What Fentanyl Abuse Does To Your Brain

03 Jan What Fentanyl Abuse Does To Your Brain

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In the wake of the opioid crisis, death is rampant, billions of dollars are lost in the war against drugs, and a new evil dwells in the shadows like a wraith; fentanyl. By this point in time, America’s opioid cisis should not be news to you. It’s currently one of the most titanic problems America faces today.

A topic of much controversy, arguments for its birth range from attacking Big Pharma, shaming unscrupulous doctors, to dismantling the entire healthcare industry. Whatever may have led us to this disastrous state, the biggest problem is fentanyl addiction—being that it’s driving overdose rates through the roof.

While rehab facilities across the nation have geared up to battle the titan, America continues to dump money into drug-fighting infrastructure, and the healthcare industry tries to reevaluate the way in which they treat pain, the most important thing we can do as a nation is to stay educated on the deadly effects of Fentanyl. Education is awareness and awareness, in today’s drug climate, can be the difference between life and death. In which case, we’re here to shed light on a horrible truth: what fentanyl abuse does to the human brain.

Opioids and The Brain

Fentanyl is an FDA approved, Schedule II drug used to treat late-stage cancer patients, patients healing from invasive surgery, and those with severe forms of chronic pain (often after other painkillers lose their efficacy). Essentially, it’s the strongest opioid the FDA has approved and it’s used to comfort those in a dire state. Although there are some similarities, fentanyl and heroin have many differences as well and have their own risks and dangers.  It might shock you to know that fentanyl is 100 times stronger than morphine and 50 times stronger than heroin.

It’s sheer potency aside, to understand what fentanyl abuse does to the brain we must first understand how opioids—as a whole—influence our brain chemistry. Our brains contain opiate receptors. Their function is to replicate certain feelings brought forth by opioids themselves, just naturally. For instance, a runner’s high occurs when endorphins are released, which is onset by our brain’s opiate receptors. This function is tied to the brain’s neurotransmitter balance (essentially, the chemicals that regulate our emotional wellbeing).

When opioids are taken, they bind to these receptors, which can then halt communication between certain pathways—thus relieving pain. Understanding why opioid users enjoy the feeling of the drug is easy; opioids begin first at the reward center of the brain, stimulating dopamine (the neurotransmitter responsible for pleasure). Thus, it is easy to understand why taking opioids for those in pain—and without pain—is appealing. It induces euphoria and blocks pain receptors.

  • Opioids bind to opiate receptors in the brain, blocking pain signals
  • Opioids stimulate dopamine, the ‘pleasure’ chemical linked to our reward system

The Dangers

While opioids, like Ritalin, were originally thought to be a synthetic masterpiece, it’s clear that the bad far outweighs the good. As with any medicine, there is always going to be side effects and dangers on the other side of the equation. Of course, these dynamics are considered and the drug is (typically) advocated for its ability to improve a problem rather than worsen one.

In which case, when high concentrations of opioids begin to influence the brain, dendritic spines—structures in our brain that foster communication between neurons—begin to wane. This causes the user to have difficulty in reasoning and disruptive thought patterns. Furthermore, as dopamine is continuously stimulated, the brain is essentially locked into a hyperactive state.

As abuse continues, more dendritic spines are destroyed, and the brain begins to experience a chemical imbalance. Being that it’s constantly flooded with opioids, it makes the pitfall of mistaking the drug for the chemical itself—rendering it unable to produce it naturally. Unfortunately, if our brains cannot produce a neurotransmitter naturally, then an imbalance is created. Which brings us to our next point:

  • Opioid abuse destroys dendritic spines, disrupting the region of the brain responsible for reasoning and thought creation
  • Opioids release heavy amounts of dopamine, eventually tricking the brain into believing opioids are a neurotransmitter—halting production of a chemical needed for emotional balance

Tolerance and Addiction

Being that opioids are such a potent substance, tolerance and dependency can develop quickly. This is the phenomenon critics are pointing to, blaming unscrupulous doctors for overprescribing opioids. By their nature—with no regard to the way in which they affect the brain—it makes sense. Someone is in pain and they don’t want to be. They take a painkiller and it relieves them. Life is better. Then, without it, they’re thrown headfirst back into suffering. They’ve seen the other side and, well, the grass is greener. That first prescription is gone and they panic, heading back to the doctor in hopes of relieving their pain once more.

The above situation, of course, is specifically for those who begin using opioids for medical reasons. Those that use them recreationally take a different path, although the destination remains the same; addiction. To understand why this occurs, we must take a deeper dive into our brain chemistry and how drugs like fentanyl influence it.

Tolerance and Addiction Explained

The first time using opioids will, scientifically speaking, be the most intense. The brain chemistry is intact, the opiate receptors healthy, and it welcomes the substance with open arms, capable of exploiting it to its fullest potential. Over time, unfortunately, fentanyl (and the likes of) begins to damage the very platform that’s receiving it.

In the initial period of use, the locus coeruleus—a region of the brain responsible for stress management—is lessened to a whisper. Not only is there euphoria and pain relief, but there’s also a ceaseless bliss that quiets the noise of everyday life.  It is this region, before dopamine stimulation, that first sounds an alarm to the user when the effects of opioids are absent.

The brain will have a kneejerk reaction and overstimulate the stress region, causing droves of anxiety to stampede across the user’s mind. Being that they have already flooded their brain, without opioids life becomes harder than it was before the introduction of them. This calls for further use, which fosters dependency. The further this cycle continues—where the absence of opioids sounds an alarm for more of it—the higher a person’s tolerance becomes.

Either to replicate the high or for pain management, users need an excessive amount to achieve the intended effect. This can take the form of doubling or even tripling their dosage. Being that opioids are extremely powerful, the road to fentanyl addiction can be scant more than a month. Eventually, the user is no longer dependent on the substance—their brain no longer produces the appropriate chemicals, structures have been destroyed, and without opioids they experience withdrawals. However, before we speak on opioid withdrawal, we have to consider the most harrowing facet of our current crisis; overdose.

  • Opioids suppress the locus coeruleus. In their absence, anxiety and panic flares
  • Opioids quickly ‘break’ the pathways they utilize, creating tolerance and dependency
  • As the brain loses control of its natural processes, opioids are needed for stability, which leads to addiction
  • White matter (those dendritic spines we spoke of) is destroyed, lessening the brain’s ability to reason, process information, and form pragmatic thoughts

Fentanyl Overdose

Opioids, by their depressant nature (like alcohol, for instance), work to depress the Central Nervous System (CNS). The CNS is responsible for certain processes like breathing, being that it sends signals to your respiratory system. Under the influence of opioids, these processes begin to slow and—if a lethal amount is taken—can wane to a halt. Often, opioids coupled with another depressant like alcohol is what drives the body into an overdose.

Fentanyl, unfortunately, is an entirely different beast. Being that drug dealers are cutting their preexisting products with fentanyl in aims to make ‘weak’ batches more potent, users are overdosing from the drug at hand because they’re unaware it’s stronger than what they’re used to. To that end, being that fentanyl is transdermal, even first responders have experienced a fentanyl overdose from simply touching the substance without knowing.

This silent killer is not typically a drug that people are using in isolation, which is part of the reason it’s as dangerous as it is. Using fentanyl on its own—without medical supervision—is nothing short of flirting with death. To oversimplify everything we’ve touched on; it’s too powerful.

It might behoove you to know that in 2011, there were some 1000 related fentanyl deaths. In 2018, experts are speculating that number is going to exceed 30,000. Of all the drugs on the streets, fentanyl has proved to be the deadliest. It’s also proved its pervasiveness, being that it can be transported easier (it comes in smaller forms) and used to ‘enhance’ other drugs.

Fentanyl does all that we explained in the 50th degree. To increase awareness, overdose symptoms include but are not limited to:

  • Feinting
  • Clammy, Bluish, and Cold skin
  • Pinpointed Pupils
  • Trouble Breathing & Stupor
  • Irregular Heartbeat
  • Loss of Consciousness
  • Falling into a Coma

Fentanyl Withdrawal Symptoms

Due to fentanyl’s potent nature, rarely is it ever recommended for someone to quit cold turkey—or to quit on their own in any capacity. Regarding how fentanyl affects the brain, it’s the locus coeruleus region that first begins to produce fentanyl withdrawal symptoms—being that it goes haywire in the absence of opioids.

Since fentanyl is long-acting, it can take up to 24 hours after the last use for the user to begin experiencing withdrawal symptoms. Typically, the process looks like this:

1-3 Days

The first three days of withdrawal can be difficult but usually, if the user is motivated and persistent, they can muscle through it. Symptoms include but are not limited to:

  • Agitation & Mood Swings
  • Loss of Appetite
  • Difficulty Sleeping
  • Muscle Spasms & Pain
  • Excessive Sweating
  • Irregular Heartbeat
  • Anxiety

3-5 Days

Once the first three days pass, the midpoint of withdrawals commence—and this stage can be notorious for its difficulty. The body has indeed detoxed from the substance but the symptoms worsen, being that the ‘need’ for opioids becomes evermore heightened. The symptoms include but are not limited to:

  • Nausea & Vomiting
  • Extreme Mood Swings (depression, anxiety)
  • Excessive Sweating
  • Dehydration
  • Fluttering Heart
  • Diarrhea
  • Psychosis (rare)

5 Days and Onward

Once the worst is over, the symptoms begin to wane. The body begins to regulate naturally and the brain attempts to restore its chemical balance. Depending on the user, the symptoms will still preside but at a much lesser extent. Undeniably, this can be a difficult time for someone in recovery—being that they finally feel better and yet, with that feeling of goodness comes craving. Symptoms include:

  • Waning of Original Symptoms
  • Strong Cravings & Urges
  • Mental Fatigue
  • Physical Fatigue
  • Irregular Bowl Movement

Fentanyl and the Brain

It should be clear by this point in the article that fentanyl is detrimental to the brain and body. For those suffering and under medical supervision and treatment, the medication can be a godsend. For those using it recreationally or without medical supervision, it’s a serious danger. Not only does it deplete the brain of its natural chemicals (thus disrupting its much-needed balance), but it creates dependency, spurs addiction, destroys thought centers, and poses the risk of a merciless overdose.

Yes, fentanyl does have a purpose—but it’s such a small one, even in the medical world, that the average person should not know its name. While it is positive for those in need, for the rest of the world it’s a nightmare. This should be understood by the mere fact that it spearheads the majority of America’s overdoses.


The idea of using fentanyl in isolation is terrifying. Yet, the opioid crisis continues to evolve, expand, and spread across the nation. While healthcare professionals and the government seek ways to remedy the problem, the best gift you can give yourself is knowledge. If you’re here because you know someone that’s struggling with fentanyl abuse, or any form of drug addiction, know that—above any other type of substance abuse—the time to reach out is now. For more information, please call our Georgia drug rehab treatment center today.


Christiansen, Thomas. “What Fentanyl Does To Your Brain” 13 Feb. 2019. https://www.therecoveryvillage.com/fentanyl-addiction/related-topics/what-fentanyl-does-your-brain/#gref

“Signs and Symptoms of Fentanyl Abuse.” Futures Recovery Healthcare. 18 Oct. 2018. 15 Mar. 2019. https://futuresrecoveryhealthcare.com/knowledge-center/fentanyl-addiction-signs-symptoms/

“Effects of Fentanyl Abuse.” Narconon. 15 Mar. 2019. https://www.narconon.org/drug-abuse/fentanyl-effects.html

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