Fentanyl: Abuse and Addiction

Buried deep within the human brain, tiny cells have open receptors, just waiting for a little molecule of an opioid to float past. When that molecule arrives, it locks into that opening in the brain, and it triggers the release of intoxicating chemicals that can infuse a person with the feeling of warmth, happiness, and comfort. The sensation of pain may be a distant memory, with only relaxation filling the void.

Every opioid works in this manner, but the prescription medication fentanyl is particularly dangerous. This medication is powerful, fast-acting, and readily available, making it an enticing choice for people who want to use and abuse drugs.

Common Uses of a Powerful Drug

U.S. Centers for Disease Control and Prevention estimates that fentanyl is 80 times more powerful than morphine, making it one of the strongest opioid medications available in the marketplace today.[1] There are many people who have a valid need for drugs that are this powerful. People with advanced cases of cancer, for example, often have pain that runs so deep and is so persistent that other forms of pain control leave them feeling uncomfortable or downright miserable. Fentanyl can allow for quick treatment of breakthrough pain episodes like this, providing relief at the end of life. Fentanyl is also used in surgical practices, allowing medical professionals to numb the sensation of pain so they can make lifesaving cuts in people with very serious medical conditions.

Since the drug has so many reasonable uses, it’s not surprising that it’s also sold in many formats, including:

  • Liquid for injections
  • Lozenges or suckers
  • Fizzing tablets
  • Patches

The organization IMS Health reports that 1.73 million prescriptions for fentanyl were dispensed in the United States during the first quarter of 2011, and many of these prescriptions likely made life tolerable for people with severe pain.[2] Unfortunately, at least some of these prescriptions were diverted for the illicit drug trade, feeding into dangerous addictions.

High Street Value

Fentanyl might seem popular because it’s common, and while it’s true that people who want to abuse this drug might find it easy to do so, there are some people who specifically seek out fentanyl as their drug of choice. The way that the drug is structured and the way it interacts in the human body can bring about some benefits that people might struggle to find in any other way.

Fentanyl sets to work in the body almost immediately, but it tends to wear off quickly.

People who abuse opiates like OxyContin might feel somewhat altered for hours, unable to function normally or interact properly, but those who take in fentanyl might seem perfectly normal mere hours after taking the drug. The substance just wears off, and it leaves no residue behind, making it an attractive choice for people who want to feel something transformative without losing a day or two of their lives in the process.

Fentanyl might also be popular because it’s difficult to detect in standard urine or blood screenings for drugs. It has a different chemical structure than the substances that typically cause alarm for screening professionals, and often, the tests used to detect drug abuse just don’t detect the presence of fentanyl. Those who want to keep their abuse secret might find fentanyl attractive for this reason.



Among all opioid drugs of abuse, fentanyl might be considered intensely dangerous due to its power. Since the drug sets to work so quickly, and since it causes such dramatic changes inside the brain of the user, it’s the sort of drug that’s hard to forget. People who use this drug just once may have the kind of transformative experience that puts them on the road to addiction almost immediately. The brain remembers dramatic experiences like this, and the cells call out for a repeat performance.[3]

The power of fentanyl can also lead to tolerance. The cells of the brain become accustomed to the constant presence of the drug, and they may begin to respond with indifference when the intoxicating molecules are present. In time, people may need to take larger and larger doses of this drug in order to feel the response that once came so easily with just a tiny bit of fentanyl. Unfortunately, fentanyl can also cause very slow breathing rates along with seizures when it’s taken at high doses. People with addictions may lose their lives just trying to get high, and they may never know that the doses they’re taking would be considered life-threatening by experts.

Pure fentanyl can clearly be dangerous, but there are some concerns that stem from the way the drug is made, and how it is sold. For example, the National Institute on Drug Abuse reports that dealers sometimes attempt to make their own versions of fentanyl in their laboratories, and when they do so, they sometimes substitute other illicit drugs for the ingredients they can’t obtain. As a result, some people who believe they’re taking fentanyl are sometimes taking other drugs, such as heroin. These users may have no idea that the substitution has taken place, and they might not adjust their dosing appropriately. This could lead to drug reactions or even overdoses.


Some people who abuse fentanyl do so by simply injecting the liquid form of the drug. These users might also take in pills filled with fentanyl, following a somewhat conventional dosing format, or they might suck on lozenges infused with the drug. All of these steps can be dangerous, of course, but some people who take in fentanyl do so by attempting to override the safety features contained in the drugs. People who take these steps may be placing themselves in even greater danger.

Fentanyl patches are infused with the medication, and they’re designed to deliver a low dose of relief for an extended period of time. A person in intense pain might slap a patch on his or her shoulder and leave it there for up to three days, and that person might only get a few milligrams of the drug during each day that passes.

Some fentanyl addicts override this slow release by cutting the patches apart and applying the potent part of the patch to the inside of their gums.

The surfaces that line the inside of the mouth are much more responsive to the presence of drugs, and they might enthusiastically pull out each and every molecule of the drug in mere minutes.

Those who don’t want stickers lining their mouths might pull the patches apart and extract the gel filling that each patch contains. These users can then place the gel inside needles and plunge those needles into their veins. Again, they’re getting the full impact of the drug in mere minutes, rather than waiting for days to pass. Unfortunately, this can be deadly and hard to reverse. People who feel overwhelmed while using a patch might simply pull the sticker out of their mouths, but those with drugs in their veins have no such easy solution available.

Vulnerable Targets

Almost anyone could become addicted to fentanyl, and dealers often work hard to keep their clients supplied with the substances they enjoy. But some experts suggest that specific types of people are most vulnerable to developing an addiction to this drug. For example, the Bureau of Narcotic Enforcement in New York State suggests that fentanyl is most often stolen from hospitals and surgical centers. This organization suggests that medical professionals take the drugs while at work, either by stealing the drugs from the medical supplies or by stealing the drug from patients. Medical professionals might enjoy the intoxication the drug brings, but they might also enjoy the quick restoration to health they obtain after a fentanyl binge. Instead of feeling woozy and discombobulated after an abuse session, they’re ready to head back to work. For busy people on the go, this might be ideal.

People with low income levels might also enjoy fentanyl, as the drug can bring them an intense sensation even at a low dose. They might find it difficult to obtain large amounts of other intoxicating substances, but a small dose of fentanyl might be well within their means. Some people also obtain the drug for free by scouring the trash receptacles of hospitals and nursing homes. Fentanyl patches often contain active amounts of the drug, even when they’ve been worn for days, so people might find all the drugs they want by diving into the dumpster.

Warning Signs

Those who believe they can spot a fentanyl addiction due to intense signs of intoxication might be seriously mistaken.

Since fentanyl wears off so quickly, users might not appear intoxicated for large swaths of time. As the addiction progresses, in fact, people with fentanyl addictions might just seem normal or a little tired during the day. Sudden shifts of energy might be cause for alarm, however, and it’s not uncommon for addicts to display these behaviors on a regular basis. They might seem hostile and keyed up in one moment, and then quiet and drowsy mere moments after leaving the bathroom or having a moment alone. These people might also have very tiny pupils, no matter how dark the room might be, and they might slur their words as they talk. These are all possible signs of intoxication, and they should be taken seriously.

People with fentanyl addictions might also hoard paraphernalia related to the drug, including:

  • Needles, both clean and dirty
  • Burned tinfoil or silverware, typically housed next to lighters or matches
  • Empty fentanyl pill bottles
  • Discarded and damaged fentanyl patches

People who abuse fentanyl lozenges might also have a sucker in their mouths throughout the day, and they may seem uncomfortable with the idea of removing the sucker in order to eat, drink or talk. Extreme agitation in the face of a reasonable request like this is a very serious sign that abuse is taking place.

When to Seek Help

The following behaviors indicate someone is addicted and may need professional help breaking free:

  • The person needs more of the drug to get the same desired effects
  • He/she has taken the drug to avoid withdrawal symptoms
  • The person can no longer control how much or how often they use fentanyl
  • A lot of their time is spent trying to find and use fentanyl
  • They use in secret or hide how much they use
  • They choose using fentanyl over spending time with friends or family
  • They know fentanyl has a negative effect on their life, but they don’t or can’t stop using

Taking Action

People with fentanyl addictions can be difficult to approach, as they might seem as though they have the issue well in hand. They might even respond with anger or fervent denials when the people they love attempt to discuss the abuse issue. It can be difficult and delicate, but we can help.

At Michael’s House, we have years of experience in treating very difficult addictions like this, and we can help you determine just what to say to help motivate the person you love to seek help. More importantly, we can also provide the targeted treatments that can help the person you love to leave a fentanyl habit behind for good before that addiction takes a fatal turn. Please call 760-548-4032 to talk to one of our trained admissions coordinators.

Start the Journey Today!


[1] https://www.cdc.gov/niosh/ershdb/EmergencyResponseCard_29750022.html
[2] https://www.deadiversion.usdoj.gov/drug_chem_info/fentanyl.pdf
[3] https://www.drugabuse.gov/drugs-abuse/fentanyl