Fentanyl Abuse Side Effects and Symptoms

Fentanyl is one of the strongest opioid drugs on the market. It is not a long-lasting drug so it is often used for surgery recovery and for breakthrough pain—meaning that when a person is already taking an opiate but has temporary pain that breaks through the opiate barrier, they may be given fentanyl. Fentanyl abuse crosses the boundaries of age, gender, religion, and socioeconomic status. Everyone can develop addiction, from people experiencing homelessness to anesthesiologists — some of the highest paid physicians, among whom there is a high incidence of fentanyl abuse. Despite the pain of addiction, there is hope for recovery. Just as addiction spans all populations, addiction rehabilitation can also help everyone.
Fentanyl abuse and addiction can be detected in a person’s behavior and bodily state. Whether you are concerned about your own use or the use of someone you love, keep an eye out for both behavioral and physiological signs of drug abuse.

Behavioral signs include:

  • Drug-seeking behaviors (such as doctor shopping, stealing money or goods to buy fentanyl, and constantly talking or thinking about using or obtaining fentanyl)
  • Using the drug to get high rather than to relieve pain as prescribed
  • Using the drug longer, more frequently, or in greater doses than medically necessary

Fentanyl has a powerful impact on the body, and its abuse manifests as the following physiological signs, and more:

  • Extreme drowsiness or unconsciousness
  • Slurred speech
  • Tiny pupils
  • Weight loss
  • Confusion
fentanyl abuse signs
Abusing fentanyl feels like the high provided by most other opioids — users often report that fentanyl feels like heroin. Its side effects are also similar to other narcotic drugs.

Fentanyl can produce the following side effects, whether it is simply being used medically or being abused:

  • Nausea
  • Constipation
  • Itching
  • Fatigue
  • Abnormal heart rate
  • Seizures
  • Skin problems, including hives or rash
  • Breathing trouble
  • Mental confusion
  • Lightheadedness or fainting
  • Dependency
  • Withdrawal symptoms after ceasing fentanyl use (such as sadness, nausea, vomiting, muscle aches, diarrhea, fever, sleep trouble)

Note that drug dependency and withdrawal symptoms are not exclusive to fentanyl abuse — some people develop fentanyl addiction without intentionally misusing the drug. Because it is so potent, fentanyl quickly creates an opioid tolerance in all users — regardless of whether they are using illicit or pharmaceutical fentanyl.

Once a dependency has developed, stopping fentanyl use can be very uncomfortable, even in the absence of addiction.

Recognizing a problem is the first step toward overcoming opioid addiction.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the go-to diagnostic tool for mental health professionals in the U.S. It contains the American Psychiatric Association’s (APA) descriptions and symptoms of all mental disorders, including addiction (which is now called substance use disorder in clinical settings).

The latest version of the Diagnostic and Statistical Manual of Mental Disorders, DSM-V, states that a diagnosis of substance use disorder is “based on evidence of impaired control, social impairment, risky use, and pharmacological criteria.”

Here are the 11 DSM-V criteria that define an addiction to opioids like fentanyl:

  1. Taking the opioid in larger amounts or for longer than medically necessary
  2. Inability to control or reduce fentanyl use
  3. Spending a great deal of time to obtain and use fentanyl
  4. Strong desire or craving for fentanyl
  5. Consistent inability to meet major obligations
  6. Continued fentanyl use despite interference with normal function
  7. Using fentanyl to the detriment of important social, work-related, or personal obligations
  8. Recurrent use of fentanyl in physically hazardous situations
  9. Consistent use of fentanyl despite knowledge of difficulties due to fentanyl use
  10. Tolerance (Not applicable to people who are using fentanyl under medical supervision)
  11. Withdrawal symptoms after stopping fentanyl (Not applicable to people who are using fentanyl under medical supervision)

The DSM-V defines severity of addiction using a criteria count from 2–11. A person’s level of addiction can be clinically determined as follows, based on the number of criteria that the person meets:

  • Absent Addiction – zero to one criterium met
  • Mild Addiction – two to three criteria met
  • Moderate Addiction – four to five criteria met
  • Severe Addiction – six or more criteria met
Entering treatment can be difficult, especially without support. If you are concerned about a loved one’s addiction, you should consider staging an intervention to support them in getting treatment of substance abuse.
There is a wrong way and a right way to do an intervention. Thus, it is usually a good idea to consult with an intervention specialist. They can help you figure out the best way to approach the situation in regards to timing, attendees, and how to communicate your thoughts with love. Though this professional can provide valuable insight on how to convince someone to go to to rehab, the decision to seek treatment ultimately lies with your loved one.
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“Fentanyl.” National Institute on Drug Abuse (NIDA), National Institutes of Health, June 2016, www.drugabuse.gov/drugs-abuse/fentanyl. Accessed 18 Jan. 2017.

Mandal, Ananya. “Fentanyl Illicit Use.” News-Medical.net, AZoNetwork, 3 July 2014, www.news-medical.net/health/Fentanyl-Illicit-Use.aspx.

Volkow, Nora D. “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.” National Institute on Drug Abuse (NIDA), National Institutes of Health, 14 May 2014, www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse. Accessed 18 Jan. 2017.

“Fentanyl: MedlinePlus Drug Information.” MedlinePlus – Health Information from the National Library of Medicine, National Institutes of Health, 15 Sept. 2016, medlineplus.gov/druginfo/meds/a605043.html. Accessed 18 Jan. 2017.

American Psychiatric Association. “Opioid Use Disorder Diagnostic Criteria.” PCSS-MAT, Providers’ Clinical Support System For Medication Assisted Treatment, pcssmat.org/wp-content/uploads/2014/02/5B-DSM-5-Opioid-Use-Disorder-Diagnostic-Criteria.pdf.

Bryson, Ethan O., and Jeffrey H. Silverstein. “Addiction and Substance Abuse in Anesthesiology.” PubMed Central (PMC), U.S. National Library of Medicine, 1 Nov. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2766183/.

Hasin, Deborah S., et al. “DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale.” PubMed Central (PMC), American Journal of Psychiatry, 1 Aug. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC3767415/.

“Substance Use Disorders.” SAMHSA, 27 Oct. 2015, www.samhsa.gov/disorders/substance-use. Accessed 18 Jan. 2017. 

American Psychiatric Association. “Opioid Use Disorder Diagnostic Criteria.” PCSS-MAT, Providers’ Clinical Support System For Medication Assisted Treatment, pcssmat.org/wp-content/uploads/2014/02/5B-DSM-5-Opioid-Use-Disorder-Diagnostic-Criteria.pdf. Accessed 18 Jan. 2017.

Signs of Fentanyl Abuse
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