Fentanyl withdrawal is a serious medical condition that can occur when someone is recovering from fentanyl addiction. Because of its unpleasant and potentially dangerous effects, fentanyl withdrawal should always be attempted under the supervision of a trained addiction specialist. Withdrawal symptoms from fentanyl include sleep problems, muscle pain, diarrhea, anxiety, and depression, to name a few. Fortunately, there are various ways to manage and treat fentanyl withdrawal. Avenues Recovery provides a comprehensive understanding of withdrawing from fentanyl and guidelines on how long fentanyl withdrawal lasts.
What is Fentanyl?
Fentanyl was first created in 1960 by a pharmaceutical company to be used as an anesthetic. It is classified as a synthetic opioid similar to morphine but is 50-100 times more powerful and is one of the most dangerous prescription drugs. It can be administered in different forms such as a patch, nasal spray, lozenges, and a shot. Furthermore, it is used to treat patients with severe pain by boosting dopamine levels in the brain and causing a euphoric “high’’. The affordable street cost of fentanyl aids today’s raging opioid epidemic. Synthetic opioids, including fentanyl, are now the most reported substances found in drug overdoses in the USA and are a factor in more than half of overdose deaths. The opioid epidemic itself is responsible for more than 136 deaths a day in America. Drug-related overdoses exceeded deaths by homicides by 306% and have continued to rise.
The Effects of Using Fentanyl
Fentanyl suppresses the central nervous system, which turns off the sensation of pain. The body gets used to this new “normal” and becomes reliant on fentanyl to feel balanced. While taking the drug a person will experience the physical and mental effects of this substance.
Side effects of Fentanyl include:
- Lowered body temperature
- Depressed heart rate, blood pressure and respiration rate
- Feeling relaxed, drowsy and mellow
- Constipation
- Unconsciousness
- Sedation
- Extreme happiness
There are a variety of factors that affect the half life of fentanyl. Heavy or prolonged use of fentanyl can lead to opioid dependence, and if stopped a person will experience fentanyl withdrawal symptoms.
How Does Your Body React When You Withdraw from Fentanyl?
Like many drugs, addiction withdrawal symptoms are common when one stops taking the substance. When beginning the process of recovery from fentanyl addiction, the substance must first be completely removed from the body through the process of detoxification. While detoxing, symptoms of withdrawal appear and can be very severe.
Physical Withdrawal Symptoms from Fentanyl
As per the US NIH [1], fentanyl withdrawal symptoms include:
- Pain in the muscles and bones
- Higher body temperature
- Sleep problems
- Diarrhea and vomiting
- Cold flashes with goosebumps
- Uncontrollable leg movements
- Severe cravings
- Restlessness
- Sweating
- Nausea
- Runny nose
- Abdominal cramps
- Increased blood rate
- Increased blood pressure (hypotension)
Emotional Withdrawal Symptoms of Fentanyl
Moreover, fentanyl withdrawal can manifest itself emotionally too. Emotional withdrawal symptoms include:
- Anxiety
- Irritability
- Depression
Since fentanyl withdrawal symptoms can be extremely uncomfortable and difficult, it is important to receive proper support and care when detoxing, such as in the Avenues drug detox center. Tapering off the drug should be done slowly.
Potential Risks
In addition to the direct symptoms, some of the effects of fentanyl withdrawal can lead to other risks, although rarely to death. Some of the major risks involved are:
- Dehydration from the vomiting and diarrhea symptoms.
- Aspiration from inhaling vomit into the airway accidentally or choking on vomit.
- Depression, which can lead to suicidal thoughts and behaviors.
- Insomnia which can cause relapse.
- Cravings can trigger a relapse, which increases the risk of overdose in an even smaller quantity since the body is no longer tolerant of the drug.
Fentanyl Withdrawal Timeline
You may be wondering “How long do fentanyl withdrawal symptoms last for?” Withdrawal symptoms appear as early as six hours after the last dose and can last for a few months. The fentanyl withdrawal timeline is in fact split into three stages (see table below).
| Stage 1 | 6-24 Hours from the last dose | Common symptoms at this stage can be anxiety, muscle pain, insomnia, sweating, and a runny nose. |
| Stage 2 | Days 3-5 | Fentanyl withdrawal symptoms typically peak at this stage until day 5, when the body adjusts to the lack of fentanyl. The second stage can include symptoms of diarrhea, nausea, and vomiting. |
| Stage 3 | From 1 week until a few months after | This is when the emotional withdrawal symptoms start and can affect a person for a few months. These symptoms include cravings, depression, and anxiety. |
Fentanyl Patch Withdrawal
A fentanyl patch releases the drug through the skin continuously for a 72-hour period. When the patch is removed it can take about a day for the fentanyl to be fully processed in the body. Once removed, it remains active for about 17 hours in the body which causes withdrawal to likely begin about a day after removal. The patch also raises tolerance and therefore withdrawal symptoms can be worse than other forms of fentanyl. The method for detoxing from a patch will differ from other forms as a result.
How to Deal with Fentanyl Withdrawal - Treatment Options
There are various ways to treat and manage withdrawal from fentanyl. Furthermore, it is crucial to seek professional help when withdrawing from fentanyl as experienced addiction experts can provide individualized and supervised treatment.
Tapering Off from Fentanyl Addiction
Tapering is the process of gradually ingesting smaller doses of a drug until your body can fully stop taking it. This process is used to prevent withdrawal symptoms from becoming unmanageable. It also prevents the body from being shocked if stopping cold turkey. It should be done with the help of a doctor or a professional for optimal results. If choosing to do this as an outpatient, it should be done under the oversight of a doctor, psychiatrist, or pain management specialist. This can also be done as an inpatient at a detox center or a drug rehabilitation center.
Taper Schedule
A doctor or professional will set a schedule for tapering off the drug based on the individual and the form of fentanyl that was used. Factors such as age, sex, length of addiction, and whether other substances are present are taken into consideration as well. A common method of tapering is to replace fentanyl with a slow-acting opioid drug until it can be stopped fully. Another tapering method is to use lower doses of fentanyl until it can be completely stopped.
Drugs that Can Help Fentanyl Withdrawal Symptoms
In addition to tapering off, there are medications that are approved by the FDA [2] to help with withdrawal symptoms. Some medications include:
- Methadone and Buprenorphine: These are both opioid replacement drugs approved by the FDA to aid in withdrawal. These slower-acting opioids work by keeping cravings and physical symptoms to a minimum until the individual is fully tapered off opioids.
- Naltrexone: Naltrexone is an approved drug that blocks the physical symptoms of withdrawal but can only be used a week after the last opioid dose.
- Sedatives: Another option is sedatives, which can be administered to help with fentanyl withdrawal symptoms.
Optimal Settings for Fentanyl Withdrawal Treatment
Withdrawal treatment for fentanyl can be administered in a variety of settings. Becoming familiar with the different options will help you choose the best one for you.
Inpatient Treatment for Fentanyl
Staying at an inpatient facility can help a patient to manage the withdrawal symptoms while receiving support for quitting a fentanyl addiction. A facility will provide medical oversight, counseling, and evaluations to help a person recover. For patients recovering from multi-drug abuse, it is especially important that they receive the proper treatment since complications can occur. Inpatient treatment will help with the short-term physical symptoms of withdrawal as well as address the long-term psychological impact. For a patient to be removed from their environment while in treatment, can also ease the healing process for them.
Outpatient Treatment
For patients that can manage their fentanyl withdrawal symptoms at home, there are outpatient treatment centers that provide services such as medication-assisted therapy for OUD, counseling, and a community for recovery. This is an option for patients that require a lower level of care and still want to maintain their routine.
Therapy for Fentanyl Addiction
Therapy can aid in recovery from fentanyl addiction and help a patient through withdrawal symptoms. The right therapy will be individually determined per person and depends on their backgrounds, needs, and circumstances.
Some commonly used therapies for withdrawing from fentanyl are:
- Individual counseling
- Group therapy
- Medication management
- Case management
- Skills training
- Mindfulness intervention
- Peer support
Counseling Modalities
Counseling can provide patients with tools and healthy life skills, and is used alongside medications in treating addictions.
Some common forms of therapy that have been found helpful are:
- Cognitive behavior therapy - this therapy is used to modify a patient’s behavior, manage stress and expectations of drug use
- Contingency management: - this is a voucher-based system that rewards patients based on negative test results. They are able to earn items for healthy living
- Motivational interviewing: - motivational interviewing addresses a patient’s resistance to change and helps motivate them to start effecting changes in their life.
Fentanyl Withdrawal Treatment at Avenues Recovery
Although addiction is a lifelong battle, with proper support and therapy recovery is possible! The right treatment can lead a patient on a path of physical and mental well-being and give him or her renewed freedom in sober living. At Avenues Recovery, we offer a variety of treatment programs and resources to help get you back on track. Reach out to us today for advice or if you need any help with a fentanyl addiction or fentanyl withdrawal.
Sources
[1] www.nih.gov
[2] www.fda.gov