Fentanyl is a synthetic opioid similar to morphine but faster-acting and up to 100 times stronger than the most potent form of heroin.  It is used to treat chronic and severe pain commonly in cancer patients or people recovering from invasive surgery, and can only be legally obtained through a medical prescription.
When prescribed, fentanyl usually comes in the form of an injection, patch, nasal spray or a lozenge while illegal fentanyl is commonly purchased as a powder, drops or in pill form.
Many people who use fentanyl report feeling a burst of euphoria followed by drowsiness and a feeling of relaxation. These pleasant sensations contribute to the addictive nature of this substance. However, it can also cause excessive perspiration, constipation and a loss of appetite.
Street names for fentanyl include China White, TNT, Goodfellas, Murder 8, Tango & Cash, Dance Fever and Friend.
Fentanyl is one of the most addictive and dangerous illegal drugs available, and even a small dose can spark a long-term dependency or even result in an overdose.
What makes fentanyl so addictive?
The strength and potency of fentanyl is thought to contribute to its highly addictive nature with one form of of this drug known as carfentanyl commonly used an as elephant tranquilliser due its strength, as it can be up to 5000 times stronger than heroin. 
Fentanyl works in a similar way to other opioids such as morphine and heroin, but the effects of this substance are faster and require a smaller dosage. It changes the way that the brain and body respond to pain – the pain is still physically present, but fentanyl blocks the brain from recognising it.
It was assumed for a number of years that there was little risk of fentanyl being introduced to the UK drugs market due to the purity of the heroin being produced. However, research has shown that the use of fentanyl has increased steadily over the past few years and this is likely due to the addictive nature of this substance.
Can I die from taking fentanyl?
The use of fentanyl can be deadly, and the rate of deaths linked to this substance appears to be increasing worldwide. There were officially 59 deaths linked to fentanyl in the UK during 2019, however the true rate of a fentanyl overdose is unknown due to the extent to which this substance is mixed with other illicit drugs. 
It is possible to overdose on fentanyl when ingested by itself, but fatal overdoses are more commonly seen when illegal fentanyl is mixed with other substances such as cocaine, heroin and MDMA. If an individual ingests a drug that is laced with fentanyl, the risk of overdose is increased as they may not be aware of the potency of this substance.
It is very unlikely that a patient that has been prescribed fentanyl in a medical setting will experience an overdose, due to the level of professional monitoring and care that they receive. However, if you believe that your prescription dosage should be increased or decreased, do not attempt to do so yourself. Speak to your GP who will be able to adjust your prescription as required.
Common signs of a fentanyl overdose include:
- Slow or shallow breathing
- Small, pinpoint pupils
- Clammy skin that is cold to the touch
- Feeling dizzy
- Confusion, trouble speaking
Naloxone is commonly used to treat overdose symptoms but is less effective on patients that have ingested fentanyl, meaning that multiple doses of naloxone may be required in order to provide effective treatment.
If you suspect that someone is suffering from a fentanyl overdose, call 999 and seek medical treatment immediately. It is important that you provide details of each substance that the individual has ingested, even if they are illegal. The medical team are not interested in prosecuting you – they are there to save lives.
Fentanyl use – what are the laws?
Fentanyl is classified as a Class A substance under UK law. It is illegal to obtain, supply, manufacture or use this drug without a medical prescription.
If you are found guilty of the illegal possession of fentanyl you can be sentenced to up to seven years in prison and/or an unlimited fine. The supply and production of fentanyl can result in a lifetime prison sentence and/or an unlimited fine. 
The sentence will usually be determined while considering factors such as the amount of fentanyl recovered, whether you intend to supply or manufacture the substance and your personal criminal history.
Being charged for drug possession, supply or manufacturing can have severe and long-lasting repercussions on your life. You may be unable to work in certain sectors or travel to a number of countries.
If you are under 18, police are legally able to inform your parents that you have been found in possession of fentanyl.
Signs and symptoms of a fentanyl addiction
The illegal use of fentanyl can quickly spiral into an addiction, as there is no medically devised plan to avoid the body building up a tolerance and no guidance for safe use. Even if you are using fentanyl as directed by a medical professional, it is possible to develop an addiction due to the potency of this substance.
A fentanyl addiction can manifest in a number of physical, psychological and behavioural symptoms that may be at best unpleasant and at worst, potentially deadly.
Physical symptoms of a fentanyl addiction can include:
- Sudden weight gain
- Extreme tiredness, fatigue and exhaustion
- Sleeping too much
- Dizziness and fainting spells
- Lack of coordination
- Itchy and irritated skin
- Nausea and vomiting
- Feeling depressed
- Slowed breathing
Psychological symptoms of a fentanyl addiction can include
- Frequent mood swings
- Feeling depressed
- Paranoia and delusions
- Visual, tactile and auditory hallucinations
- Intense cravings for fentanyl
- Needing to take more fentanyl in order to experience the same effects
Behavioural symptoms of a fentanyl addiction can include:
- Becoming isolated and withdrawn
- Neglecting responsibilities at school, work and home
- Suddenly spending time with a new group of friends
- Avoiding social situations where fentanyl use is not present
- Denying that there is a problem
- Experiencing negative consequences due to fentanyl use but continuing to use it
- Attempting to reduce or completely stop using fentanyl but being unable to do so
- Spending large amounts of time thinking about, acquiring and using fentanyl
Long-term effects of a fentanyl addiction
While many patients are able to safely take fentanyl long-term as a way to manage chronic pain, this is only possible with a carefully monitored medical prescription.
Using fentanyl illegally or taking more than the recommended dose can result in a number of long-term side effects over a period of time. These effects can vary according to the method in which the substance is ingested, but the risk of overdose remains high with all forms of illegal fentanyl.
Long-term effects of fentanyl addiction include:
- Increased risk of overdose
- Gastrointestinal problems including constipation
- Skin abscesses and infection
- Damaged and collapsed veins
- Higher chance of developing tetanus
- Legal and financial troubles
- Strained relationships with family, friends and colleagues
- Loss of employment
Recovering from a fentanyl addiction
Although fentanyl is a highly powerful drug, it is possible to recover from an addiction to this substance with the help of a specialised rehabilitation centre and an effective treatment plan.
As the risk of overdose is so high, the first stage of treatment involves complete detoxification. Patients will not be permitted to ingest fentanyl, and as a result, they may experience a number of physical and psychological withdrawal symptoms.
Common symptoms of fentanyl withdrawal include:
- Sleep disturbances, trouble falling and staying asleep
- Intense cravings for fentanyl
- Digestive problems including diarrhoea and cramps
- Nausea and vomiting
- Leg twitches and spasms
- Aching muscles and bones
There are a range of medications available to help manage the more unpleasant withdrawal symptoms and cravings – methadone is a safer and less addictive replacement for fentanyl, and the dosage of this medication can be slowly tapered off with far less risk of overdose. To combat intense cravings and reduce the chance of relapse, naltrexone can be prescribed which dulls the effect of fentanyl and prevents the addictive sensations of euphoria and relaxation.
Along with full detoxification, an effective treatment plan will offer a range of counselling options in which a therapist will challenge negative self-beliefs and mindsets around drug use. You may be offered cognitive behavioural therapy, group therapy, family therapy or other less-common forms of treatment including holistic therapy and motivational interviewing.
In order to increase the chances of long-term recovery and prevent an early relapse, patients will be provided with a personalised aftercare plan once they leave the treatment centre. You may be encouraged to undergo ongoing counselling with a private therapist or to attend local support groups such as Narcotics Anonymous (NA) where you will find a community of people who share many of your experiences.
You do not need to struggle with a fentanyl addiction alone. Reach out for help today – our team at OK Rehab will be happy to support and guide you towards recovery.