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Fentanyl addiction: what you need to know

Fentanyl addiction | symptoms, consequences, and treatment

Written by Drew Redd. Mina Draskovic, B.Psy., reviewed this content for accuracy on April 19, 2024

Fentanyl is a synthetic opioid that can be up to a hundred times stronger than morphine. Fentanyl addiction can develop quickly, characterized by a high dependency and severe withdrawal symptoms. 

According to Aljazeera News, over 106,000 people died of an overdose in the U.S. in 2021, with two-thirds (67%) of those deaths involving synthetic opioids including fentanyl. Since the COVID-19 pandemic, the opioid crisis has been fueled by fentanyl and other synthetic opioids.

If you or someone you know has fallen into a fentanyl addiction, Ardu’s fentanyl addiction treatment program will help you achieve lasting sobriety.

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What is fentanyl?

Fentanyl is a powerful synthetic opioid, prescribed to treat severe pain, but also made illegally and sold as a street drug. It’s similar to morphine, but around 50 to 100 times more potent. Fentanyl use disorder, or fentanyl addiction, is a chronic medical condition characterized by compulsive and problematic use of fentanyl. Opioids such as fentanyl work by binding to particular receptors in the brain, reducing pain and causing euphoria. They can also suppress breathing and have severe withdrawal symptoms, increasing the risk of overdose and death.

Illicit fentanyl is mostly mixed with other drugs or pressed into fake pills. Users may not even know they’re taking fentanyl. The drug’s potency, low cost, and widespread availability have made it a major driver of the opioid epidemic. Fentanyl’s powerful effects and high risk of overdose make it a dangerous drug, whether obtained legally by prescription or illegally on the street. 

Our opioid addiction treatment center provides personalized treatment and compassionate support for those struggling with opioid use disorders. 

What are the types of fentanyl?

There are two main types of fentanyl:

  1. Pharmaceutical fentanyl is legally manufactured and prescribed by healthcare professionals to treat severe pain, especially in patients with cancer or those undergoing surgery. This type of fentanyl is available as:
    • Transdermal patches (Duragesic)
    • Lozenges (Actiq)
    • Injectable solutions
    • Sublingual tablets (Abstral)
    • Sublingual sprays (Subsys)
    • Nasal sprays (Lazanda)
    • Buccal tablets (Fentora)
  2. Illicitly manufactured fentanyl (IMF) is produced in illegal laboratories and sold on the street as a standalone drug. It is often mixed with other substances such as heroin, cocaine, or counterfeit prescription pills. IMF is highly potent and dangerous, increasing the risk of fatal overdoses. IMF has been a major contributor to the ongoing opioid epidemic in the United States. This type of fentanyl is available as:
    • Powder
    • Tablets (counterfeit prescription pills)
    • Liquid
    • Nasal sprays
    • Blotter paper
    • Candy-like forms (e.g., gummy bears, lollipops)
    • Fentanyl analogs (e.g., carfentanil, acetylfentanyl, butyrfentanyl)
    • Street fentanyl, “China White” or “TNT” (powder, pills, or mixed with other substances)

Don’t take prescription pills that weren’t given to you directly by a doctor or pharmacist. 

How to recognize fentanyl addiction

Addiction to fentanyl can be tough to spot. Some signs might be subtle or hidden, while other red flags are more obvious. 

Physical symptoms of fentanyl addiction include:

  1. Drowsiness or excessive sleepiness
  2. Constricted pupils
  3. Slowed breathing or shallow respiration
  4. Nausea and vomiting
  5. Constipation
  6. Weakness or fatigue
  7. Dizziness or loss of coordination
  8. Slurred speech
  9. Flu-like symptoms during withdrawal (e.g., sweating, chills, muscle aches)

Psychological and behavioral signs of fentanyl addiction are:

  1. Intense cravings for the drug
  2. Neglecting responsibilities at work, school, or home
  3. Social withdrawal
  4. Secretive behavior and lying about drug use
  5. Financial problems due to spending money on fentanyl
  6. Mood swings, irritability, or changes in personality
  7. Insomnia or excessive sleepiness
  8. Tolerance (you need higher doses to achieve the desired effect)
  9. Continued use despite negative consequences
  10. Inability to stop using fentanyl despite attempts to quit
  11. Engaging in risky behaviors while under the influence
  12. Noticeable changes in appearance, such as rapid weight loss or poor hygiene
  13. Possession of drug paraphernalia, such as needles or pipes

Fentanyl addiction is a life-threatening condition that requires immediate medical attention and ongoing support. If you notice any of these signs in yourself or a loved one, don’t wait—reach out for professional help right away. 

We are here to offer compassionate, professional care. The skilled team at our drug rehab programs tailor fentanyl use disorder treatment to your needs. Our approach addresses the physical, psychological, and emotional aspects of addiction, employing evidence-based therapies, medically-assisted detox, and a nurturing environment to guide you on the path to recovery.

Risk factors and causes of addiction to fentanyl

There are many reasons why people might become addicted to fentanyl. A 2017 study revealed that many start using the drug legitimately for pain management but develop a dependence over time. 

Risk factors and causes of fentanyl addiction include:

  • People who have struggled with addiction to other opioids are at a higher risk of developing fentanyl addiction due to cross-tolerance. Researchers at the University of North Carolina found that “replacing the initial drug with a comparable agent will result in a lower pharmacologic response compared to that experienced by a drug-naive individual.” In simple words, when someone who is already addicted to a drug switches to a similar drug, they will not feel the same high or effects as someone who has never taken that type of drug before.
  • People with untreated mental disorders, such as depression, anxiety, or posttraumatic stress disorder (PTSD), may self-medicate with fentanyl. Garland, et. al. revealed that a large majority of participants in their study (over 80%) reported using opioids, including fentanyl, to self-medicate negative emotional states such as anxiety, depression, and anger.
  • People often start taking fentanyl legitimately because of their chronic pain, so their doctor prescribes one of the most powerful painkillers. But even when used as directed, they can become dependent and addicted over time as their body gets used to the drug. 
  • An environment where drug use and trauma are common puts you at a really high risk of fentanyl addiction. That environment molds your perceptions and coping mechanisms in an unhealthy way from an early age.
  • Research suggests that certain genetic factors may contribute to a person’s vulnerability to fentanyl addiction. Jordan and Xi identified several candidate genes where decreased expression leads to increased drug self-administration and relapse behavior.
  • Fentanyl has become way too easy to access. This widespread availability of black-market fentanyl has played a huge role in driving up rates of fentanyl addiction.
  • A lot of people don’t really understand just how powerful fentanyl is or how risky it can be. The lack of knowledge about its potency and dangers often leads to accidental overdoses, which can be the start of an addiction.

Overcome your addiction with a multi-pronged approach to prevention, education, and accessible fentanyl addiction treatment programs. At Ardu, we understand the complexities of fentanyl addiction. Our dedicated staff will meet you right where you’re at with personalized treatment plans and approaches that are proven to work. 

If you or someone you care about is trapped in fentanyl’s vicious cycle, give us a call so we can fight this battle together.

How does fentanyl addiction affect health?

Fentanyl can have devastating effects on your health. Let’s walk you through some of the harmful ways fentanyl addiction can impact your body and mind.

Life-threatening breathing issues

Fentanyl can dangerously slow or stop your breathing by depressing respiratory function. This can lead to respiratory failure, brain damage, and even death from lack of oxygen. 

Topacoglu, et. al. found that when fentanyl is combined with central nervous system depressants such as alcohol, benzodiazepines, or other opioids, the risk of life-threatening respiratory depression greatly increases. This polydrug mixture can suppress or arrest breathing, risking death.

Elevated risk of transmissible diseases

Fentanyl carries major risks for catching and spreading infectious diseases. Sharing needles is one of the fastest ways to transmit bloodborne illnesses such as HIV, hepatitis B, and hepatitis C. These diseases can have devastating, lifelong consequences on your health.

Impaired brain function

Chronic abuse of fentanyl can take a toll on cognitive abilities over time. It may cause deficits in key cognitive domains, including attention, working memory, episodic memory, and executive function. A 2006 research article hypothesizes that “cognitive deficits are pronounced immediately after peak withdrawal symptoms have passed and then partially recover.”

Cognitive impairment was more frequent among people who used heroin and/or fentanyl than those who misused prescription opioids…Among [people living with HIV/AIDS] only, the misuse of opioids was associated with a higher frequency of neuropsychiatric symptoms such as depression and apathy. (Tamargo, et. al.)

Cognitive impairments happen because of the direct effects of fentanyl on the brain’s opioid receptors, as well as indirect effects like disruption of neurotransmitter systems.

Gastrointestinal complications

Fentanyl addiction wreaks havoc on the gastrointestinal (GI) system. According to a 2017 study, opioid-induced constipation (OIC) is an extremely common side effect for people abusing or addicted to fentanyl. 

As an opioid, fentanyl binds to receptors in the gut, causing chronic constipation that can be extremely painful. Nausea and vomiting are also common because of fentanyl’s effects on the digestive tract. Over time, this can lead to persistent abdominal pain and discomfort.

Strained heart health

Fentanyl puts a dangerous strain on your cardiovascular system. It forces your heart to work harder, increasing the risk of a heart attack or irregular, life-threatening arrhythmias. Even in the absence of other substances, fentanyl can cause cardiomyopathy and acute heart failure in healthy adults, demonstrating its potential for direct cardiotoxicity.

A study published by the AVMA Journals found that fentanyl abuse reduces the amount of oxygenated blood supply to the heart muscle, decreases blood flow through the coronary arteries, and slows down both blood pressure and heart rate—all of which can strain and damage the heart over time.

Muscle deterioration and bone density loss

Long-term fentanyl addiction takes a massive toll on your physical strength and skeletal system. The opioid causes muscles throughout your body to deteriorate and waste away from disuse. They inhibit osteoblastic activity, which is responsible for bone formation. Márquez-Grant, et. al. demonstrated that drug abuse, including opioids such as fentanyl, “can alter bone mineral density, can increase the risk of fractures, destroy bone and changes to the dentition.”

Worsened mental health

Opioid addiction, including fentanyl, is often associated with the development or worsening of co-occurring mental health disorders such as depression and anxiety. Many turn to fentanyl to self-medicate untreated psychological conditions, only for the fentanyl abuse to exacerbate those conditions or trigger other mental health problems. Dual diagnosis treatment is crucial to address both addiction and underlying mental health issues.

If you’re battling both opioid addiction and mental health challenges, Ardu has your back. Our compassionate team understands the complex interplay between substance abuse and mental illness—which often requires co-occurring disorders treatment.

Co-occurring disorders or dual diagnosis involve the presence of a mental health condition alongside addiction. It requires specialized care that can tackle both issues simultaneously. Our dual diagnosis program addresses the root causes of your struggles. You’ll receive personalized support, equipping you with the tools to manage your mental health and achieve sobriety.

Can addiction to fentanyl be fatal?

Fentanyl addiction is extremely dangerous and can be fatal. Here’s why

  • Fentanyl is extremely addictive, both psychologically and physically. Dependence develops quickly, reinforcing compulsive use despite grave health and legal consequences.
  • As a synthetic opioid that is 50–100 times more potent than morphine, it takes just a very small amount to cause an overdose. Many overdoses occur because fentanyl is being laced into other common drugs and ingested by ignorant users. Research shows that fentanyl overdoses have become the leading cause of death among Americans aged 18-45, surpassing other causes such as car accidents, gun violence, and suicide.
  • One of the biggest dangers is that high doses of fentanyl can dangerously suppress breathing to the point of respiratory failure and death from lack of oxygen. This can happen suddenly with just slightly too much fentanyl.
  • Much of the fentanyl being sold illegally is made in clandestine labs with no safety controls. This leads to inconsistent dosing and contamination risks that increase the risk of overdose.
  • When you suddenly abstain from fentanyl after developing dependence, you may trigger intense, protracted withdrawal symptoms such as vomiting, diarrhea, and body pain that may spur further use.

If you recognize the following signs of fentanyl overdose, immediately call 911.

  1. Unconsciousness or unresponsiveness
  2. Limp body
  3. Vomiting
  4. Pale, clammy skin
  5. Purple or bluish lips and fingernails (from lack of oxygen)
  6. Slow, erratic, or stopped breathing
  7. Choking or gurgling sounds
  8. Constricted or pinpoint pupils

Fentanyl’s potency, illicit manufacturing, and addictiveness make overdose and fatality very real dangers for anyone struggling with addiction to this substance. Seek professional treatment to address the physical and psychological aspects of opioid addiction before it becomes a matter of life or death.

Ardu’s fentanyl detox center

The first step towards sobriety is to rid your system of fentanyl. At our fentanyl detox center, you’ll have a team of compassionate medical professionals by your side to make the detox phase as safe and comfortable as possible.

We understand the white-knuckle grip of fentanyl withdrawal—the pain, anxiety, nausea, and severe cravings. Our physicians will carefully monitor your vitals and provide FDA-approved medications to alleviate the symptoms and ease you through the detox process as securely as possible.

With Ardu’s opioid detox programs, you can purge fentanyl from your system while focusing on your physical and mental recovery. Transition into our comprehensive addiction treatment program and develop the skills and resilience for lifelong sobriety.

Ardu’s fentanyl rehab center

At Ardu, we understand just how addictive and destructive fentanyl can be. That’s why our comprehensive rehab program takes an all-encompassing approach to help you regain control of your life. We’ll equip you with the tools and support system to achieve lasting recovery.

Our medication-assisted treatment combines FDA-approved drugs such as buprenorphine with counseling to curb cravings and ease withdrawal. Whether you need the round-the-clock structure of our inpatient care facility or prefer the flexibility of our outpatient treatment program, you’ll have a personalized plan tailored to your needs.

The path to healing goes beyond just alleviating physical dependence. Our compassionate staff guides you through different medical and holistic therapies to address the underlying roots of addiction. In our individual therapy and group counseling, you’ll develop vital coping strategies. Cognitive-behavioral therapy (CBT) rewires negative thought patterns, while dialectical behavior therapy (DBT) cultivates mindfulness. We help build trust and understanding with loved ones through multi-family therapy to repair strained relationships.

We also promote complete mind-body healing through holistic treatment approaches to addiction such as yoga therapy, meditation therapy, massage, and nutritional counseling. Our unwavering support continues after treatment through sober living, alumni groups, and ethical aftercare.

With compassionate experts, personalized treatment plans, and a holistic approach to healing, Ardu provides the highest quality integrated care for long-term opioid addiction recovery. We pave the road from detox to treatment to recovery. 

Get help with Ardu Recovery Center

Our recovery center welcomes people seeking help to overcome their opioid addiction. Our dedicated team of professionals is here to guide and support you in your addiction treatment process, laying the foundation for long-term sobriety and relapse prevention.

To enroll in an Ardu opioid treatment program, contact Ardu Recovery Center online or via phone (801-872-8480). We will work with you to find a recovery path that works for you during the detox process and beyond. 

Read our admissions process page for more information.

Drew Redd

Drew Redd is the executive director of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Fentanyl addiction FAQ

Who created fentanyl?

Fentanyl was first synthesized by Dr. Paul Janssen in 1960 at his laboratory in Belgium. Initially developed as a potent pain reliever, fentanyl and its analogs have since been used for medical purposes for pain management, anesthesia, and sedation. The misuse and production of illicit drugs such as fentanyl have contributed to its widespread availability and misuse outside of medical settings.

What fentanyl looks like candy?

Illicitly manufactured fentanyl, particularly when pressed into counterfeit pills, can sometimes resemble candy due to its colorful appearance and candy-like shapes. This is especially concerning because it can attract teenagers and young adults who may mistake these pills for harmless substances. These pills can be extremely dangerous and potentially lethal, containing potent doses of fentanyl or fentanyl analogs.

What is a pink pill with M 10 on it?

A pink pill with “M 10” on it could be a 10 mg dose of methadone hydrochloride, a medication used to treat opioid addiction and manage chronic pain. Without a precise imprint and proper identification, it’s challenging to confirm the exact nature of the pill. Consult a medical professional or pharmacist for accurate identification and appropriate use of any medication.

Is fentanyl in an epidural?

Fentanyl is commonly used in epidural anesthesia to provide pain relief during childbirth or certain surgical procedures. When administered epidurally, fentanyl can help reduce pain sensations without causing significant sedation or loss of consciousness. The concentration and dosage of fentanyl used in epidural anesthesia are carefully controlled by healthcare professionals to minimize the risk of adverse effects or overdose.

How strong is fentanyl?

Fentanyl is one of the most potent opioid drugs available for medical use. It is estimated to be 50 to 100 times more potent than morphine, and significantly more potent than other commonly used opioids like oxycodone or hydrocodone. Even in small doses, fentanyl can produce profound respiratory depression, sedation, and euphoria, making it a high-risk drug for misuse and overdose.

What color is fentanyl?

Pure fentanyl, when synthesized or manufactured legally for medical use, is typically a white powder. Illicitly manufactured fentanyl or counterfeit pills containing fentanyl can come in many colors, including white, pink, blue, or even multicolored. The color of fentanyl can vary depending on the manufacturing process, the presence of additives or cutting agents, and how it is formulated or packaged.


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Webster LR. Risk Factors for Opioid-Use Disorder and Overdose. Anesth Analg. 2017 Nov;125(5):1741-1748. doi: 10.1213/ANE.0000000000002496. PMID: 29049118.

Dumas, E. O., & Pollack, G. M. (2008). Opioid Tolerance Development: A Pharmacokinetic/Pharmacodynamic Perspective. The AAPS Journal, 10(4). https://doi.org/10.1208/s12248-008-9056-1

Garland, E. L., Hanley, A. W., Thomas, E. A., Knoll, P., & Ferraro, J. (2015). Low Dispositional Mindfulness Predicts Self-Medication of Negative Emotion with Prescription Opioids. Journal of Addiction Medicine, 9(1), 61. https://doi.org/10.1097/ADM.0000000000000090

Jordan, C. J., & Xi, Z. (2022, January 12). Identification of the Risk Genes Associated With Vulnerability to Addiction: Major Findings From Transgenic Animals. Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2021.811192

Topacoglu, H., Karcioglu, O., Cimrin, A. H., & Arnold, J. (2005). Respiratory arrest after low-dose fentanyl. Annals of Saudi Medicine, 25(6), 508-510. https://doi.org/10.5144/0256-4947.2005.508

Tamargo JA MS, Campa A PhD, Martinez SS PhD, Li T, Sherman KE MD, PhD, Zarini G PhD, Meade CS PhD, Mandler RN MD, Baum MK PhD. Cognitive Impairment among People Who Use Heroin and Fentanyl: Findings from the Miami Adult Studies on HIV (MASH) Cohort. J Psychoactive Drugs. 2021 Jul-Aug;53(3):215-223. doi: 10.1080/02791072.2020.1850946. Epub 2020 Nov 22. PMID: 33225878; PMCID: PMC8140063.

Camilleri, M., Lembo, A., & Katzka, D. A. (2017). Opioids in Gastroenterology: Treating Adverse Effects and Creating Therapeutic Benefits. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 15(9), 1338. https://doi.org/10.1016/j.cgh.2017.05.014

Baumgartner, C., Koenighaus, H., Ebner, J., Henke, J., Schuster, T., & Erhardt, W. (2009, March 1). Cardiovascular effects of fentanyl and propofol on hemodynamic function in rabbits. American Journal of Veterinary Research. https://doi.org/10.2460/ajvr.70.3.409

Márquez-Grant, N., Baldini, E., Jeynes, V., Biehler-Gomez, L., Aoukhiyad, L., Passalacqua, N. V., Giordano, G., Candia, D. D., & Cattaneo, C. (2022). How Do Drugs Affect the Skeleton? Implications for Forensic Anthropology. Biology, 11(4). https://doi.org/10.3390/biology11040524

Yousif, B. N. (2023, September 17). How the fentanyl crisis’ fourth wave has hit every corner of the US. https://www.bbc.com/news/world-us-canada-66826895

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