Lazanda, a potent opioid nasal spray prescribed for cancer pain, leads to abuse, dependence and addiction. Rehab facilities can help you taper off of the drug safely. 

Lazanda is a potent opioid that is generally reserved for severe pain in people with cancer. Because it is such a strong opioid, Lazanda puts people at high risk for abuse, dependence and addiction.

Article at a Glance:

  • Lazanda is an opioid used for cancer pain and is up to 100 times stronger than morphine.
  • As an addictive narcotic nasal spray, Lazanda is a Schedule II controlled substance.
  • Side effects include constipation, diarrhea and nasal symptoms.
  • Because withdrawal symptoms can be hard to manage on your own, professional detox and rehab facilities can help wean you off Lazanda safely.

Lazanda Addiction

Lazanda contains the opioid fentanyl and is a Schedule II controlled substance. Schedule II controlled substances have a high potential for addiction and abuse. Refills of prescription drugs on this list are not allowed, and only a doctor who is licensed to prescribe opiates can prescribe Lazanda.

People who are prescribed Lazanda may develop an addiction or dependence even if they use the medication responsibly. This is because it is an opioid analgesic. The brain forms a tolerance to opioid analgesics quickly, making them very addictive.

Although it is unclear how many people with Lazanda prescriptions misuse the drug, it is considered at risk for diversion. In other words, people who are not prescribed the drug may take it from other people with legitimate prescriptions and either take the drug themselves or sell it.

If you begin to suspect that you or someone in your life has developed a Lazanda addiction, get help as soon as possible. You may notice the following addiction signs: becoming obsessed with finding and using Lazanda, seeking prescriptions for Lazanda more often than previously and losing interest in activities you once found enjoyable.

What is Lazanda?

Lazanda is a potent opioid used to relieve pain. Specifically, it is designed for people with cancer pain who are tolerant to other opioids. Because of its risks, Lazanda is restricted to a Risk Mitigation and Evaluation Strategy, or REMS program. Doctors, pharmacies and patients all must be enrolled in the program to prescribe and receive Lazanda.

It should only be used to treat sudden, severe pain rather than mild or short-term pain, like pain from headaches, dental procedures or surgeries. Doses are delivered via a nasal spray of 100 mcl of solution. Lazanda is available in doses of 100 mcg, 300 mcg and 400 mcg doses.

Signs, Symptoms & Side Effects of Abuse

Common side effects of using Lazanda include:

  • Nausea or vomiting
  • Dizziness
  • Fever
  • Constipation

As the drug is a nasal spray, nasal side effects can also occur. These include:

  • Nasal discomfort or irritation
  • Runny nose
  • Congestion
  • Nosebleed
  • Postnasal drip

Overdose Risk

The risk of an overdose increases dramatically when the drug is used by individuals who do not regularly take potent, long-acting opioids. To be considered opioid-tolerant, you must take the equivalent dose of 60 mg of oral morphine daily for at least a week.

Never share your Lazanda prescription with anyone for any reason. Doses are calculated specifically for individual people. The same dose that works well for one opioid-tolerant person may result in death for another.

The main symptom of an overdose is severe respiratory depression, or slowed breathing. Lazanda acts directly on respiratory mechanisms in the brain stem that regulate automatic breathing. The drug interferes with the brain stem’s ability to analyze carbon dioxide levels in the body and respond by breathing. By suppressing activity in the brain stem, the body has no way of knowing that it needs to breathe.

Other signs of an overdose include pinpoint pupils and a severely decreased level of consciousness. If too high of a dose is taken, the person may deteriorate rapidly from responding to questions in full sentences to being completely unaware of their surroundings. Other symptoms of an overdose can include cold, clammy skin, blue lips and fingers.

Lazanda is not approved for use by anyone under the age of 18. Lazanda has a high chance of death when it is taken by children.

In the event of an emergency, or if you believe you are witnessing an overdose, call 911 immediately. If you have an opioid reversal agent like naloxone available, you should administer naloxone and then call 911.

Lazanda and Alcohol

You should never mix alcohol with Lazanda, as this can lead to coma, overdose or even death.

This is because both alcohol and opioid analgesics suppress the respiratory system. Individuals who begin taking more of the drug to achieve the desired effect are at an increased risk of overdose if they also use alcohol.

Long-Term Consequences

Using Lazanda for a prolonged period may lead to lower hormone levels in some people. Low hormone levels can, in turn, lead to changes in sexual ability in men, reduce the occurrence of menstruation, lower libido and cause fertility issues.

Another long-term effect is developing a tolerance to opioid analgesics.

Lazanda Withdrawal

People who no longer wish to treat their pain with Lazanda should first set up a meeting with their doctor to discuss the best way to stop the medication. Lazanda should never be stopped suddenly or “cold turkey,” as this can produce unwanted withdrawal symptoms.

In most cases, doctors will gradually lower your dosage over time so that your body can adjust to less and less of the medication. This tapering approach will help you avoid withdrawal symptoms. Remember, you should never adjust your dosage or treatment schedule unless your doctor explicitly tells you to.

If you are having trouble managing withdrawal symptoms, you may want to consider a medically-assisted detoxification program. In this program, you can safely detox while being able to come to medical professionals with any struggles or questions you have regarding withdrawal.

Withdrawal Symptoms

Common withdrawal symptoms of short-acting opioids like Lazanda include:

  • Nausea and vomiting
  • Anxiety
  • Insomnia
  • Feeling hot or cold
  • Sweating
  • Muscle cramps
  • Runny eyes and nose
  • Diarrhea

Withdrawal Timeline

Lazanda’s withdrawal timeline is different for everyone. If you take Lazanda on a regular basis, you may start to experience withdrawal symptoms around the time that your next dose would have been taken. Withdrawal symptoms may last up to 10 days.

Lazanda Addiction Treatment & Detox

People who may have developed an addiction to Lazanda can benefit from The Recovery Village’s resources and rehabilitation programs. The first step in recovery, regardless of whether someone enters inpatient or outpatient rehab, is to safely detox from the medication. Once the drug is completely out of your system, you can participate in individual and group counseling sessions and recreational therapy activities at The Recovery Village.

Inpatient Rehab
Inpatient rehab gives you the opportunity to live at a designated inpatient center while you safely recover from addiction. This is a beneficial treatment option for people with severe Lazanda addiction or those who might find recovery difficult due to distractions in their home life. While at The Recovery Village, people in inpatient rehab can learn skills on how to manage their addiction struggles from professionally trained staff.

Outpatient Rehab
After the inpatient rehab is completed, you will begin the second leg of treatment with outpatient rehab. In this program, you will live at home while you attend your scheduled treatment appointments. Some people with less severe addiction may opt-out of inpatient rehab and begin recovery with outpatient rehab or teletherapy instead.

Choosing a Lazanda Rehab Center

Choosing a rehab center to support you during your journey to recovery is an important step in living a happier, healthier, substance-free life. To make the most informed decision possible, it is recommended that you schedule a meeting with your doctor to discuss specific features you should seek in a rehab center.

If you or someone you know is suffering from Lazanda addiction or another type of substance use disorder, seek professional help as soon as possible. Contact The Recovery Village today to discuss resources and treatment options that may work for your situation.

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Editor – Rob Alston
Rob Alston has traveled around Australia, Japan, Europe, and America as a writer and editor for industries including personal wellness and recovery. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
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How is Lazanda used?

Lazanda should be used only as directed by your doctor. It is a nasal spray that should only be utilized for breakthrough and severe pain that happens when a person is already taking opioid painkillers.

Lazanda is available in three doses that are color-coded to be easily distinguished from each other. Dosing can vary, so make sure that your doctor and pharmacist explain exactly how you should use the drug.

How long does Lazanda stay in your system?

How long Lazanda stays in your system depends on a variety of factors including your kidney and liver function, your dosage and how frequently you take Lazanda. Fentanyl, the active component of Lazanda, can be found in your blood for up to 12 hours since the last dose. It can also be found in your urine for up to three days and in your saliva for up to two days. If you have a hair test, a 1.5-inch section of hair can show fentanyl use for the past 90 days.

In the event of a Lazanda overdose emergency, should naloxone be administered?

Opioid reversal agents such as naloxone rapidly stop the effects of opioids like Lazanda. If you suspect that someone is having an overdose, you should administer naloxone and call 911.


U.S. National Library of Medicine. “Lazanda.” February 24, 2020. Accessed August 2, 2020.

United States Drug Enforcement Administration. “Fentanyl.” Accessed August 2, 2020.

World Health Organization. “Clinical Guidelines for Withdrawal Manag[…]e in Closed Settings.” Published 2009. Accessed August 2, 2020.

ARUP Laboratories. “Drug Plasma Half-Life and Urine Detection Window.” January 2019. Accessed August 2, 2020.

Gryczynski J, Schwartz RP, Mitchell SG, et al. “Hair Drug Testing Results and Self-repor[…]isk Illicit Drug Use.” Drug and Alcohol Dependence, May 17, 2014. Accessed August 2, 2020.

Cansford Laboratories. “Oral Fluid (Saliva) Testing.” Accessed August 2, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.