Fentanyl Abuse: Signs & Symptoms

10 Jan Fentanyl Abuse: Signs & Symptoms

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Over the past decade, the US opioid crisis has swept across the country, forever altering the lives of millions of citizens who fell into the clutches of addiction. Despite a rising public outcry over this calamity, the situation has only grown worse with each passing year. Now, opioids are responsible for taking more American lives annually than car accidents.

Heroin was once the king of opioids; the big bad at the heart of most opioid-related overdoses. But, in 2016, a new contender stepped into the ring and took the ignominious title of most dangerous opioid or drug of any kind. This substance we speak of is the synthetic opioid known as fentanyl, which according to the CDC, accounted for more than a third of all opioid-related overdose deaths in 2017 (to the tune of 29,000 lives). Alarmingly, between 2013 and 2017 overdose deaths involving fentanyl increased by more than 100% every single year. The dangers of fentanyl overdose are at the forefront for every single individual who decides to experiment with this drug.

This powerful new upstart substance took the country by storm thanks to a push by Chinese drug manufacturers and Mexican cartels, as they smuggled countless kilos of the deadly opioid up through the southern border. Because of its rapid introduction to the market, much of the public remains blissfully unaware of what fentanyl is, and what fentanyl abuse even looks like. To this end, below we will discuss the most common signs and symptoms of fentanyl abuse so that you can protect those you care for from this public menace.

What is Fentanyl

Fentanyl is a powerful painkiller that can be up to 50 times as powerful as pharmacy-grade morphine or heroin. Even though these drugs may seem similar on the surface, fentanyl and heroin have many differences including potency, effects, and strains. It was initially synthesized in Belgium in the late ’50s and introduced as a general anesthetic under the name Sublimaze. This medication was created for acute or chronic pain that is, by all means, intolerable. Its potency made it ideal for treating sudden and intense pain like that which can be experienced by soldiers injured in combat or late-stage cancer patients. It’s small size but heavy punch made it easy to store, transport, and administer.

The drug is the main ingredient in a variety of strong painkillers, notably:

  • Duragesic
  • Fentora
  • Sublimaze

Fentanyl can be taken as a patch, lollipop, dissolvable tongue film, or pill. The medication itself can be quite safe if administered or prescribed in the proper dosage by knowledgeable medical professionals. When taken as intended, the effects can be strong feelings of pleasure, tranquility, and relaxation. Side effects include:

  • Calm
  • Confusion
  • Constipation
  • Drowsiness
  • Euphoria
  • Muscle slackening
  • Nausea
  • Respiratory depression (slowed breathing)
  • Sedation

Where Fentanyl becomes dicey is when it is used illegally for recreational purposes. Illicit drug dealers all-too-often erroneously measure the substance, which leads to batches of fentanyl that result in strings of overdoses in the surrounding area. Further, dealers regularly cut weak heroin with fentanyl to increase its strength and high. The problem lies in the fact that overdoses are infinitely more likely when opioids are mixed, especially by amateurs.  

Fentanyl Abuse Symptoms

Because fentanyl is so potent, abuse and physical dependence are common results of regular use. Even those who are taking it as prescribed can fall prey to its power. Although some people head purposefully into fentanyl use, and others stumble their way in, the end result remains the same; a horrid physical and psychological addiction.

While an individual may be able to conceal their substance abuse in the beginning, as time goes on and the roots of addiction take hold, signs, and symptoms of fentanyl abuse will eventually manifest. Such symptoms can be broken down into four categories: psychosocial, behavioral, cognitive, and physical.  

Psychosocial Symptoms of Fentanyl Abuse

  • Anxiety – Anxiety can take place in many forms, including the uncomfortable need for more fentanyl, a general anxiousness, or anxiety that flirts with paranoia.  
  • Depression – The long-term use of fentanyl affects the brain by altering the neurotransmitters and the natural production and release of dopamine. This synthetic enhancement indelibly rewires the brain and makes it difficult for a person to be happy without the fentanyl high.
  • Disinterest in past pursuits – Many former passions or hobbies will fall by the wayside as the pursuit of fentanyl and the high seeking behavior takes precedence.

Behavioral Symptoms of Fentanyl Abuse

  • A desire to cut down, but an inability to do so – The person regularly states that they want to stop or cut down on their fentanyl use, but find themselves unable to do so.
  • Continuing to use fentanyl even after issues – Run-ins with the law, spats with friends, issues with family, and underperformance at work are common results of fentanyl use. An abuser will continue to use the substance despite all of the negative repercussions of their habits and lifestyle.
  • Erratic behavior – Drug users will begin to behave erratically over time. This behavior will likely only worsen as the fentanyl changes the chemistry of the brain. Other symptoms caused by fentanyl abuse such as anxiety and agitation only add to this odd conduct.
  • Giving up old interests – A person abusing fentanyl may stop going to old clubs, or playing sports, or participating in other activities that they used to love. Much of this is because they sacrifice these things in the name of getting high on fentanyl.
  • Lack of prescription self-control – Someone who was medically prescribed fentanyl will seemingly take their prescription far more often or in higher doses than recommended. They have great difficulty spacing out doses and grow ornery in the interim.
  • Lying – A fentanyl abuser will often go to great lengths to acquire more of the drug, and they will then do their best to cover that fact up. Deceit becomes second nature for many such unfortunate abusers.
  • Social isolation – Substance abuse involves constant deceit, whether in actions or words, especially with those who know the user well. To avoid having to lie and then feel bad about lying, many fentanyl abusers socially isolate themselves. On top of that, they begin to choose a crowd of other fentanyl abusers in their pursuit of the high.
  • Misusing fentanyl – A fentanyl abuser may take fentanyl and then consume alcohol, or they might take it and then drive.

Cognitive Symptoms of Fentanyl Abuse

  • Fixation on finding more of the drug – Fentanyl abuse leads to dependence, which involves seeking the drug whenever possible. To attain the high the body craves and to stave off withdrawals, a fentanyl user will prioritize ‘getting high.’
  • Intense cravings for the drug – Cravings are a natural aspect of any addictive substance but are especially strong—in this case—because of fentanyl’s potent nature.
  • Trouble concentrating – Regular opioids abuse can cause long-term brain damage that alters concentration and memory. Someone who is currently high will have difficulty focusing.

Physical Symptoms of Fentanyl Abuse

Physical Symptoms of a Fentanyl High:

  • Diarrhea
  • Vertigo
  • Exhaustion
  • Nausea
  • Racing heart
  • Slowed breathing
  • Slurred words
  • Vomiting

Physical Symptoms of Regular Fentanyl Abuse

  • Constipation
  • Drowsiness
  • Gastrointestinal distress
  • Itching
  • Regularly injured due to poor motor coordination or poor decision making

Teenage Fentanyl Abuse

Doctors do not regularly give teens fentanyl. Typically, they would obtain it through medicine cabinets at their home or a friend’s home. If parents desire to keep their kids safe, it would be wise to hide and lock away any type of powerful prescription drug. Even if you trust your children and their friends, the best of kids can still cross lines and dabble with seemingly innocent drug experimentation, especially if they read “painkiller” on the label and just assume that a drug like Duragesic is no different from Vicodin.

While the most common method of teens obtaining fentanyl is through an adult’s medicine cabinet, it is sometimes sold illicitly by drug dealers in a powder form. Recently, there have been far too many cases of teens buying what they thought was cocaine and it turned out to be either fentanyl or low-grade cocaine laced with fentanyl. These drugs are dangerous as is but especially so with teenagers who have low tolerances and even less common sense.

To help your teen avoid fentanyl abuse take the following steps:

  • Sit them down and talk with them about the risk factors of substance and alcohol abuse. Discuss the dangers of underage drinking and drug use and all of the possible repercussions to their actions. Identify the deadly consequences that accompany prescription drugs and mixing substances with alcohol or pain medication.
  • Secure your powerful pain medication by either hiding them or locking them.  
  • Keep an eye on your pill bottles and the number of pills still in them.
  • Listen for drug seeking language; fentanyl goes by a variety of street names such as Apache, Cash, China girl, China town, China white, Jackpot, Poison, TNT, and Tango.

Fentanyl Withdrawal

As a fentanyl abuser continues to use the powerful opioid, their physical dependence upon the drug will grow in proportion with their tolerance increase, leading to a fentanyl addiction. They will crave higher doses with added consistency. When the drug is out of their bloodstream, fentanyl withdrawal symptoms will set in. The symptoms of fentanyl withdrawal depend on a host of factors such as:

  • Biological predilections
  • Family drug history
  • Frequency of dose
  • Method of ingestion
  • Previous trauma while going through withdrawals
  • Purity of dose
  • Sex
  • Size of dose
  • Underlying mental health issues

Symptoms of Fentanyl Withdrawal

Fentanyl withdrawal will continue for days as the body seeks to detoxify and retain an equilibrium. The initial symptoms will typically set in within 6 to 12 days of the most recent fentanyl dose. Such symptoms include:

  • Aches
  • Anxiety
  • Arrhythmia
  • Cravings
  • Dehydration
  • Despair
  • Excessive sweating
  • Frustration
  • Goosebumps
  • Hypertension
  • Itchiness
  • Nausea
  • Restlessness
  • Rising fever
  • Runny nose
  • Sleeplessness
  • Stomach cramps
  • Sudden diarrhea
  • Sweats
  • Tearing up
  • Vomiting
  • Yawning

Fentanyl Withdrawal Timeline

The stabilization phase of Fentanyl detoxification can be broken up into four distinct stages. They are:

  1. Stage 1 – Symptoms Set In: In the first 6-12 hours, a fentanyl user will likely begin feeling the adverse effects of withdrawal symptoms. Such feelings will amplify as the body starts to desperately crave the familiar presence of the opioid.
  2. Stage 2 – Symptoms Take Hold: In the next 12 hours, most of the symptoms will take full effect, leaving a patient sick, exhausted, exasperated, hurting, and desperately craving the drug.
  3. Stage 3 – Symptoms Peak: In the second and third day of fentanyl withdrawal, symptoms will typically climax. A person’s body will be dehydrated and weakened by the lack of food, sleep, and constant nausea.
  4. Stage 4 – Symptoms Diminish: In the fourth and fifth day of fentanyl detoxification, withdrawal symptoms will begin to settle down, if not entirely disappear. Although a patient will still feel out of whack, symptoms are considerably more manageable, especially since this might be the first time in a few days where a person’s been able to actually sleep, eat, and gather strength.

Because fentanyl withdrawals can be quite uncomfortable and dangerous, if you or someone you care for struggles with fentanyl abuse and seeks to get clean, it would be wise to undergo the detoxification process under the care of medical supervisors at an inpatient treatment center. Giving doctors the ability to monitor and maintain your heart rate, blood pressure, and liquid levels make this process infinitely safer. On top of that, it provides a patient with a drug-free retreat where there is no option to relapse and no chance to take more of the drug to allay symptoms of withdrawal.


Fentanyl addiction is a horrible reality for many people. Unfortunately, many loved ones do not catch the signs of abuse until it is too late. To prevent this tragedy from striking close to home, be vigilant, remember the signs of fentanyl abuse, and act when you recognize them in a friend or loved one. With the help of an inpatient facility such as Georgia Drug Detox, this horrid habit can be successfully kicked. If you are looking for addiction treatment options or need to detox from the effects of fentanyl, please give our rehab center a call today.


  • CDC, National Vital Statistics Report: “Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011–2016.” https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf
  • National Institute on Drugs: “What is Fentanyl?” https://www.drugabuse.gov/publications/drugfacts/fentanyl
  • National Institute on Drugs: “Fentanyl.” https://www.drugabuse.gov/drugs-abuse/fentanyl
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