The Devastating Effects of Fentanyl Abuse

Originally developed as an intravenous anesthetic in 1957, fentanyl was first sold under the trade name Sublimaze. Starting in the mid-1990s, other means of administration began appearing—skin patches, lollipops, tablets, nasal and under-the-tongue sprays—and such slow-release options made the drug increasingly popular for easing severe pain in terminally ill patients. Fentanyl is a Schedule II drug under U.S. law, meaning it can be prescribed for medical use but also has high potential for abuse.

In 2007, fentanyl first appeared as a street heroin additive, an illicit use that has become common—and deadly.

Fairly common side effects from taking prescribed fentanyl include darkened bowel movements, heavy perspiration, coughing, chest pain, blurry vision, dry mouth, chills, increased thirst, lightheadedness, aching back or side, tingling in extremities, muscle cramps, mood swings, sore throat, and tinnitus.

Less common side effects—which should always be reported to the prescribing doctor—include severe stomach pain, loss of muscle coordination, pounding headache, hallucinations, seizures, body tremors, and irregular heartbeat.

Fentanyl is prescribed primarily in cases of severe and incurable pain, typically in a hospital setting. Cancer patients who have been declared terminal are frequent prescription recipients. Some fentanyl versions are used as large-animal tranquilizers because potent doses are inexpensive.

Fentanyl and its analogues are so potent that professionals handle them only under extremely controlled conditions. Law-enforcement officials investigating suspected fentanyl labs often use the same hazmat protection that’s standard for toxic chemical spills.

Because fentanyl is typically prescribed in patch form to patients who feel any pain relief would be an improvement, fewer addictions start as legitimate prescriptions than with many other drugs. There’s a bigger risk if prescriptions are furnished in the easily consumable, easily alterable pill form. Someone really desperate for a stronger, faster effect might heat a patch to make it release fentanyl faster, or rip it open to get to the whole dose at once.

More commonly, illicit fentanyl is purchased as a street drug—either alone or as part of a heroin mix—and snorted, injected, or taken as a pill. Sometimes it’s used to saturate blotter paper, which is then placed under the tongue.

Symptoms of fentanyl addiction and use include: bouts of euphoria and drowsiness, lethargy, loss of interest in old activities, slowed breathing, difficulty walking, pinpoint pupils, shakiness, dizziness, itching, slurred speech, extreme sleepiness, “nodding” off and swelling in the limbs. Physical signs of injection sites such as scarring, scabbing or dark marks around veins.

Symptoms of fentanyl withdrawal include: chronic irritability, restless legs, inability to find comfort, dysphoria, chills, heavy perspiration, insomnia, dilated pupils, diarrhea, and anxiety.

Symptoms of fentanyl overdose include: sudden collapse, unresponsiveness, faint pulse, lips turning blue, “gurgling” breathing, frothing at the mouth, stiffening muscles, slowing heart rate, and disorientation. When you call 911, make sure to say if you think it’s fentanyl that caused the overdose—because the drug is so potent, it requires a stronger-than-standard anti-opiate dose to minimize harmful effects.