Fentanyl addiction and use has evolved into a major public health crisis in recent years, with the drug leading the nation in overdose deaths by a massive margin. The powerful synthetic opioid is up to 50 times more potent than heroin and is often used by people who are addicted to opioids; however, it is also showing up in almost every other street drug and finding its way into the hands of many unsuspecting users. Whether consumed intentionally or accidentally, the substance is exceedingly dangerous which has led to a significant increase in overdose deaths, particularly in young adults.
The DEA has been issuing warnings to the community about the increased prevalence of this drug, as well as its dangers to prevent fentanyl poisoning and drug overdoses. What is concerning is that many of the young adults dying of fentanyl drug overdose are often unaware the drug was present in the substance they were taking.
Fortunately, there are some ways to identify if your child is using fentanyl. Paying attention to these warning signs and noticing fentanyl addiction and substance abuse early is an important part of getting your child the help that they need before any harmful consequences.
What is Fentanyl?
Fentanyl belongs to a class of opioid analgesics. Pharmaceutical fentanyl is used to treat severe pain after surgery, for cancer patients, and for people who have chronic pain conditions that don’t respond to other medications. Fentanyl is an incredibly potent opioid, and even a small amount can lead to serious side effects or overdose. Opioids include prescription drugs that are used to treat pain, but they also include illegal drugs made from the powerful sap of the poppy flower. In addition to fentanyl, opioids include drugs and pain medications like:
Fentanyl is a synthetic opioid, meaning it’s made in a laboratory rather than from the poppy plant. Fentanyl labs are found worldwide, and these synthetic opioids are shipped illegally into the United States by drug dealers. The Drug Enforcement Administration warns that more countries are now producing fentanyl and sending it to the United States, making it essential for parents to be aware of the growing danger. If you have prescription medication at home, including fentanyl, it’s best to keep a close eye on them if you believe your child might be abusing fentanyl.
How does Fentanyl Affect the Brain?
Fentanyl and other synthetic opioids work by binding to opioid receptors in the brain. These opioid receptors can be found in regions that control pain and emotions. Because of the strong effect it has on the brain, a person taking prescription fentanyl as directed by their provider may experience dependence and develop a substance use disorder. This occurs because of how the brain adapts to the drug, builds up a strong tolerance, and becomes less sensitive to the quantity prescribed. This leaves users craving more of the drug and taking fentanyl at larger doses than prescribed.
What are the Common Types of Fentanyl
There are two types of fentanyl: medical fentanyl which can only be obtained with a prescription from a medical doctor and illegal fentanyl which is manufactured illegally by drug dealers around the world.
“Legal” Medical Grade Fentanyl
- Fentanyl lollipops, lozenges, sublingual tablets (Actiq, Fentora, Duragesic)
- Fentanyl transdermal patches (Duragesic, Abstral, Substys)
- IV fentanyl (Sublimaze)
- Pressed fentanyl pills
- Powdered fentanyl
- Rainbow fentanyl
- Liquid fentanyl (Nasal sprays, eye drops, blotting paper)
- Fentanyl Laced Drugs
Behavioral Changes to Watch For
Fentanyl addiction will often result in changes in someone’s behavior and lifestyle. Look for the following signs of behavioral change in people addicted to fentanyl:
1. Sudden changes in mood or demeanor.
If your child is normally happy and outgoing but suddenly becomes withdrawn or frequently tired, it could be a sign that they are using fentanyl. Opiates are CNS depressants – this means that “nodding off”, seeming “out of it” and other similar patterns are common.
2. Changes in friends or interests.
If your child starts hanging out with a new crowd or suddenly loses interest in activities they used to love, it could be due to drug use. This is one of the most important things to notice. While normal teenage and young adult development involve shifts in friend groups, a child abandoning healthy friends for a group that you are less than excited about could be a warning sign.
3. Neglecting responsibilities.
A sudden drop in grades, skipping practice or class, not showing up for work – all of these things can happen when someone is using fentanyl (or another opioid drug). This is especially pertinent if previously, your loved one was relatively responsible and enjoyed these activities.
4. Secretive behavior.
If your child is being unusually secretive about their whereabouts or what they are doing, it may be a sign that they are using drugs and trying to hide it from you. This includes making up excuses for why they cannot participate in activities with the family or why they have a constant need for privacy. While a little less scientific, this is often something that parents can “feel” from their child. If your parental warning light is on, it is probably for a good reason.
5. Disregard for personal hygiene and appearance.
Again, this one is tough because many teenagers go through phases where they don’t take amazing care of themselves, but it can also be a giveaway that something serious is going on. Fentanyl and other opioids co-opt the part of the brain responsible for basic functioning and prioritize use over many other aspects of daily living. Letting oneself go is never a good sign – even if drug use is not at play, this can be a sign of other mental health conditions.
6. Stealing and constant need for money.
While young adults and teenagers often have difficulty with budgeting and being financially responsible, if you notice that you always seem to be giving your loved on more money, it may be a sign of drug use. Additionally, a very common indicator is theft – whether that be in the form of cash taken out of your purse or wallet or missing iPads around the house. Paying attention to how much cash you have on hand and noticing if the number inexplicably changes is helpful, as is limiting the number of resources you give your loved one if you suspect something is going on.
Withdrawal Symptoms that Can Give Use Away
If your son or daughter is very good at hiding their use, sometimes they will manage to avoid any of these behavioral changes being displayed. In these situations, many parents report that the first time they realized what was happening was when they started to identify withdrawal symptoms when their loved one ran out of opiates to use. Here are some of the most common fentanyl withdrawal symptoms:
1. Agitation and irritability.
This is especially common in children who are used to being relatively even-keeled emotionally. If your child suddenly starts lashing out for no reason or seems on edge all of the time, it may be due to fentanyl withdrawal. Withdrawal is very uncomfortable and even in minor cases that don’t have heavy accompanying physical symptoms, this can be very present.
2. Anxiety and depression.
These two mental health conditions are often present prior to substance use starting and can even be an underlying cause, but withdrawal certainly exacerbates them. If your child is struggling with anxiety or depression, it may be difficult to tell a huge difference, but still worth paying attention to.
One of the hallmark symptoms of fentanyl withdrawal is the inability to sleep. This often leads to a relapse, as it becomes so untenable for someone to go through. It will quickly become apparent if your child is not sleeping due to withdrawal though, as exhaustion becomes difficult to hide as it progresses.
4. Nausea and vomiting.
This is another classic withdrawal symptom. Often when coming off of fentanyl or other opiates, vomiting can be frequent and violent.
This symptom usually goes hand-in-hand with nausea and vomiting.
6. Cold Sweats
Often, people withdrawing from opiates will experience cold sweats. When this happens, they may be continually trying to regulate the temperature of the home, or wearing excessive amounts of clothing to help combat the cold sweats.
How long does Fentanyl withdrawal last?
The duration of withdrawal depends on several factors such as duration of misuse and quantity abused, but for most the symptoms begin as early as 12-24 hours after the last dose. Physical withdrawal symptoms can persist up to a week after the last dose, but psychological symptoms may last longer and could develop into post-acute withdrawal syndrome.
It is not safe to detox from fentanyl addiction cold turkey as fentanyl withdrawal can be fatal if not properly monitored by a medical professional at a treatment center. A medical detox will treat fentanyl addiction and withdrawal by prescribing medications to safely and comfortably manage the symptoms of fentanyl withdrawal as well as reduce the cravings for the drug.
Physical Changes and Signs of Use
Fentanyl addiction can lead to a variety of physical health problems.
1. Changes in weight.
This is often one of the first physical signs that something is going on, as weight loss (or gain) can be difficult to hide. Depending on how long someone has been using fentanyl, this may range from a few pounds to a much more significant amount.
2. Track marks.
Another very common physical sign of fentanyl use is track marks. These are needle marks, usually on the arms, that indicate intravenous drug abuse. They can be accompanied by bruising, as well as scarring if someone has been using them for a long time.
3. Bloodshot eyes.
People who use drugs frequently have bloodshot eyes, due to the fact that many drugs are vasoconstrictors. This means that they constrict the blood vessels, which in turn makes the eyes look red.
4. Dilated pupils.
Another common sign of drug abuse is dilated pupils. This is most often seen in people who use stimulants but can also be present in those using opioids like fentanyl.
5. Changes in eating habits.
People who are using drugs often have changes in their eating habits. This can manifest as either weight loss or weight gain, depending on the person. It can also be difficult to hide if someone is not eating as frequently as they used to.
6. Changes in sleeping habits.
Just like with eating, when someone is using drugs they often have changes in their sleeping habits. This can be difficulty falling asleep or staying asleep. It can also manifest as sleeping more or less than usual.
7. Changes in appearance.
People who use drugs often let their physical appearance suffer. This can manifest as not showering, not brushing their hair, or not taking care of their clothes.
Another sign that someone is using drugs is if you find drug paraphernalia. This can be needles, pipes, bongs, lighters, rolling papers, spoons, or anything else that may be associated with drug use.
9. Secretive behavior.
People who are using drugs often become secretive and try to hide their behavior. This can manifest as lying, being evasive, or not wanting to talk about what they’re doing.
10. Financial problems.
Drug use is an expensive habit, and it can often lead to financial problems. If someone is suddenly asking to borrow money or is having difficulty paying their bills, it may be a sign that they are using drugs.
How Long Does Fentanyl Stay in Your System?
Fentanyl’s half-life is relatively short, meaning that it is detectable in the body for a shorter period of time than some other drugs. The average half-life of fentanyl is around 18 hours, which means that it takes about 36 hours to completely remove the drug from your system. In terms of how long it will show up on drug tests, this will vary depending on how much and how often someone has used the drug. Generally speaking, fentanyl can be detected in urine tests for up to 3 days after use, and up to 6 days in blood tests. Hair follicle tests are known for being more sensitive and can detect fentanyl use up to 90 days after the last use.
Drug Paraphernalia to Look For
When looking for signs of fentanyl use, one of the things to look out for is drug paraphernalia. This can include needles, pipes, bongs, lighters, rolling papers, spoons, and other items used to consume or prepare the drug. Often fentanyl is consumed by freebasing it off of tinfoil and aluminum foil as well.
Needles are typically how fentanyl is taken intravenously and should not be overlooked as a sign of drug use. Fentanyl needles are a dangerous instrument that can easily lead to an overdose.
When used intravenously, fentanyl is more potent than other opioids and its effects can be felt quickly. Due to this potency, it is possible for users to take too much of the drug in one dose, leading to an accidental overdose.
Fentanyl needles are often shared among users, increasing the chance of contamination with other drugs, and infectious bacteria. When different drugs are mixed with fentanyl, it could cause a negative reaction that could lead to an overdose. Furthermore, sharing needles may transmit bacteria and blood-borne infections such as HIV, hepatitis B, and hepatitis C.
For these reasons, it is important for people who use fentanyl needles to be aware of the risks associated with the drug and how to reduce their risk of overdosing or contracting deadly infections.
Pipes, Bongs, and other Smoking Paraphernalia
Pipes, bongs, and other smoking devices can be used to smoke fentanyl or mix it with other drugs, such as marijuana, methamphetamine, or crack cocaine. Lighters may also be found around areas where a person has been using drugs. Rolling papers can be used to make blunts and joints that are then smoked.
Household Items Used to Consume Fentanyl
In addition to more obvious drug paraphernalia, household items can also be used to consume fentanyl. These items include spoons, bottle caps, and aluminum foil.
Spoons are used for mixing drugs with water or other liquids before they are injected intravenously. Signs that a spoon has been used to prepare fentanyl include burn marks at the bottom, bent from overuse, and suspicious residue in the spoon.
Bottle caps, aluminum foil, or candy wrappers can also be used to mix, prepare, or swallow drugs. This is especially common among users who cannot inject the drug intravenously or are trying to hide their use from family and friends.
Signs of Fentanyl Overdose
Fentanyl is a powerful opioid that can be more potent than other opioids, such as heroin or oxycodone. For this reason, it is important to know how to recognize the signs of an overdose.
An overdose occurs when someone takes too much of a drug and is unable to control how much they consume. It is also possible for an overdose to occur even with a small amount of fentanyl due to its potency.
If someone is overdosing on fentanyl, they may experience symptoms such as extreme drowsiness, pinpoint pupils, slowed breathing/respiratory depression, slowed heart rate, pale skin, clammy skin, confusion/disorientation, loss of consciousness/unresponsive state, rapid heartbeat/pulse, seizures, nausea/vomiting, and blue skin around the lips and fingertips
If someone you know is showing any of the signs it is important to seek medical attention immediately. Call 911 and if you have any Narcan (naloxone) nasal spray, you can administer a dose to someone who is overdosing in order to reverse the effects of opiates
Getting Help for Fentanyl Addiction
If this article hits close to home and you determine that a loved one is in fact struggling with a fentanyl addiction or other substance use disorders, there is definitely help available. New Life House is an age-specific recovery program that provides a full continuum of wrap-around care. From therapeutic and clinical support groups to life skills, family work, peer-based community, structure, counseling, and more, we have been helping young men and their families transform their lives since 1985. New Life House provides a comprehensive approach to recovery by working closely with Clear Recovery Center as well as immersing individuals in a closely-knit community that continually holds one another to a higher standard.
The most important thing to remember with fentanyl dependence is that there is no time to waste when it comes to treatment. Because of the extraordinary impurity found in the fentanyl supply and the ease with which overdose can take place, taking action and helping your child turn their life around is crucial and not something that should be delayed.
Last Updated on November 30, 2022