Fentanyl Withdrawal and Treatment

What is Fentanyl?

Fentanyl is a synthetic opioid and a Schedule II controlled substance. ¹ It is typically reserved for treating patients that suffer from chronic pain and are tolerant to other opioids. Dose for dose, it is an extremely potent painkiller, and it can be up to 100 times as strong as morphine.² People that take fentanyl are often closely monitored by doctors and medical practitioners. Some people also knowingly or unknowingly use it with heroin, as it is sometimes used to augment or lace the street supply of that drug. Duragesic is the brand name version of a prescription pain medication containing fentanyl.

Because fentanyl can cause euphoria, it can be addictive. Its rewarding effects can result in compulsive use. Regular fentanyl use can lead to tolerance and dependence, and abruptly stopping use can lead to withdrawal symptoms. ³ These symptoms are typically not fatal. But they can be very uncomfortable and lead to relapse.

Fentanyl Withdrawal Symptoms

In some cases—namely, a legal prescription—a user may be tapered off the medication, either by their primary care doctor or in an inpatient or outpatient detox setting. Those who have used the drug illicitly and are ready to quit may be prescribed medications to treat withdrawal symptoms and manage cravings. Fentanyl withdrawal symptoms include a number of side effects, such as:

• Chills.
• Rapid breathing.
• Rapid heartbeat.
• Tearing of the eyes.
• Vomiting.
• Anorexia.
• Nausea.
• Irritability.
• Stomach cramps.
• Weakness.
• Anxiety.
• Joint pain.
• Back pain. ³

These symptoms may vary depending on the amount of fentanyl the person is taking. A mild withdrawal is possible; however, the larger and more frequent the dose, the more likely withdrawal symptoms will become bothersome.

How Long Does Fentanyl Withdrawal Last?

The duration of withdrawal depends on the length of time an addict has been taking fentanyl and how much of the medication, if any, are currently in their system. A typical withdrawal timeline can last from 4 to 20 days after last use of fentanyl, depending on whether the person was using the patch or injecting the drug. ⁴

How to Treat Fentanyl Withdrawal

Fentanyl withdrawal treatment should be completed under the watch of a medical provider. Under the care of a treatment team, patients can be made comfortable and their symptoms kept to a minimum.

Various options for withdrawal care include hospitals, detox centers, and inpatient and outpatient rehab programs. People who have been prescribed fentanyl by a doctor can also work individually with their provider to discontinue use. Depending on the person’s situation, the program may prescribe opioid replacement medications such as methadone or buprenorphine to make the symptoms less intense.

Tapering Off Fentanyl

As mentioned above, detoxification from fentanyl can also be done through a taper. Tapering is a method that requires a doctor to slowly prescribe less and less of a drug to wean the person off of the substance and prevent withdrawal symptoms.

Many tapers are completed over a number of weeks or months to prevent acute withdrawal. The body takes time after the fentanyl is removed to return to normal, as well, and people may experience post-acute withdrawal symptoms such as mild unease and cravings for up to 6 months after quitting. ⁴ Some people that have been initially stabilized on methadone or buprenorphine remain on them long-term to prevent relapse and minimize persistent cravings.

Medication for Fentanyl Withdrawal

There are many medications that may be used for fentanyl withdrawal. Many of these medications may also be used in an opioid treatment program, specifically to help mitigate withdrawal symptoms. Some medications used in the treatment of fentanyl withdrawal may include:

• Buprenorphine.
• Naloxone.

Not everybody’s treatment program will be the same, and your medical team may prescribe different medications depending on your situation during withdrawal. It’s important to maintain open and honest communication with your doctors during the treatment process.

Are There Any Home Remedies for Getting Clean Safely?

Although some people believe that flushing the body clean with liquids can provide relief from withdrawal symptoms, there is no proven home remedy for easing the withdrawal syndrome. For the most effective results, it is best to forgo alternative or “natural” treatments and seek medical help.

Rehabilitation centers and detoxification programs have proven methods to help relieve the detoxification process.

How Long Does It Take to Detox From Fentanyl?

The length of detox depends on how long an addict has been using fentanyl. The average withdrawal symptom timeline lasts from 4-10 days for short-acting forms of fentanyl such as Actiq, and 10-20 days for long-acting forms, such as Duragesic.⁴

Treatment for Fentanyl Addiction and Withdrawal

For people who are struggling with fentanyl addiction, detox should be followed with some form of rehab or recovery program. Addiction treatment for fentanyl can take place through an inpatient or outpatient treatment program, or through a 12-step program such as Narcotics Anonymous.

Treatment in a rehab center will often consist of different types of therapies that help the user explore the reasons for their substance abuse and address any other issues in their life that may impede recoveries, such as family, relationship, or employment problems. Addiction treatment can be completed over as long or as short of a time as the person needs.

 

 

More Information About Fentanyl:

Fentanyl Information at a Glance
Medication Name, Costs	Class of Medicine
Generic Name: Fentanyl Generic Name Variations: Fentanyl citrate 1 Brand Names: Abstral, Actiq, Duragesic, Sublimaze 1 Cost/Price: Varies ($0.31 for 500mcg/50ml syringe to $150 for 1600mcg lozenge) 1	Drug Type: opioid analgesic 1 Function or Use: treatment of breakthrough cancer pain or severe pain relief 1 Half-life: 7 hours 1
Form, Intake, and Dose	Interactions and Complications
Drug Forms: tablets, transdermal patches, injectable solutions, soluble films, nasal spray, sublingual spray, lozenges  1, 2 Administration Routes: oral, buccal, sublingual, transmucosal, injection 2 Dose: transdermal patch: 12, 25, 50, 75, 100 mcg/h; lozenges on a stick: 200, 400, 600, 800, 1200, 1600 mcg; sublingual tab: 100, 200, 300, 400, 600, 800 mcg; sublingual spray: 100, 200, 400, 600, 800, 1200, 1600 mcg packs; nasal spray: 100, 400 mcg/spray 2 Overdose: possible and can be fatal 5 Overdose Symptoms: trouble breathing, slow heartbeat, severe drowsiness, cold and clammy skin, dizziness, confusion, seizures, hallucinations 5	Alcohol Interaction: use with alcohol can increase the chances of severe side effects such as respiratory depression, low blood pressure, extreme sedation, and coma 5 Opioid Interaction: can cause profound sedation, respiratory depression, and coma 5 Prescription Medications: sedatives and tranquilizers can increase depressant effects and lead to respiratory depression and coma 5 Contraindications: opioid non-tolerant patients, acute pain, post-operative pain, mild pain, those with acute or severe bronchial asthma 5
Effects and Adverse Reactions	Substance Abuse
Short-Term: euphoria, nausea, confusion, constipation, sedation 8 Long-Term: tolerance, dependence, addiction, life-threatening respiratory depression, possible overdose 8	Risk of Substance Abuse: High Signs of Abuse: repeated “loss” of fentanyl prescriptions and “doctor shopping” to get more prescriptions for the drug 8
Physiological Problem Signs and Symptoms	Dependence and Addiction Issues
Withdrawal Syndrome Onset: 12-30 hours after last dose 3 Withdrawal Symptoms: restlessness, chills, irritability, vomiting, nausea, weakness, joint pain, insomnia, anorexia, tearing, runny nose 5	Physical Dependence: High risk 7 Psychological Dependence: High risk 7
Legal Schedules and Ratings
Controlled Substances Act Rating: Schedule II 6