What Are Fentanyl Withdrawal Symptoms? Everything You Need To Know

Fentanyl has become increasingly prevalent as a street drug in recent years.[1] According to the Centers for Disease Control and Prevention (CDC), fentanyl-related deaths have surged over the past twenty years, with synthetic opioids like fentanyl being responsible for killing many of the 80,000-plus people who died of an opioid overdose in 2021.[2]

Recognizing the signs of fentanyl withdrawal is important for those seeking to break free from addiction. From intense cravings and flu-like symptoms to psychological distress and physical discomfort, navigating fentanyl withdrawal requires knowledge, support, and access to appropriate medical care for a safe and full recovery.

What is Fentanyl?

Fentanyl is a potent synthetic opioid pain medication. It’s prescribed for severe pain, like post-surgery or cancer pain, but it’s also illegally made and sold as a street drug, often mixed with heroin or cocaine.[3] It’s much stronger than other opioids, increasing the risk of overdose and addiction.[4]

Fentanyl is primarily utilized in the medical field for its potent pain-relieving properties.[5] Following surgical procedures, fentanyl is crucial in post-operative pain management, offering immediate relief when other analgesics may not suffice. Additionally, fentanyl is commonly prescribed to cancer patients experiencing intense pain, providing much-needed comfort in palliative care settings.

In cases of chronic pain, such as severe back pain, medical practitioners may also turn to fentanyl for its efficacy in alleviating persistent discomfort. However, these applications necessitate stringent medical oversight due to fentanyl’s high potency and the associated risks of misuse and addiction.

What Are the Common Symptoms of Fentanyl Withdrawal?

Fentanyl is highly addictive due to its potent effects on the brain’s reward system, leading to a rapid onset of addiction. [6] Fentanyl binds to opioid receptors in the brain, triggering a flood of dopamine, which produces intense feelings of pleasure and euphoria.

Over time, the brain adjusts to these elevated dopamine levels, leading to tolerance, where higher doses of fentanyl are needed to achieve the desired effects. Continued use can then lead to physical dependence, where the body requires fentanyl to function normally. Additionally, the euphoric effects of fentanyl can lead to psychological dependence, with individuals craving the drug to escape negative emotions or cope with stress.

Common signs of fentanyl withdrawal can include:[7]

• Intense drug cravings: A strong desire or compulsion to use fentanyl again, often driving the individual to seek out the drug at any cost.
• Gastrointestinal disturbances: Nausea, vomiting, and diarrhea are typical withdrawal symptoms, often likened to a severe case of the flu. These symptoms can lead to dehydration and electrolyte imbalances if not managed properly.
• Psychological distress: Anxiety, restlessness, and agitation are prevalent during fentanyl withdrawal. Individuals may experience heightened nervousness or unease, making relaxing or remaining calm challenging.
• Sleep disturbances: Insomnia or disrupted sleep patterns are common, with individuals experiencing difficulty falling or staying asleep throughout the night. This can exacerbate other withdrawal symptoms and lead to fatigue and irritability during the day.
• Muscle aches and pains: Widespread discomfort in the muscles and joints is a frequent complaint during fentanyl withdrawal. These aches can range from mild to severe, contributing to overall physical discomfort.
• Sweating and chills: Profuse sweating, accompanied by alternating sensations of hot and cold, is characteristic of fentanyl withdrawal. These fluctuations in body temperature can be uncomfortable and contribute to feelings of malaise.
• Goosebumps or “goose flesh”: This common symptom of fentanyl withdrawal, also known as piloerection, involves the skin developing raised bumps as a physiological reaction. This symptom is commonly associated with opioid withdrawal.
• Excessive yawning: Yawning more frequently than usual is a common occurrence during opioid withdrawal, including fentanyl withdrawal. It is believed to be related to changes in neurotransmitter levels in the brain.
• Irritability and mood swings: Individuals undergoing fentanyl withdrawal may experience heightened irritability, mood swings, and emotional volatility. These mood disturbances can strain interpersonal relationships and make coping with withdrawal more challenging.
• Depression and dysphoria: Feelings of sadness, hopelessness, and dysphoria may accompany fentanyl withdrawal, reflecting the neurochemical changes occurring in the brain during this process.
• Cramps and abdominal pain: Muscle cramps and abdominal pain are reported by some individuals experiencing fentanyl withdrawal. These symptoms may be due to gastrointestinal disturbances or changes in muscle tone.
• Increased heart rate and blood pressure: Some individuals may experience transient increases in heart rate and blood pressure during fentanyl withdrawal. These physiological changes can contribute to feelings of discomfort and anxiety.

How Much Fentanyl Does it Take to Cause an Overdose?

The amount of fentanyl needed to cause an overdose varies widely among individuals due to factors such as tolerance, body weight, and overall health. Fentanyl is significantly more potent than other opioids, so even a small amount can be lethal. For individuals without opioid tolerance, as little as 2 milligrams of fentanyl can be fatal if ingested or injected.[8]

It’s also important to note that illicitly manufactured fentanyl, often found mixed with other drugs like heroin or cocaine, can vary in potency, making it even more unpredictable and dangerous. Additionally, accidental exposure to fentanyl, such as through skin contact or inhalation of airborne particles, can also lead to overdose in certain circumstances.

What Are the Signs of a Fentanyl Overdose?

Signs of a fentanyl overdose include:[9]

• Extreme drowsiness or unconsciousness: Individuals may become unresponsive or unable to wake up.
• Shallow or slow breathing: Breathing may become dangerously slow or irregular, or the person may stop breathing altogether.
• Pinpoint pupils: The pupils of the eyes constrict significantly, appearing as tiny dots, even in low light.
• Blue or grayish skin: Due to a lack of oxygen, lips, fingertips, or the face may turn bluish or grayish.
• Cold, clammy skin: The skin may feel cold and damp.
• Weak pulse: The pulse may be weak, erratic, or difficult to detect.
• Confusion or disorientation: The individual may appear confused or disoriented or have difficulty speaking.
• Seizures: Seizures can occur in severe cases of fentanyl overdose.
• Vomiting: Some individuals may vomit during a fentanyl overdose.
• Loss of consciousness: In the most severe cases, the individual may lose consciousness entirely.

What Should I Do if Someone is Overdosing on Fentanyl?

If you suspect someone is overdosing on fentanyl, act swiftly. Call emergency services immediately, providing accurate details of the situation and your location. If you have Narcan (naloxone) available, administer it according to the manufacturer’s instructions, and be prepared to give multiple doses if necessary, as fentanyl’s potent effects may require repeated administration.[10]

Stay with the person, monitoring their breathing and vital signs, and be prepared to perform rescue breathing if needed. When emergency responders arrive, provide them with relevant information, including the suspected substance ingested. Follow medical instructions closely and seek support for the individual and yourself in the aftermath of the incident. Time is critical during an overdose, so quick action can make a significant difference in saving lives.

How Can I Get Help for Fentanyl and Opioid Addiction?

If you or someone you know is struggling with fentanyl or opioid addiction, there are several avenues to seek help:[11]

• Medical detoxification: Consider a medically supervised detox program where trained professionals can safely manage withdrawal symptoms and provide support during the initial stages of recovery. This may involve tapering off opioids gradually or using medications to ease withdrawal discomfort.
• Treatment programs: Explore residential or outpatient treatment programs that offer comprehensive care for opioid addiction. These programs typically include therapy (individual and group), counseling, education on addiction and coping skills, and support from healthcare professionals.
• Medication-Assisted Treatment (MAT): MAT combines medications (such as methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies to address opioid addiction. MAT can help reduce cravings, prevent relapse, and support long-term recovery.
• Support groups: Joining support groups like Narcotics Anonymous (NA) or SMART Recovery can provide valuable peer support, encouragement, and accountability during recovery. These groups offer a sense of community and understanding from others who have gone through similar experiences.
• Aftercare planning: Develop a comprehensive aftercare plan to support ongoing sobriety after completing a treatment program. This may include continued therapy, participation in support groups, regular check-ins with healthcare providers, and healthy lifestyle changes.