Fentanyl Use and Opioid Addiction

Fentanyl has become the primary opioid used by many people with opioid use disorder today. It is strong, fast-acting and widely available, which is why so many people rely on it to avoid withdrawal and feel “normal.” Over time, fentanyl can take over the brain and body in ways that make stopping feel impossible. Many people know the risks and still use fentanyl because the pain of withdrawal is worse. Understanding how fentanyl affects the body — and how treatment helps — can be the first step toward recovery.

Fentanyl is a powerful synthetic opioid that is much stronger than heroin or prescription pain pills. Most people who use fentanyl do so intentionally, often multiple times per day, to prevent withdrawal. Because it works quickly and wears off fast, fentanyl can trap people in a cycle of using just to feel okay.

Over time, fentanyl changes how the brain works. The brain becomes used to very high levels of opioids and stops making its own natural chemicals that control pain, mood and stress. This makes cravings stronger and daily functioning harder without the drug.

Long-Term Effects of Fentanyl Use

Long-term fentanyl use impacts nearly every system in the body. These changes are medical — not personal failures.

Effects on the brain may include:

  • Strong cravings and loss of control over use
  • Trouble feeling pleasure from everyday activities
  • Anxiety, depression and mood swings
  • Problems with focus, memory and decision-making

Effects on the body may include:

  • Slowed breathing and low oxygen levels
  • Sleep problems and extreme fatigue
  • Hormone changes that affect energy and sex drive
  • Increased pain sensitivity over time

Effects on daily life often include:

  • Using just to avoid being sick
  • Trouble keeping a job or housing
  • Strained relationships and isolation
  • Fear of withdrawal or overdose

These effects often grow worse the longer fentanyl use continues. 

Fentanyl Withdrawal Symptoms

Fentanyl withdrawal can be severe and can begin quickly — sometimes within hours of last use. Many people continue using fentanyl mainly to avoid these symptoms.

Common fentanyl withdrawal symptoms include:

  • Severe muscle and bone pain
  • Nausea, vomiting and diarrhea
  • Sweating, chills and shaking
  • Anxiety, panic and restlessness
  • Insomnia and extreme fatigue
  • Strong cravings and irritability

While opioid withdrawal is usually not life-threatening, it can feel unbearable and lead people back to use quickly. This is why medical treatment is so important.

Overdose Risk and Warning Signs

Fentanyl greatly increases the risk of overdose, even for people with high tolerance. The strength of fentanyl can vary, and using alone or mixing substances increases danger.

Signs of a fentanyl overdose may include:

  • Extreme drowsiness or unresponsiveness
  • Slow or stopped breathing
  • Blue or gray lips or fingernails
  • Gurgling or choking sounds
  • Confusion or collapse

Overdose is a medical emergency. IF YOU THINK SOMEONE MAY BE HAVING AN OVERDOSE, CALL 911 IMMEDIATELY.  Administer naloxone if available and try to keep the person awake and breathing.  Quick action can save lives.  

How Opioid Treatment Programs Can Help

Opioid Treatment Programs (OTPs) play a key role in reducing harm and helping people enter recovery from fentanyl.  Methadone, a medication used in OTPs, can be effective in helping overcome fentanyl addiction.  By treating fentanyl addiction with methadone, OTPs reduce cravings, withdrawal and overdose risk — even when other substances are involved.  Medications for opioid use disorder (MOUD), including both methadone and suboxone, help stabilize the brain and allow people to focus on health and recovery. 

What Foundations Health OTPs Provide

At Foundations Health OTPs, we understand that illicit substance use often happens alongside opioid addiction. Our programs provide:

  • Medications that reduce opioid cravings and withdrawal
  • Same day withdrawal management, walk-ins welcome
  • Level-of-care assessments
  • Psychiatric care and medications
  • Counseling that addresses substance use and mental health
  • Education about fentanyl and overdose prevention
  • Peer support to reduce risk and improve stability

Care is provided without judgment and with respect for where each person is in their journey. 

Hope and Next Steps

Recovery is possible — even with fentanyl use.  Treatment can reduce harm potential right away and help people rebuild their lives over time. Everyone deserves care, dignity and support. If you or someone you love is using fentanyl or struggling with opioid addiction, help is available now. Contact a Foundations Health Opioid Treatment Program to learn more about treatment options.  

References

Centers for Disease Control and Prevention. (2023). Polysubstance use and overdose.
https://www.cdc.gov/overdose-prevention/about/polysubstance-overdose.html

National Institute on Drug Abuse. (2022). What is fentanyl?
https://nida.nih.gov/research-topics/trends-statistics/infographics/what-fentanyl

Substance Abuse and Mental Health Services Administration. (2023). Medications for opioid use disorder (Treatment Improvement Protocol 63).
TIP 63: Medications for Opioid Use Disorder – Full Document | SAMHSA