Fentanyl overdose is a very real possibility, as the tragic death of Prince, last year made abundantly clear. In fact, in the United States, the drug has accounted for thousands of overdose deaths over the course of the past ten years. This is because fentanyl can be abused both as a prescription opioid drug and manufactured as an illicit drug in some labs. Given this reality, the proportion of opioid overdose deaths attributed to fentanyl rose from 32 percent to 74 percent in 2016. With these startling statistics and the danger of fentanyl, it is crucial to understand what a fentanyl overdose looks like. Knowing the physical and behavioral signs to look for in fentanyl abuse can help friends and family members keep those around them safe. To give the best information possible on this atopic, this post addresses four major points:
- What fentanyl is?
- How to overdose on fentanyl.
- What a fentanyl overdose looks like.
- What to do after a fentanyl overdose.
What is Fentanyl? Drug Information for the Opioid Analgesic
Before getting to the nitty-gritty of fentanyl abuse and overdose, you may be asking one simple question: “What is fentanyl?” In simple terms, fentanyl is an opioid analgesic – meaning it is designed to work as a painkiller using opioids as the most active ingredient. However, what most people do not realize about this particular form of opioid is that it is extremely potent – and therefore a major culprit in prescription drug abuse, addiction, and overdose.
“Fentanyl is a synthetic opioid painkiller approved for treating very severe pain. While it’s in the same class as more commonly prescribed opioids (such as oxycodone), the Centers for Disease Control and Prevention warns that fentanyl is 50 times stronger than heroin and 100 times more potent than morphine. The Drug Enforcement Agency describes fentanyl as the most potent opioid available for use in medical treatment.”
~ Alison Mango, writing for Huffington Post
Because of its strength, the fentanyl dosage must be very exact. Doctors usually start patients out on a very low dose of the opioid, gradually increasing the dose as the need arises. There is a range of fentanyl side effects, including everything from nausea to hallucinations. These side effects should not be ignored, as they can also be signs of abuse of the drug.
How to Overdose? Understanding What Fentanyl Overdose Looks Like
Because of the possibility of overdose, fentanyl should only be used with a prescription – and the details of that prescription should be followed closely. In other words, fatal fentanyl overdose is often the result of abusing the drug. Overdose Definition: Drug overdose occurs when opioids (or any other form of the drug) produce dangerous and sometimes fatal symptoms in the person who is taking the drug. Overdose on the opioid analgesic can occur when the drug is used in any other way than how it is prescribed or by anyone who is not on the prescription. Dangerous and irresponsible uses of fentanyl include any of the following circumstances:
- Fentanyl is taken more often than is prescribed.
- Larger amounts of fentanyl are taken than are prescribed.
- Someone not listed on the prescription takes fentanyl.
- Fentanyl is used recreationally.
- Fentanyl is used at the same time as alcohol or other drugs.
If there is any point to understand how to overdose on fentanyl, it is to use the drug outside of a prescription. While an accidental overdose of fentanyl is possible in some circumstances, it will often be preceded by abuse of the drug. With this in mind, it is important to understand both the signs of abuse and symptoms of a fentanyl overdose. Physical and Behavioral Signs of Fentanyl Abuse While abusing fentanyl does not always lead to an overdose on the drug, fentanyl abuse certainly makes overdose much more likely. As we note above, fentanyl is 50 to 100 times more potent than other forms of opioid medication. Abusing the drug can, therefore, be extremely dangerous, and sometimes even fatal if it leads to overdose. As an opioid, abuse of fentanyl is associated with many of the same signs that are seen with other opiates – both heroin and prescription medication. Some of the most common signs of fentanyl abuse include:
- A feeling of euphoria or extreme relaxation
- Sedation and drowsiness
- Vomiting, or at least feeling nauseous
- A false sense of well-being during drug use
- Confusion or dizziness
- Building up a tolerance to the effects of fentanyl
- Increased drug-seeking behavior
- Forging prescriptions, switching doctors or stealing to obtain drugs
- Experiencing withdrawal symptoms when stopping the use of fentanyl
Sometimes it can be difficult to see these signs of fentanyl abuse, particularly since those who abuse drugs are usually good at hiding their drug-seeking behaviors. However, if you do recognize several of these signs of abuse either in yourself or someone you know and love, this may signify that fentanyl is being abused. It also means that it is time to reach out for professional help for drug addiction or abuse before it leads to a dangerous overdose. Fentanyl Overdose Symptoms to Look Out For There is no question that fentanyl is highly potent, particularly when compared to other types of opioids. Because of the strength of the drug, abusing fentanyl can often lead to an overdose on the drug. Fentanyl overdose usually results in a particular set of physical symptoms. If these symptoms go untreated, overdose on the opioid drug can sometimes be fatal. Because of this, it is important to know what to look for when it comes to both fentanyl abuse and fentanyl overdose. Some of the most common physical symptoms of an overdose to look for include:
- Confusion and difficulty in thinking
- Difficulty in speaking or moving
- Dizziness
- A pale face
- Vomiting or retching sounds
- Extremely small pupils
- A lowered heart rate and low blood pressure
- Acting drowsy or frequently fainting
- Being unresponsive
- A limp body while unconscious
- Slow breathing, or difficulty breathing
- Respiratory arrest
Seeing several of these signs at the same time is a major sign that someone has overdosed. If you see any of these overdose symptoms in someone around you, it is crucial to get the person using fentanyl professional help as soon as possible. You should call 911 or take the user to an emergency room immediately. It is also worth noting that overdosing on fentanyl becomes much more likely when the opiate is mixed with the use of alcohol or any other kind of drug. Because of the interaction between the drugs, fentanyl should never be taken in conjunction with alcohol or other drugs. Increased Danger with the Use of Fentanyl Patches Both fentanyl abuse and addiction – not to mention the potential for a drug overdose – become even more likely when using a fentanyl patch. This form of the opioid medication is only used when a patient is already accustomed to the effects of opiates and is therefore only used in cases of extreme pain. The patch is usually only applied once every 72 hours, and in some cases as little as once a week. This is because of the strength of the opioid found within the patch.  The use of fentanyl patches can be extremely risky, as they are associated with respiratory problems and can become fatal if used at the same time as certain other drugs (including alcohol). In no case should you use a fentanyl patch without a prescription from a doctor, or in any other way than is laid out in the prescription? Doing so can be dangerous, and even fatal.
What to Do About Fentanyl Overdose Symptoms
As we note above, recognizing any of the symptoms of drug abuse or overdose should lead to getting treatment for problematic behaviors. Symptoms of overdosing on fentanyl should lead to immediate emergency response: calling 911 or getting to the emergency room as soon as possible. In addition to these emergency measures, naloxone (or Narcan) is a recently developed drug that serves as an antidote to the overdose symptoms outlined above. If naloxone is available, directions should be carefully followed for the administration to reverse the fentanyl side effects. If you have overdosed on the drug, the next steps may not be as immediately clear after the physical symptoms of overdose have been treated. Taking these steps to get help, however, are equally important. The first step after experiencing an overdose on fentanyl, as the quote from the CDC below makes clear, is to build up one’s knowledge base regarding the effects of the drug. Being familiar with what circumstances and types of drug abuse are likely to lead to fentanyl overdose and death can go a long way toward harm reduction from the drug. Similarly, taking the time to learn the signs of both drug abuse and addiction can help avoid an overdose altogether. Overdose on fentanyl (or any other opioid for that matter) can be completely avoidable if you can take action on the signs and symptoms outlined here.
“Adaptation of harm reduction practices designed to reduce health-related consequences of unsafe drug use, including the addition of warnings about fentanyl’s characteristics and toxicity, could mitigate the fentanyl-related impact of the U.S. opioid epidemic in communities affected by fentanyl. Population-based strategies to prevent and reduce opioid use and opioid use disorders, such as an expansion of access to evidence-based treatment, are likely to be effective in preventing fentanyl overdose and death. The high percentage of fatal overdoses occurring at home with no naloxone present, coupled with the rapid onset of overdose symptoms after using fentanyl through injection or insufflation, underscores the urgent need to expand initiatives to link persons at high risk for an overdose to harm reduction services and evidence-based treatment.”
~ Centers for Disease Control and Prevention
In addition to building up an understanding of drug abuse and drug overdose as a whole, it is just as important to get professional help for what may be an addiction to fentanyl. While having overdosed on the drug is not necessarily the same thing as being addicted, it may be a sign that fentanyl abuse or fentanyl addiction is present. Some of the ways that you can seek out help for this include:
- Drug Rehab: Attending either an inpatient or outpatient treatment program for drug addiction, providing behavioral therapy and group support.
- Drug Detox: A medically managed means of coming off of the drug, fentanyl detox is a safe way to go through withdrawal.
- Narcotics Anonymous: This is a support group that accepts anyone and everyone who struggles with addiction in any form.
The Takeaway: Overdose is a Major Sign of Drug Abuse and Addiction
If there is one thing to take away from this overview of fentanyl overdose and fentanyl abuse, it is that having overdosed on the drug is usually associated with abuse of and addiction to the drug. If you find that you or someone you know is addicted to fentanyl, you should reach out for professional addiction treatment help. Getting help for fentanyl overdose can save your physical health, your relationships and your life.
Sources:
Alison Mango. (2016, June). What is Fentanyl? Retrieved from: https://www.huffingtonpost.com/healthcom/what-is-fentanyl-the-fact_b_10323730.html CBS News. (2015, August). Naloxone, Fentanyl Antidote. Retrieved from: https://www.cbc.ca/news/canada/british-columbia/naloxone-fentanyl-antidote-available-in-take-home-kit-that-s-saved-hundreds-of-lives-1.3185768 Centers for Disease Control and Prevention. (2017, April). Characteristics of Fentanyl Overdose. Retrieved from: https://www.cdc.gov/mmwr/volumes/66/wr/mm6614a2.htm Edward W. Boyer. (2012, July0> Management of Opioid Analgesic Overdose. Retrieved from: https://www.cbc.ca/news/canada/british-columbia/naloxone-fentanyl-antidote-available-in-take-home-kit-that-s-saved-hundreds-of-lives-1.3185768 Huffington Post. (2015, March). Opioid Fentanyl Blamed for Spike in U.S. Drug Overdoses. Retrieved from: https://www.huffingtonpost.com/2015/03/18/opioid-fentanyl-drug-overdose_n_6895986.html U.S. National Library of Medicine. (2017). Fentanyl Patch. Retrieved form: https://medlineplus.gov/druginfo/meds/a601202.html