A synthetic opioid drug that is 50 to 100 times stronger than morphine, fentanyl is used for pain in patients when other pain control methods are no longer effective. It’s also used to help people prepare for or recover from surgery.
Fentanyl is also abused. The drug is often made in clandestine labs and sold to users or pressed into pills that look like something else.
Nearly 70% of the 107,375 drug overdose deaths in the United States in 2021 involved a synthetic opioid. Most of the time, individuals are unaware that fentanyl is in the drug they are taking. This increases the likelihood of overdose.
What Is Fentanyl Used For?
Fentanyl is a prescription opioid medication that comes in two forms. Each version is designed for slightly different types of people.
The injectable version of fentanyl is designed for the following four uses:
- Preoperative pain relief before the anesthetic is administered
- Postoperative pain relief when the anesthetic wears off
- People who need open-heart surgery or complicated procedures who need extra anesthesia help
The fentanyl patch is designed for people who have pain that’s severe enough to require around-the-clock treatment. People like this have tried other options, and they didn’t get the relief they needed.
Fentanyl Overdose Statistics
- In 2021, approximately 71,238 people in the United States died from an overdose involving a synthetic opioid drug like fentanyl.
- Only 1 kilogram of fentanyl can potentially kill 500,000 people.
- Between May 23 and September 8, 2022, the DEA (Drug Enforcement Administration) removed more than 36 million lethal doses of fentanyl from the illegal drug supply in the form of 10.2 million fentanyl pills and 980 pounds of fentanyl powder.
- More than 150 people die daily from an overdose involving a synthetic opioid such as fentanyl.
- Fentanyl can be lethal in doses as small as 2 mg.
- Fentanyl overdose deaths are on the rise. From 2013 to 2020, there were 18 times more overdose deaths involving synthetic opioids like fentanyl.
What Are the Signs of Fentanyl Overdose?
Fentanyl is a central nervous system depressant drug, which means it can slow down life-sustaining functions like breathing and heart rate. The drug can also make a person drowsy and have trouble staying awake.
A fentanyl overdose can cause issues with coordination, balance, and reflexes as well as mental confusion. The person might appear extremely intoxicated or even seem drunk. This is commonly called “on the nod.”
Someone experiencing a fentanyl overdose may be noncommunicative and even potentially lose consciousness.
What Are the Symptoms of Fentanyl Overdose?
A fentanyl overdose is a medical emergency that requires prompt medical attention.
Symptoms of a fentanyl overdose include the following:
- Pinpoint pupils
- Extreme drowsiness
- Cold or clammy skin
- Bluish tint to the fingernails, lips, or skin
- Nausea and vomiting
- Weak pulse and slow heart rate
- Breathing issues
- Lethargy
- Reduced blood pressure
Long-Term Consequences of a Fentanyl Overdose
When people talk about the risks of fentanyl abuse, they often focus on the number of people who died due to overdose.
In 2021, 71,238 people died due to overdoses of synthetic opioids like fentanyl. In 2020, 57,834 people died from fentanyl. These statistics from the Centers for Disease Control and Prevention highlight just how many people die from this drug. However, people who overdose and do not die may also face serious problems.
In 2019, the U.S. Department of Health and Human Services published a report about the health consequences faced by people who survived an opioid overdose. The following problems were identified in the report:
- Respiratory depression: During an overdose, people breathe very slowly or not at all. Some people develop complications like dizziness or confusion after an overdose, even after their breathing returns to normal.
- Brain injury: Slowed breathing can damage crucial cells within the brain, leading to problems like disorientation, incontinence, paralysis, and changes in behavior. Some people have memory loss and reduced physical function too.
- Organ damage: A lack of oxygen can also lead to serious tissue damage in organs like the kidneys, heart, and lungs.
In a separate study published in 2020, researchers examined the medical records of people who survived an opioid overdose and were treated in the hospital. Out of the 17,241 patients included in the study, 635 died within the following year. Of them, 67.4% died due to another overdose. People who survive one overdose are at risk for another in time.
Dangers of Withdrawal Symptoms
Fentanyl is an extremely addictive drug. Due to its potency, drug dependence can form quickly and easily, even when the drug is taken as directed through a medical and necessary prescription.
Fentanyl binds to opioid receptors in the brain, which changes the way the body perceives pain and processes rewards. The brain can become accustomed to the changes fentanyl makes to its chemical makeup and circuitry, which can lead to dependence. This means that when fentanyl is no longer active in the body, withdrawal symptoms can start.
Fentanyl is a short-acting opioid, which means that it only remains active in the brain and body for a matter of hours at most. This can mean that withdrawal can start within 8 to 12 hours after the last dose.
The drug cravings that occur during opioid withdrawal can be intense, which can lead to an extreme desire to return to drug use.
Withdrawal symptoms from opioid drugs like fentanyl can be life-threatening and include the following:
- Nausea and vomiting
- Diarrhea
- Sleep difficulties
- Fatigue
- Tremors
- Goosebumps
- Irritability
- Trouble focusing
- Agitation
- Anxiety
- Depression
- Muscle, joint, and abdominal pain
- Sweating
- Irregular heart rate and blood pressure
- Yawning
- Tearing
- Runny nose
- Potential hallucinations or seizures
Withdrawal from fentanyl can be extremely uncomfortable and dangerous. The drug cravings that occur during opioid withdrawal can be intense, which can lead to an extreme desire to return to drug use.
Relapse after any period of abstinence can increase the risk of fatal overdose. The body and brain are no longer used to the doses that were previously taken. When that same dose is taken, overdose is likely.
What to Do in the Event of an Overdose
In a study cited by the Centers for Disease Control and Prevention, researchers found that bystanders were present in more than one in three opioid overdoses. People who see an overdose could provide critical care that could save a life.
If you suspect a fentanyl overdose, this is a medical emergency. Take the following steps:
- Call 911 immediately.
- If naloxone (the opioid overdose reversal drug) is on hand, administer it as directed.
- Do your best to keep the person conscious and breathing.
- Place the individual in the rescue position on their side to prevent choking.
- Stay with the person and give as many details to emergency personnel as possible. For example, tell them what drugs the person took, how much and when they took the drugs, any medical or mental health history you are aware of, and what rescue measures you have administered.
Treatment Options for Fentanyl Overdose
A fentanyl overdose is a medical emergency that requires prompt medical attention. The opioid antagonist naloxone (Narcan) can help.
Naloxone is an opioid agonist. The National Institute on Drug Abuse explains that agonists attach to opioid receptors and reverse the effects of opioids like fentanyl. When someone is overdosing, naloxone can quickly restore normal breathing. However, it can wear off. When it does, the person can slip into an opioid overdose again.
If you suspect that someone has overdosed, provide naloxone. However, you should also make sure that the person gets help in a hospital. Close monitoring can ensure medical professionals step in if the overdose starts again.
The person can then transition into a fentanyl detox and fentanyl treatment facility to minimize the odds of relapse and promote long-term recovery.
Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More
- Fentanyl. (September 2019). Drug Enforcement Administration.
- Fentanyl Awareness. Drug Enforcement Administration.
- U.S. Overdose Deaths In 2021 Increased Half as Much as in 2020 – But Are Still Up 15%. (May 2022). Centers for Disease Control and Prevention.
- Facts About Fentanyl. Drug Enforcement Administration.
- One Pill Can Kill. Drug Enforcement Administration.
- Fentanyl Facts. (February 2022). Centers for Disease Control and Prevention.
- Fentanyl. (June 2022). Centers for Disease Control and Prevention.
- Opioid Withdrawal. (September 2022). StatPearls.
- Fentanyl Citrate Injection. (November 2012). U.S. Food and Drug Administration.
- Duragesic Prescribing Information. (March 2021). U.S. Food and Drug Administration.
- Nonfatal Opioid Overdose and Associated Health Outcomes: Final Summary Report. (September 2019). U.S. Department of Health and Human Services.
- One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose. (January 2020). Annals of Emergency Medicine.
- Naloxone DrugFacts. (January 2022). National Institute on Drug Abuse
- Lifesaving Naloxone. (April 2023). Centers for Disease Control and Prevention.
