Fentanyl Addiction: Side Effects, Symptoms and Treatment

Fentanyl is a prescription opioid painkiller that is chemically related to other addictive prescription painkillers, like hydrocodone and methadone. In a hospital setting, this narcotic is used to rapidly treat severe pain in people who are tolerant to other opioids. Fentanyl is so potent that doctors often reserve it for patients who have terminal cancer and most surgical patients.

Though this drug has medical uses, a euphoric fentanyl high can occur if a person takes too much of it. Thus, it is no surprise that fentanyl has been sold illicitly for decades. Today, fentanyl is often substituted for heroin — and it is just as dangerous as the notorious street drug.

What Is Fentanyl?

Fentanyl is a synthetic opioid prescribed to relieve chronic pain related to terminal cancer or severe pain. Available as a transdermal patch and in oral and injectable formulations, fentanyl is easy to use. In 2021, 21.6 out of every 100,000 Americans died from drug overdoses involving fentanyl. Though most of those people resided in the Northeastern United States, fentanyl overdose deaths were reported from all across the country, many of which were preceded by fentanyl addiction.

The Drug Enforcement Administration (DEA) classifies fentanyl as a Schedule II controlled substance, which means that it “has a high potential for abuse, with use potentially leading to severe psychological or physical dependence.” Fentanyl is considered a dangerous drug, alongside other Schedule II substances such as cocaine, methamphetamine, Vicodin, Adderall and OxyContin. A fentanyl high mimics that of most other painkillers, rendering the person euphoric and numb — mentally and physically.

Common Forms of Fentanyl

Most often, doctors administer fentanyl as an injection, a patch that adheres to the skin or a lozenge known as a “fentanyl lollipop.” However, illicit forms of the drug are not as distinctive.

On the streets, fentanyl and its illicit variations may appear as a powder, which can be melted into a liquid and administered like a heroin injection.

Fentanyl Brand Names

Legally manufactured fentanyl is sold by pharmaceutical companies under the following brand names and formulations:

• Actiq – lollipops
• Fentora – effervescent buccal tablets
• Duragesic – transdermal patches
• Subsys – sublingual spray
• Abstral – sublingual tablets
• Lazanda – nasal spray

Common Fentanyl Street Names

Non-pharmaceutical versions of fentanyl exist on the market, complete with slang terms. Common adulterations involve the addition of heroin or cocaine to fentanyl. Illicit fentanyl is often found as a powder or attached to blotter paper. Here are some common street names for fentanyl or fentanyl-laced heroin:

• Apache
• Cash
• China Girl
• China Town
• China White
• Dance Fever
• Friend
• Goodfella
• Great Bear
• Jackpot
• Murder 8
• Tango
• TNT

Related Topic: Street Names for Drugs

Is Fentanyl Addictive?

Like other opioids, fentanyl is highly addictive. Therefore, fentanyl addiction can develop easily if this drug is not used as it is prescribed. Since fentanyl impacts the brain’s reward centers, like heroin does, it’s hard to stop using this drug once you have started. This also means that substance abuse treatment methods used to treat heroin addiction, such as cognitive behavioral therapy, can also be used to treat fentanyl addiction.

Fentanyl is most dangerous when it is crushed, then snorted or injected. It is also dangerous when combined with other drugs — including alcohol. However, even with medical supervision, fentanyl addiction and dependence can develop.

How Addictive is Fentanyl?

As a Schedule II controlled substance, fentanyl carries a high risk of abuse, addiction and dependence. The risk of a fentanyl addiction increases if you are taking fentanyl without a prescription.

How Quickly Can a Fentanyl Addiction Develop?

It does not take long for a fentanyl addiction to develop. For some people, mental fentanyl addiction can begin upon their first use of the drug. Due to its potency, physical dependency and fentanyl addiction can occur after a person has used the drug just a couple of times.

Is Fentanyl More Addictive Than Heroin?

It is unclear if fentanyl is more addictive than heroin. Heroin is a Schedule I controlled substance, meaning it carries a high risk of addiction and has no legitimate medical use. However, fentanyl is a Schedule II controlled substance. This means it carries a high risk of addiction but does have a legitimate medical use. Ultimately, both fentanyl and heroin are highly addictive substances.

Are Fentanyl Patches Addictive?

All forms of fentanyl are Schedule II controlled substances. Therefore, they all carry a high risk of addiction, abuse and dependence. This includes fentanyl patches.

Why Fentanyl Is So Addictive 

Fentanyl is addictive because it triggers the brain’s reward system, leading to a surge of feel-good chemicals like dopamine in the brain. Over time, this can lead to the person compulsively taking fentanyl to try to chase that good feeling.

Fentanyl Addiction Statistics

Fentanyl misuse and addiction are widespread. In 2022 alone, about 991,000 Americans misused fentanyl, making fentanyl one of the most misused prescription opioids. This includes about 507,000 Americans who misused prescription fentanyl, about 19% of those with fentanyl prescriptions.

Meanwhile, fentanyl overdose deaths continue to skyrocket. Fentanyl overdoses spiked 24% between 2020 and 2021. Between September 2022 and August 2023, almost 74,000 Americans died from an overdose of synthetic opioids like fentanyl.

History of Fentanyl Addiction

Fentanyl was first introduced to the United States in the 1960s as an injectable anesthetic branded as Sublimaze. The Controlled Substances Act of 1970 labeled fentanyl a Schedule II drug due to its addictive qualities. As the 1970s progressed, illicit versions of fentanyl began showing up on the market, increasing the chances of fentanyl addiction. By the early 1990s, the patch was available for transdermal use. However, the drug did not become widely known for another two decades.

When music superstar Prince died of a fentanyl overdose in 2016, the drug was still relatively unknown among Americans. Meanwhile, fentanyl addiction and misuse had quietly grown more common in the years prior to Prince’s death, spiking between 2014 and 2015. During this time, the death rate of non-methadone synthetic opioids like fentanyl increased by over 70%.

If you are struggling with fentanyl addiction, treatment can help you, too. Take the first step towards life after addiction by getting in touch with The Recovery Village.

Am I Addicted to Fentanyl?

If you suspect that yourself or a loved one is addicted to fentanyl, early detection and treatment is key. Our online fentanyl quiz can help you determine whether or not you are at risk for a fentanyl addiction.

Learn more about commonly abused opioids.

Codeine | Fentanyl | Hydrocodone | Morphine | Oxycodone | Percocet

Signs and Symptoms of Fentanyl Addiction

When someone develops a fentanyl addiction, many signs and symptoms of addiction emerge. Some of these – like the ever-present risk of overdose – can be immediately life-threatening, while others can be more subtle. Identifying a fentanyl addiction early on is key to combating the substance use disorder.

Physical Signs

Physical signs of a fentanyl addiction can be nonspecific and similar for many different drugs. While overdose is one of the riskiest physical signs of a fentanyl addiction, other signs include:

• Glazed eyes
• Slurred or rambling speech
• Slowed movement
• Weight loss
• Changes in sleep patterns

Psychological Signs

Psychological signs of a fentanyl addiction involve changes in the person’s mental state. Those who struggle with fentanyl addiction may exhibit some psychological symptoms such as:

• Changes in perception
• Attention problems 
• Changes in thinking patterns
• Confusion
• Problems relating to others

Behavioral Signs

A person’s behavior can often change when they become addicted to a substance like fentanyl. You may notice changes in behaviors, including:

• Secretiveness and lying
• Avoiding activities the person once enjoyed
• Loss of motivation
• Neglect of physical appearance
• Stealing

Health Risks of Fentanyl Addiction

A fentanyl addiction can have many physical, psychological and behavioral effects. While the biggest risk of a fentanyl addiction is an overdose, other effects of a fentanyl addiction can occur as well.

Long-Term Health Risks 

One of the biggest health risks of fentanyl addiction is overdose, which can occur no matter how long a person has taken fentanyl. Other long-term health risks of taking opioids like fentanyl include:

• Chronic constipation
• Sleep-disordered breathing
• Heart attack and heart failure
• Falls and fractures
• Hormone abnormalities
• Infertility
• Immunosuppression

Fentanyl Overdose Risk

Fentanyl carries a high overdose risk, with almost 74,000 Americans losing their lives to synthetic opioids like fentanyl between September 2022 and August 2023 alone. Symptoms of a fentanyl overdose include:

• Pale and clammy skin
• Limp muscles
• Purple or blue fingernails or lips 
• Vomiting 
• Gurgling 
• Unable to rouse
• Slowed or stopped breathing or heartbeat 

A fentanyl overdose is a medical emergency. If you suspect someone has overdosed on fentanyl, call 911 immediately and administer naloxone (Narcan) if available.

Fentanyl-Laced Drugs

In 2022 alone, the Drug Enforcement Administration seized more than 59.6 million fentanyl-laced counterfeit medications and more than 13,300 pounds of powdered fentanyl. Illicit drug dealers sometimes sneak fentanyl into other drugs to make a more potent product. This can mean that you are exposed to fentanyl without ever knowing it. Because powdered fentanyl resembles other opioids, it is often mixed with other drugs to make counterfeit opioids. This can lead to an increased risk of overdose because fentanyl is much more potent than other opioids.

Fentanyl Addiction Withdrawal and Detox

When someone takes fentanyl regularly and suddenly stops or cuts back on the drug, withdrawal symptoms often emerge as your body struggles to recalibrate without the drug present. Fentanyl withdrawal symptoms can be extremely uncomfortable. The best way to ease yourself off fentanyl and minimize fentanyl withdrawal symptoms is to enroll in a fentanyl detox program.

Fentanyl Withdrawal Symptoms

Fentanyl withdrawal symptoms are similar to those of other opioids and include:

• Muscle aches
• Trouble sleeping
• Runny eyes
• Runny nose
• Sweating
• Yawning
• Enlarged pupils 
• Abdominal cramps
• Diarrhea
• Goosebumps
• Nausea and vomiting
• Agitation
• Anxiety

Fentanyl Detox

Medical detox is a way to undergo fentanyl withdrawal while minimizing withdrawal symptoms. In medical detox from fentanyl, you have round-the-clock care from doctors and nurses to monitor and treat your withdrawal symptoms as they arise. Medication-assisted treatment with methadone and buprenorphine-based products may be used if clinically appropriate and are the gold standard treatments for helping someone recover from a fentanyl addiction.

How Long Does Fentanyl Stay in Your System?

Like many drugs, traces of fentanyl can linger in your body for long after the drug’s effects have worn off. Fentanyl can stay in your system for varying amounts of time, depending on what is being tested.

• Blood: Fentanyl can be detected in the blood within 3 to 12 hours of its last use.
• Saliva tests: Fentanyl can be found in saliva for up to 36 hours.
• Urine tests: Fentanyl and its metabolites can be detected in urine 24 hours to three days after the last use.
• Hair tests: Fentanyl can be found in a 1.5-inch hair sample about 90 days after the last use.

Treatment for Fentanyl Addiction

Recovery from fentanyl addiction is possible, as fentanyl addiction is a treatable condition. However, it is important to make sure you have the support of a qualified medical team to embark on your fentanyl recovery journey. Following medical detox to wean you off fentanyl, inpatient and outpatient fentanyl rehab can keep you fentanyl-free for good.

Inpatient Fentanyl Rehab

Inpatient fentanyl rehab often follows medical detox. In this rehab program, you live on-site in a sober living environment so you can focus on your recovery. Extensive therapy is available to teach you the skills to stay away from fentanyl and help you explore why you began to rely on fentanyl in the first place.

Outpatient Fentanyl Rehab

Outpatient fentanyl rehab offers additional freedom compared with the inpatient option. For this reason, outpatient rehab often follows inpatient rehab. In outpatient rehab, you can live at home but come in for regular therapy sessions. When you are in outpatient rehab, you may be able to work or go to school alongside your rehab.

Get Help for Fentanyl Addiction Today

Fentanyl addiction is hard to overcome on your own, but help is available. At The Recovery Village, we believe the cornerstone of recovery is meeting you where you are in the fentanyl recovery process and following your lead. Whether it’s helping you to wean off fentanyl or stay off fentanyl, our fentanyl recovery experts are here to encourage you every step of the way. Don’t wait: contact us today to see how we can help.

Editor – Heather Lomax

At Advanced Recovery Systems, Heather uses her experience by working closely with medical experts to produce helpful, accurate articles on the challenges of navigating substance use, recovery and mental health conditions. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more