I have taken fentanyl once. I was having surgery requiring twilight sedation and was scared out of my mind. “Make sure you give me the maximum of whatever you’re giving me, okay?” I said to the nurse, my hands shaking as she administered a combination of Sublimaze, an IV-injectable form of fentanyl, and Valium. In an instant every anxiety, every pain, every feeling of worry I ever had floated away and I was fine. Before this moment, I had barely eaten for a week and hadn’t slept more than a few hours out of fear of undergoing this surgery, and suddenly all I could think was that this was absolutely wonderful. On the drive home with my husband later that day, still feeling pillowy and nice, I remember telling him, “I should never, ever take fentanyl again for anything, or this will be the thing that I become addicted to.”
The Super Opiate
Fentanyl is a synthetic opiate 80-100 times more powerful than morphine, and 40-50 more potent than heroin. First produced in the 1960s, it was originally used as an anesthetic and to manage breakthrough pain that did not respond to conventional medicines. By the 1990s, the development of personal-use products such as Duragesic, a slow-release transdermal fentanyl patch, Actiq, a lollipop, and Fentora, a buccal tablet form of the drug led to an explosion of fentanyl use both in clinical practice and amongst recreational users. Its powerful effects, rapid onset, and short half-life make it highly effective and highly addictive both for those taking it therapeutically and for those seeking out a new high.
The Wide Net of Fentanyl
Some people come by their fentanyl addiction through having been prescribed slow-release transdermal patches or lozenges to manage severe pain. Over time, you become dependent both physically and psychologically, and your desperation to ward off withdrawal may lead you to fabricate symptoms or doctor-shop to ensure a steady supply. Others seek out fentanyl for recreational use right off the bat, sometimes after already establishing a history of opiate use, sometimes as new users who view the prescription pain reliever as a cleaner, less stigmatized avenue to opiate-derived highs. Recreational users may smoke, inject, or swallow fentanyl in pill form, but the most common method of ingestion is eating the gel from patches. Young people, in particular, may be susceptible to seeing fentanyl as an attractive alternative to drugs like heroin. In a piece originally written for The Fix under a pseudonym, Drew Grant says:[1. http://www.thefix.com/content/addiction-prescription-pill-abuse-fentanyl-patch-1071?page=all]
You never tried heroin, because you hate needles. Your friends back home—who will all be addicted to heroin and shooting up in front of you every time you go stay with your parents—will make you uncomfortable with their unhygienic hypodermic [stuff], sitting with those belts or tubes tied around their arms in giant warehouses like some really depressing cliché. They don’t know what they are missing. You are classy. You are a synthetic opioid addict, not an actual heroin addict, the difference between the two being that one sounds like a character in a Phillip K. Dick book and that is cool, while heroin sounds like something you do when you give up.
In fact, fentanyl is just as addictive or more addictive than traditional street drug opiates, and its potency makes it considerably more dangerous for both new and experienced drug users. It takes an incredibly small amount of the drug to produce serious respiratory depression and lead to death. Last spring, the U.S. Drug Enforcement Administration issued a statement warning of the dangers of fentanyl across the country, after observing a dramatic increase in fentanyl-related overdoses.[2. http://www.reuters.com/article/2015/03/18/us-usa-drugs-fentanyl-idUSKBN0ME2EF20150318] Dr. Karen Woodall of the Ontario Centre of Forensic Sciences says, “The big problem with fentanyl is that a lot of people who aren’t tolerant to the drug are taking it. And if you’re not tolerant, it’s a lot more likely to cause serious toxicity and even death.”[3. http://www.macleans.ca/society/health/fentanyl-the-king-of-all-opiates-and-a-killer-drug-crisis/] Fentanyl now causes twice as many deaths in Ontario as heroin.
While many addicts use legitimately-produced fentanyl products, increased demand and decreased availability of prescriptions have led to an underground, unregulated fentanyl manufacturing industry. These products, often sold in pill form, allow users even less control over what they are taking and increase the risk of overdose. Fentanyl is also being cut with other drugs such as heroin and cocaine to maximize potency, presenting significant dangers as users are unable to regulate their dosage. Even seasoned opiate users with high tolerance levels cannot predict how much fentanyl will be present in a particular batch, and will be unable to modulate their usage to maintain relative safety. What’s even more alarming is the fact that many users don’t even know that they are taking it. Between 2005 and 2007, over 1000 people in Chicago, Detroit, and Philadelphia died from overdosing on fentanyl-laced heroin, many of them completely unaware that they were using fentanyl.
Breaking the Cycle
Regardless of how your addiction to fentanyl develops, breaking it can be an intimidating prospect. Fentanyl can produce uncomfortable withdrawal symptoms even after your first time using it, and the drive to continue using to ward off emotional and physical pain can be overwhelming. Even if you are fully cognizant of the damaging effects the drug is having on your life and the dangers it presents to your physical health, the prospect of withdrawal may keep you locked in the cycle of addiction. Gabe Gliker recounted his own experience of fentanyl addiction in a powerful essay for Vice:[4. http://www.vice.com/en_ca/read/i-used-to-abuse-fentanyl]
I remember sitting in my house alone freebasing […] this one patch and mixing it with other drugs, when I came to a stark realization that I was ruining my life; but I couldn’t stop. Or, more accurately, I didn’t want to stop because I was afraid of the withdrawal. It took me losing most of my friends and alienating myself at school to realize I was being [a horrible person]. So I quit.
Medically supervised detox can help you manage the pain of withdrawal to make it the most comfortable experience possible. However, withdrawal is only the first step; to ensure that you do not go back to using, it is critical to explore the underlying issues that led to your drug use and develop a realistic, sustainable plan to prevent future use. Within the context of a comprehensive opiate addiction treatment program, you can develop the self-awareness and practical skills to identify your triggers, develop healthy coping mechanisms, and begin to repair the damage of your addiction both within yourself and with your loved ones. At Alta Mira, our highly-trained clinicians have the expertise to address the special needs of both recreational fentanyl users and people whose fentanyl addiction arose from prescription use. We use every available tool to ensure your psychological and physical safety while you free yourself from addiction.
Overcoming fentanyl addiction can be difficult, but it is possible and it is worth it. As Gliker writes, “[Withdrawal is] very surreal to me now that a few years have passed, but I’m still grateful I went through it—because now I know that fent is [messed] up—and I will never touch [it] again.”
Alta Mira provides compassionate, effective treatment for people struggling with fentanyl addiction. Contact us today to learn more about how our innovative program can help you or your loved one break the cycle of addiction and create a more stable, fulfilling life.
Image Source: Unsplash user Jonathan Bean