Actiq, Duragesic, and Sublimaze. When prescribed by a doctor, it can be dispensed through injection, a dermal patch, or even lollipops.
Illegal fentanyl is sold in different forms. It can come in powder form or be dropped on blotter paper. It also comes in eye droppers, nasal sprays, and pressed into pills that resemble prescription opioids.
Powdered fentanyl resembles many other drugs. Because it is odorless and tasteless, it is often mixed with drugs like heroin, cocaine, and methamphetamine to increase their potency. Drugs laced with fentanyl are hazardous, and many people are unaware that their drugs contain fentanyl.
Illegal fentanyl is dangerous because it is made without the strict quality controls that pharmaceutical fentanyl is subject to and is mainly responsible for the recent increases in overdose deaths in the US.
How Fentanyl Works in the Body
Opioids like fentanyl mimic the effect of endorphins. Endorphins are neurotransmitters produced by the nervous system. They block pain by binding to opioid receptors in the spinal cord and areas of the brain that control pain and emotions. These neurotransmitters block the release of pain signals to the brain, causing pain relief.
When opioids like fentanyl bind to opioid receptors, they cause a much stronger pain-blocking signal than endorphins. This is why opioids are prescribed only in cases of severe and debilitating pain.
To discover how long fentanyl (and Norfentanyl) stays in the system and how long the effects last, read our online resource on this topic.
Fentanyl Addiction
Dopamine is a neurotransmitter associated with feelings of pleasure and causes us to remember the behaviors that resulted in those feelings. When fentanyl binds to opioid receptors in parts of the brain responsible for releasing dopamine, it causes feelings of euphoria.
The brain remembers this high and registers it as a reward, and is naturally inclined to repeat behaviors that trigger feelings of pleasure. This leads to repeated use and over time, this can create an altered dopamine response. As a result, the brain begins to crave the high only an opioid drug such as fentanyl delivers, leading to addiction.
Not only does the brain seek out the high, but as tolerance for the drug develops, increased amounts of fentanyl are necessary to recreate the same high.
Signs of Fentanyl Use
When used correctly and as directed by a physician, fentanyl can effectively manage pain. But because it has a high risk of abuse, it is essential to be aware of the signs of fentanyl addiction.
The symptoms of fentanyl abuse differ from person to person, and not all of these signs may be present. Therefore, this is not an exhaustive list by any means, but the following are the most common signs of fentanyl use.
Behavioral Changes
Fentanyl signs and fentanyl symptoms most often manifest through behavior. Depending on the length of the addiction, you will see more or less of these signs. The longer the addiction exists, the more these behaviors are exhibited.
If you notice changes in someone’s behavior that lead you to suspect fentanyl abuse, here are some behaviors that can be indicative of an addiction:
- Declining performance and/or frequent absences from work or school
- Social withdrawal and lack of interest in activities they used to enjoy
- Neglecting daily responsibilities regularly
- “Doctor shopping” - visiting numerous doctors to get multiple fentanyl prescriptions.
- Forging prescriptions for fentanyl
- “Losing” their medication to get multiple prescriptions
- Neglecting personal hygiene
- Problems with the law - fentanyl abuse can lead to criminal activity as people seek to get their hands on the drug
- Financial problems - addiction can lead to financial difficulties as people spend more money on the substance and have less for essentials like rent or food.
Cognitive and Psychological Changes
Since fentanyl, like all opioids, affects brain chemistry, repeated use over time can result in cognitive changes, which become more pronounced the longer the addiction is.
Common cognitive changes included in fentanyl symptoms are:
- Impaired judgment - this can include making reckless decisions, resulting in risky behavior that puts them or others in danger.
- Difficulty paying attention or concentrating - Inability to concentrate or pay attention has many consequences, including poor work and school performance, which can snowball into significant problems like losing one’s job or dropping out of school.
- Impaired memory
- Cravings for fentanyl
- Suicidal ideation
- Mood swings - those who abuse fentanyl may experience mood swings, irritability, and anxiety.
- Hyperactivity
Physical Changes
Those abusing fentanyl may exhibit the following physical fentanyl symptoms.
- Dilated and Constricted pupils
- Difficulty sleeping / a change in sleep patterns
- Lethargy
- Nausea
- Decreased heart rate
- Constipation
- Muscle rigidity
- Dry mouth
- Constricted throat
Getting Help
If someone you love is addicted to fentanyl, you may be struggling with some challenging thoughts and behaviors, including the following:
- Feeling a range of emotions from anxiety to an all-consuming fear that your loved one’s life is at risk and they may die
- Distancing yourself from them to avoid mood swings and confrontations
- Making excuses or lying to yourself or others about their behavior
- Considering contacting the police when your loved one uses drugs or gets them through illegal activity
- Feeling afraid to talk to them about their addiction for fear of driving them away
If you are experiencing or having thoughts and behaviors similar to these, know that it is normal to avoid addressing your concerns because you fear that your relationship or family will suffer the consequences. Unfortunately, even doctors can sometimes overlook common fentanyl symptoms or other signs of opioid abuse because they assess their patients through the bias of being familiar with them instead of objectively assessing them for opioid-related problems.
Some addiction experts recommend that doctors should also interview family members or caretakers as part of routine follow-up procedures for patients taking opioid medications like fentanyl. The purpose of this is to learn about any concerns they have and if they see any changes in the patient that may indicate opioid-related problems.
Regardless of specific doctor’s practices, you can always voice your concerns to your loved one’s doctor if you think they may be addicted to fentanyl or other opioids. A person is more likely to recover from addiction if those around them refuse to ignore or tolerate the problem.
As an additional option, or if it is not possible to talk to your loved one’s doctor, you can contact any one of Avenues Recovery's inpatient rehab or outpatient rehab locations for guidance.
Or call the Avenues Admissions hotline at 1-866-440-0355. It is a free and confidential information service for individuals and family members facing mental and/or substance use disorders. Furthermore, they can refer you to local treatment facilities, community organizations, and support groups that can provide you with guidance, support, and information about fentanyl rehab so you can determine the best next steps to take.
To learn more about fentanyl addiction and ove