Fentanyl Addiction: Symptoms, Causes and Treatment

Fentanyl addiction, a dependence on the powerful synthetic opioid, poses significant harm and overdose risk. It is a serious and growing public health concern in New Jersey, where it is both prescribed for severe pain and illegally manufactured and mixed with other drugs.

New Jersey was one of the five states reporting the highest number of fentanyl and heroin addiction reports to the National Forensic Laboratory Information System in 2019. In Bergen County specifically, fentanyl-related drug deaths jumped dramatically from 34% to nearly 80% of all overdose fatalities between 2016 and 2020. Camden County recorded 285 fentanyl overdose cases in 2022, making it notable for its high occurrences of fentanyl overdoses. Bergen County alone recorded 110 deaths due to fentanyl overdose, highlighting the devastating impact of this synthetic opioid across New Jersey communities.

Fentanyl addiction causes physical symptoms like muscle aches, fever, nausea, and diarrhea, along with sleep issues, anxiety, and cravings. Mentally, it leads to depression, irritability, and concentration difficulties.

Fentanyl addiction results from prescription misuse, the availability of cheaper illegal fentanyl, and mental health issues like depression or anxiety.

Treatment options for fentanyl addiction in New Jersey include medication-assisted therapy (MAT) using medications like methadone or buprenorphine to reduce cravings and withdrawal symptoms and behavioral therapies. 

What Is Fentanyl Addiction?

Fentanyl addiction is the compulsive use of fentanyl despite harmful effects on physical, emotional, and psychological health. Classified as Opioid Use Disorder (OUD), it involves dependence on a synthetic opioid 50 times stronger than heroin and 100 times more potent than morphine.

It comes in two forms: pharmaceutical fentanyl, used medically for severe pain via patches or lozenges, and illegally made fentanyl (IMF), mixed with other drugs. IMF is unpredictable and greatly increases overdose risk.

Fentanyl activates brain opioid receptors, causing pain relief and euphoria but also drowsiness, nausea, confusion, constipation, and sedation. Tolerance builds rapidly, requiring higher doses for the same effect.

Due to its potency, even small amounts cause respiratory depression, unconsciousness, coma, or death. Fentanyl addiction is life-threatening and requires urgent medical intervention.

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What Are The Symptoms of Fentanyl Addiction?

The symptoms of Fentanyl addiction include loss of appetite, numbness and tingling, pinpoint pupils, sleep disruptions, mood swings, confusion, loss of control, cravings and compulsions, and neglecting responsibilities. 

Here are the common symptoms of fentanyl addiction:

Physical Symptoms

Common physical symptoms of fentanyl addiction include:

• Chest Pain and Breathing Problems: Fentanyl depresses the central nervous system, straining the heart and reducing oxygen flow. This leads to chest pain and difficulty breathing, worsened by muscle rigidity that restricts lung movement.
• Loss of Appetite: Fentanyl disrupts brain signals that control hunger, resulting in a significant decrease in the desire to eat.
• Numbness and Tingling: The drug alters sensory processing in the central nervous system, causing reduced feeling or tingling in the hands, feet, and lips.
• Urinary Issues: Fentanyl interferes with the autonomic nervous system, leading to problems with bladder control and difficulty urinating.
• Pinpoint Pupils: Fentanyl overstimulates opioid receptors in the eye, causing extreme pupil constriction, a key sign of opioid use or overdose.
• Sleep Disruptions: Long-term fentanyl use disturbs normal sleep patterns, causing trouble falling asleep, staying asleep, and waking up feeling unrested.

Mental and Behavioral Symptoms

Common mental and behavioral symptoms of fentanyl addiction include:

• Mood Swings: Fentanyl disrupts dopamine and serotonin levels, causing shifts between euphoria and drowsiness, with mood instability as a common side effect.
• Confusion: The drug impairs brain function through neurotoxic effects, leading to slowed thinking, disorientation, and difficulty concentrating.
• Loss of Control: Use escalates beyond intended limits, with individuals taking more fentanyl or using it for longer periods than planned.
• Cravings and Compulsions: Strong urges to use fentanyl overpower awareness of harm, driven by changes in the brain’s reward system.
• Unsuccessful Attempts to Quit: Repeated efforts to stop or cut back fail due to the intense grip of addiction, despite clear negative consequences.
• Prioritizing the Drug: Time, money, and effort focus on obtaining and using fentanyl, overshadowing personal, professional, and social obligations.
• Neglecting Responsibilities: Daily duties suffer as drug use becomes the central focus, leading to missed obligations, declining performance, and strained relationships.

What Are The Causes of Fentanyl Addiction?

The causes of Fentanyl addiction include rapid dependence and potent effects, chemical makeup and misuse, environmental triggers, mental health connection, young adulthood, coping mechanisms, and the role of genetics. 

• Rapid Dependence and Potent Effects: Fentanyl’s strength and fast-acting impact lead to physical dependence quickly, sometimes within weeks. Even short-term use raises the risk of long-term addiction, with a single dose carrying a high risk of overdose or death.
• Chemical Makeup and Misuse: Fentanyl’s high potency and chemical properties make it highly addictive. People start using it to ease withdrawal from other opioids and unknowingly develop dependence without realizing the shift.
• Environmental Triggers: Stressors like financial hardship, job loss, or grief push individuals toward fentanyl use. Those on prescription fentanyl for pain rely on it more heavily during emotional or psychological distress.
• Mental Health Connection: Mental health issues like depression and anxiety go hand-in-hand with addiction. A research report presented by the National Institute of Drug Abuse (NIDA) titled ‘Common Comorbidities with Substance Use Disorders ‘ suggests that half of those with a mental illness will also experience a substance use disorder at some point in their lives. Conditions like depression, bipolar disorder, ADHD, and personality disorders all increase the risk of fentanyl addiction.
• Young Adulthood and Coping Mechanisms: Substance use begins in youth, especially during the transition to young adulthood. Stress from school, relationships, or work pressures leads individuals to use fentanyl as a way to cope with emotional or psychological strain.
• The Role of Genetics: Genetic factors increase vulnerability to addiction when combined with environmental and psychological influences. These interactions make fentanyl addiction a complex condition, shaped by biology and life experiences, not just personal choice.

What Are The Risk Factors for Fentanyl Addiction?

The risk factors for fentanyl addiction include genetic predisposition, past substance use, environment, and mental health conditions.

• Genetic Predisposition: A 2016 research by Sharma B, Bruner A et al. titled ‘Opioid Use Disorders’ shows that genetics plays a significant role in addiction vulnerability. Studies estimate that genes influence 40-60% of the susceptibility to addiction. Specific genetic variations have been linked to opioid use disorder (OUD), including fentanyl addiction.

• Past Substance Abuse: People with a history of substance use have changes in brain function that increase sensitivity to fentanyl’s effects. This raises the likelihood of misuse and dependence on stronger opioids.
• Environmental Influences: Exposure to opioid use, non-medical use of painkillers, and easy access to drugs increase the risk of fentanyl addiction. The more available these substances are, the higher the chance of misuse.
• Mental Health Conditions and Chronic Pain: Chronic pain occurs with anxiety, depression, and sleep issues. These conditions increase vulnerability to opioid misuse and complicate recovery without proper support.
• Early Substance Use: Using drugs during adolescence or early adulthood interferes with brain development and increases the risk of addiction. Early opioid exposure leads to more severe dependence and withdrawal later on.

How is Fentanyl Addiction Treated?

Fentanyl addiction is treated by medically supervised withdrawal management, medication-assisted therapies, behavioral counseling approaches, and peer support networks. These comprehensive fentanyl addiction treatment strategies in NJ work together to address both the physical dependence and psychological aspects of addiction.

Here are the common fentanyl addiction treatment options:

• Detoxification (Medically Managed Withdrawal): The initial step involves medically supervised detoxification to manage withdrawal symptoms safely. Doctors prescribe medications like methadone, buprenorphine, or lofexidine to ease withdrawal discomfort and cravings.
• Medication-Assisted Treatment (MAT): A cornerstone of fentanyl addiction treatment, MAT combines medication with behavioral therapies. Medications like methadone or buprenorphine help reduce cravings and withdrawal symptoms, allowing individuals to focus on recovery. According to Grande, L. A.’s 2023 study, ‘Evidence on Buprenorphine Dose Limits: A Review’, higher doses of buprenorphine significantly improved treatment outcomes, with doses between 30-32 mg per day resulting in approximately 60% of patients maintaining their treatment program over a 24-week period.
• Behavioral Therapies: Therapy addresses the thoughts and behaviors behind addiction. CBT and motivational interviewing teach coping skills, relapse prevention, and strategies for managing life without substance use.
• Support Groups: Group support connects individuals with others in recovery. It offers shared experiences, emotional support, and a sense of community to strengthen long-term recovery.

How is Fentanyl Addiction Prevented?

Fentanyl addiction is prevented by implementing strategies like working closely with your doctor, safely handling prescription opioids, and avoiding risky combinations. Here’s how to minimize your risk of addiction:

• Work with Your Doctor: Talk openly with your doctor about pain. Use non-opioid treatments when possible. Create a pain plan that limits opioid use. Keep follow-up appointments to track progress and adjust treatment as needed.
• Safe Handling of Prescription Opioids: Take opioids exactly as prescribed. Do not increase the dose. Learn side effects and report problems immediately. Store pills in a locked cabinet, out of reach of others.
• Avoid Risky Combinations: Do not mix opioids with alcohol or drugs that slow the central nervous system, such as benzodiazepines. These combinations raise the risk of severe breathing problems and overdose.
• Dispose of Unused Medication Responsibly: Never share opioids. Use drug take-back programs or pharmacy disposal for unused pills. Follow FDA guidelines for safe disposal when no return option is available.

What Are the Fentanyl Withdrawal Symptoms?

Fentanyl withdrawal symptoms include yawning, rhinorrhea (runny nose), tachycardia (rapid heart rate), insomnia, tremors, restlessness, excessive sweating, and gastrointestinal distress such as nausea and diarrhea.

Additional symptoms involve muscle aches, anxiety, irritability, chills, and intense drug cravings. In more severe cases, individuals experience heightened pain sensitivity, weight loss, and significant psychological distress during withdrawal.

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How Can Benzodiazepine Addiction Complicate the Treatment of Fentanyl Addiction?

Addiction to benzodiazepines complicates the treatment of fentanyl addiction by increasing the severity of withdrawal symptoms and the risk of adverse interactions. Both substances depress the central nervous system, and their combined use leads to heightened sedation, respiratory depression, and overdose.

During treatment, managing withdrawal from both substances requires careful coordination and medical supervision to ensure safety and effectiveness. Integrating treatments that address both benzodiazepine and opioid dependence, such as medication-assisted therapy (MAT) and comprehensive behavioral therapies, is essential for a successful recovery. This dual approach helps mitigate complications and supports long-term sobriety.

How Long Does It Take to Detox from Fentanyl Addiction?

Detox from fentanyl addiction takes 5 to 10 days for acute physical symptoms to subside, though full recovery and stabilization require additional time, extending into weeks or months, as therapy and support address the psychological aspects of addiction.

Is Fentanyl Addiction Treatment Covered By Insurance?

Yes, fentanyl addiction treatment is typically covered by most insurance plans, including private insurance, Medicaid, and Medicare, as addiction treatment is considered an essential health benefit under the Affordable Care Act.

Coverage includes detoxification, inpatient and outpatient programs, medication-assisted treatment, and counseling. However, the specific level of coverage varies depending on your individual plan, including deductibles, copayments, and network providers.

To determine your exact coverage and out-of-pocket costs for fentanyl addiction treatment, it’s recommended to verify insurance directly with your provider or have a treatment facility check your benefits.