Recognizing Signs of Fentanyl Misuse
Fentanyl is a manmade opioid that is up to 50 times more potent than heroin and up to 100 times stronger than morphine.1, 2 Fentanyl misuse can result in harm to your health and wellbeing and potentially lead to overdose resulting in death.1 The drug is one of the major contributors to fatal and nonfatal overdoses in the United States as fentanyl is often secretly mixed (laced) with other drugs.2
According to the Centers for Disease Control and Prevention (CDC), more than 150 people die every day from overdoses due to synthetic opioids like fentanyl.2 The National Institute on Drug Abuse reports that in 2020, there were 56,516 overdose deaths due to synthetic opioids, primarily involving fentanyl.3
If you suspect that a loved one uses fentanyl or substances that could potentially be laced with fentanyl, you should be aware of the signs of fentanyl use, addiction warning signs, and overdose symptoms so that you know what steps to take next. This page will help you understand what fentanyl is, the symptoms of fentanyl use, the dangers of using it, and how to help someone you care about seek help.
What is Fentanyl?
Fentanyl is a powerful synthetic opioid drug that is between 50 and 100 times more potent than morphine.1 The drug is available as a prescription medication, known as Actiq, Duragesic, and Sublimaze, which is used to treat advanced cancer pain, chronic pain (in some cases), and pain after surgery.1, 4
Fentanyl is also made illegally (primarily in foreign labs), smuggled into the U.S., and sold on the drug market.4 Because fentanyl is cheap and potent, it is sometimes mixed (laced) with other drugs, such as cocaine, heroin and other opioids, and methamphetamine. It is nearly impossible to tell if drugs have been laced with fentanyl unless you test your drugs with fentanyl test strips. Test strips are inexpensive and typically give results within 5 minutes, which can be the difference between life or death.4
Prescription fentanyl is often used as patches that are applied to the skin or as lozenges that are used like cough drops.1 Illegal fentanyl is sold as liquids or powders that are used in eye drops and nasal sprays; it is also pressed into counterfeit pills that look like legitimate prescription opioids.2, 4 People can inject, snort, or smoke fentanyl.5 Fentanyl misuse is dangerous because there is no way to know how much fentanyl is actually in the product you are using, and therefore the tiniest amount mixed into another substance can kill you.4
The availability of fentanyl has increased in recent decades, partly due to a surge in supply. The Drug Enforcement Administration (DEA) reports that there has been a significant increase in the availability and lethality of fake prescription pills containing fentanyl and methamphetamine.6 More than 9.5 million counterfeit pills were seized in 2021, which is more than in 2019 and 2020 combined.6
Signs of Fentanyl Misuse
It is not always easy to spot fentanyl misuse signs, but you should be aware of certain behavioral, physical, and psychological signs that could indicate that a person is using the drug.
The signs of fentanyl misuse that you may observe can include:1, 5, 7, 8
- Appearing euphoric for no apparent reason.
- Constricted pupils.
- Depressed mood.
- Drowsiness or sedation.
- Slurred speech.
- Changes in social group.
- Lack of interest in family or friends or becoming socially isolated.
- Lack of interest in physical appearance.
- Secretive behavior.
- Presence of drug paraphernalia, such as needles, pill bottles, or pipes.
- Missing school or work.
- Lack of energy or motivation.
- Poor attention and memory.
- Complaining of chronic pain with no clear cause.
- Seeking prescriptions from others or multiple doctors.
If someone you care about displays some of these signs of fentanyl use it may be time to seek help. People who misuse opioids like fentanyl can risk developing an addiction as well as serious physical and psychological harm; they can suffer from severe issues like overdose, coma, respiratory depression (dangerously slowed breathing), and death.5
Fentanyl can be very addictive because it is highly potent.1 Opioid addiction, medically known as opioid use disorder (OUD) is the term used by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose addiction to opioids like fentanyl.7 A person who is struggling with an OUD is unable to control their substance use and compulsively uses fentanyl despite the negative effects and potential dangers.1
Other Dangerous Effects & Symptoms of Fentanyl Misuse
People can achieve a feeling of euphoria and other pleasurable effects from fentanyl, but using fentanyl can come with several consequences and dangers. Some of the dangerous potential health effects of fentanyl can include:1, 5, 10
- Risk of overdose, which can lead to hypoxia (a condition where your brain doesn’t get enough oxygen), slowed breathing, coma, brain damage, and death. Even just 2 milligrams of fentanyl can kill someone.
- Loss of consciousness.
- Dangerous slowing of heart and breath rate when combined with alcohol.
- Risk of HIV, hepatitis, and other infectious diseases from shared needles.
- Risk of miscarriage during pregnancy.
- Risk of low birth weight and neonatal abstinence syndrome.
- Severe withdrawal symptoms, such as restlessness, muscle and bone pain, diarrhea, vomiting, cold flashes with goosebumps, or uncontrollable leg movements, for people who are dependent and stop using the drug.
What to Do If Someone Is Showing Signs of Fentanyl Misuse
If someone you care about is exhibiting some or all of the signs of fentanyl use, you may want to know what to do to help them. It may be time to take the next steps in getting them to seek help. Taking action could potentially save a person’s life. Even if the person isn’t willing to seek help, there are steps you can take to assist them. Some of the things to consider can include:11, 12
- Learning more about addiction and rehab. This can help you understand what they are dealing with so you are better able to help them.
- Talking to your loved one about your concerns. Let them know that you can see that they are struggling and you want to help.
- Encouraging them to speak to their doctor. People aren’t always open to hearing what their friends or family have to say about their addiction, but they may be willing to listen to a professional.
- Researching treatment options. You can use the Substance Abuse and Mental Health Services Administration’s FindTreatment.gov website, or use the Rehabs.com directory to find a drug rehab that suits your loved one’s needs.
- Encouraging them to start attending a self-help group like Narcotics Anonymous (NA). These groups provide support from others who are in recovery and can help your loved one see that there is a light at the end of the tunnel.
No matter how severe a person’s addiction might be, treatment can help. The Surgeon General’s Report on Alcohol, Drugs, and Health says that treatment can dramatically improve a person’s health and quality of life, reduce fatalities, and help people remain in recovery.13
Different types of treatment can help fentanyl addiction. People may start with drug detox to help them withdraw from fentanyl.14 Detox is not a standalone form of substance use treatment but rather the first step in the recovery process.15 After detox, people should receive help with transitioning to further treatment to address the underlying behavioral issues that led to the addiction.16
Fentanyl addiction treatment often involves a combination of behavioral therapies and medication.17 Medications that your loved one may receive can include:16, 18, 19
- Methadone is an opioid drug that works by fully activating opioid receptors in the brain. It helps eases withdrawal symptoms and helps reduce opioid cravings. Methadone is used during detox and the maintenance phase of treatment.
- Buprenorphine is an opioid drug that partially activates opioid receptors. It minimizes withdrawal symptoms and cravings. Buprenorphine is also used during detox and maintenance. It can be combined with an opioid antagonist known as naloxone which prevents individuals from misusing other opioids because naloxone will potentiate opioid withdrawals if opioids are in the body.
- Naltrexone is an opioid antagonist medication that prevents opioids from binding to opioid receptors. It blocks the effects of opioids, so a person won’t get high if they are using opioids but rather will experience withdrawal effects as this medication will potentiate withdrawals if opioids are in the body. As a result, this medication is not used during the acute detox period but rather is a long-term maintenance medication.
Behavioral therapies and other interventions are also important components of the recovery process. This can include:1, 12, 20
- Contingency management, also known as motivational incentives. This provides positive reinforcements, such as vouchers to exchange for tangible goods, for healthy changes, like negative drug tests.
- Cognitive-behavioral therapy (CBT) helps people change their behaviors and teaches stress management, coping, and relapse prevention skills.
- Motivational interviewing is designed to address a person’s ambivalence about changing their substance use and helps them find internal motivation to make positive life changes.
- 12-step groups can complement the above-mentioned treatment approaches. 12-step groups can help people stay in recovery and provide encouragement from others who have been in the same shoes. People might participate in these groups indefinitely to receive support and prevent relapse.
- A mobile medical application known as reSET® is a prescription CBT app that has been cleared by the FDA for use by people with OUD in outpatient treatment programs when under the care of a health care professional. It is used in conjunction with treatment that includes buprenorphine and contingency management.
Get Help for Fentanyl Misuse
If you or someone you care about is struggling with fentanyl misuse or addiction, it may be time to seek help. Finding treatment may feel overwhelming, but American Addiction Centers can help. Call us today at to speak to a compassionate admissions navigator. You will be able to learn about treatment options and can verify your insurance over the phone. We are available 24/7 via our confidential, free helpline so you can start on the road to recovery today.