FENTANYL ADDICTION TREATMENT

What is Fentanyl?

Fentanyl is a potent synthetic opioid that belongs to the family of pain-relieving (analgesic) medications. It is widely used in the medical field to manage severe pain associated with surgeries, cancer treatment, and other chronic pain conditions, as it is 50 times stronger than heroin and 100 times stronger than morphine. While fentanyl has been proven to be effective in medical settings, its power and potency contribute to its misuse, which has given rise to a pressing public health concern.

There are various ways in which fentanyl can be consumed, both medically and illicitly. In a medical setting, fentanyl is typically administered under strict supervision by healthcare professionals. Common medical forms include:

Transdermal Patches: Fentanyl patches are applied to the skin and slowly release the medication over an extended period, providing long-lasting pain relief.

Intravenous (IV) Injection: Fentanyl can be administered directly into the bloodstream through intravenous injection, often used in surgical and anaesthesia settings.

Buccal Tablets: Some formulations of fentanyl are designed for oral transmucosal administration, either as lollipops or tablets placed on the cheek or under the tongue.

Illicitly, individuals may misuse fentanyl in several dangerous ways:

Intravenous Use: Some individuals dissolve fentanyl powder and inject it intravenously, seeking a rapid and intense euphoric effect.

Nasal Sprays: Illicitly manufactured fentanyl may be converted into a nasal spray, allowing for absorption through the nasal mucosa.

Pills and Tablets: Fentanyl may be pressed into counterfeit pills or tablets, leading to the risk of accidental overdose, as users may be unaware of the potency.

Smoking: In some cases, fentanyl powder is smoked, which poses additional health risks.

It's crucial to emphasise the extreme potency of fentanyl and the associated risks, particularly when obtained illicitly. Illicitly manufactured fentanyl is a significant contributor to opioid-related overdoses due to its potency and the challenges of dosage control in non-medical settings. Misuse of fentanyl, whether obtained from legitimate medical sources or illegally, poses serious health risks and can lead to life-threatening consequences.

Risks and adverse effects of fentanyl

Fentanyl use carries inherent risks and side effects, ranging from respiratory depression to nausea, sedation, and dizziness. Frequently misusing fentanyl can also cause confusion, depression, difficulty walking, speech impediments, muscle weakness, and fatigue. Many individuals also experience nausea, vomiting, weight loss, vision hallucinations, and pinpoint pupil pain. In addition, fentanyl can lead to unconsciousness, comas, and death.

Fentanyl Overdose

The narrow margin between a therapeutic dose and a lethal dose of fentanyl heightens the risk of overdose. Accidental overdose, marked by respiratory failure, is a grave consequence of misuse. The urgency of addressing this risk is paramount in mitigating the devastating effects of fentanyl on the central nervous system. Alongside loss of consciousness, individuals may also become limp, pale, or clammy.

Overdose can be temporarily reversed with Naloxone, giving the individual who overdosed time to get medical help. Naloxone is a medication that can rapidly reverse the effects of opioid overdose by binding to the same brain receptors that fentanyl targets. In the context of fentanyl overdose, naloxone is a crucial intervention due to the drug's potency and the rapid onset of respiratory distress associated with its use. Fentanyl overdoses can occur quickly, and prompt administration of naloxone is essential for preventing fatalities. Naloxone is typically administered as an injection, either intramuscularly (into a muscle), intravenously (into a vein), or intranasally (through the nose) using a nasal spray. It is important to note that naloxone has a relatively short duration of action compared to some opioids, so additional doses or continuous medical monitoring may be necessary to prevent a recurrence of overdose symptoms.

How does fentanyl affect the brain?

Fentanyl, like other opioids, affects the brain by interacting with the body's endogenous opioid system. The opioid system is a complex network of receptors, neurotransmitters, and pathways involved in the regulation of pain, reward, and other physiological functions.

With prolonged use, the brain can adapt to the presence of fentanyl, leading to the development of tolerance. Tolerance means that higher doses of the drug are needed to achieve the same effects. Additionally, continued use can result in physical dependence, where the body relies on the presence of the drug to function normally. Other prevalent effects of fentanyl on the brain and body include:

Pain Modulation: The primary therapeutic effect of fentanyl is pain relief. It does so by reducing the transmission of pain signals along the nervous system and alters the brain's interpretation of pain.

Euphoria and Relaxation: In addition to its analgesic (pain relieving) properties, fentanyl induces a sense of euphoria and relaxation. This effect is part of what makes opioids, including fentanyl, appealing for recreational use and contributes to their potential for misuse.

Reward Pathway Activation: Fentanyl use is also present in the brain's reward pathway, which is associated with pleasurable sensations and reinforcement. Fentanyl's activation of this pathway contributes to the reinforcing effects of the drug, making individuals more likely to seek its use.

Dopamine Release: Fentanyl, like other opioids, leads to the release of dopamine, a neurotransmitter associated with pleasure and reward, in certain brain regions. This surge in dopamine levels reinforces the association between fentanyl use and pleasurable feelings, contributing to the development of addiction.

Tolerance and Dependence: With prolonged use, the brain can adapt to the presence of fentanyl, leading to the development of tolerance. Tolerance means that higher doses of the drug are needed to achieve the same effects. Additionally, continued use can result in physical dependence, where the body relies on the presence of the drug to function normally.

It's important to recognise that while fentanyl's effects on the brain can be beneficial in a medical context for managing severe pain, its misuse and potential for addiction pose significant health risks. Understanding how fentanyl interacts with the brain is crucial for developing effective interventions and treatment strategies for those affected by addiction.

Fentanyl Withdrawal Symptoms

The cycle of fentanyl addiction is perpetuated by the development of physical dependence, making withdrawal a formidable obstacle to recovery. Withdrawal occurs when an individual who has developed physical dependence on fentanyl abruptly reduces or discontinues its use. The severity and duration of withdrawal symptoms can vary depending on factors such as the level of dependence, the duration of use, and individual differences.

Symptoms such as anxiety, insomnia, muscle pain, and nausea intensify the challenge, emphasising the need for comprehensive and supportive treatment strategies. Other symptoms also include:

• Muscle and bone pain
• Insomnia and sleep disturbances
• Gastrointestinal distress
• Anxiety and restlessness
• Depression and mood swings
• Tremors and shivering

While fentanyl withdrawal symptoms are typically not life-threatening, they can be highly uncomfortable and debilitating. Seeking professional assistance during withdrawal is recommended to manage symptoms effectively and provide support through the process. Supervised withdrawal within a specialised treatment centre can further ensure a safer and more comfortable experience for individuals working towards recovery.

How is fentanyl addiction treated?

Addressing fentanyl addiction necessitates a comprehensive approach that acknowledges the intricate interplay between physical dependence, psychological factors, and the potential for relapse. From medical detoxification to the integration of medication-assisted treatment, behavioural therapies, and ongoing support systems, the treatment of fentanyl addiction aims not only to alleviate withdrawal symptoms but also to address the root causes of addiction and equip individuals with the tools for sustained recovery.

Medical detox

Medical detoxification (detox) is a critical and supervised process designed to help individuals safely withdraw from substances such as fentanyl. As fentanyl is a potent synthetic opioid, it necessitates a carefully managed detoxification due to the severity of withdrawal symptoms and the risk of its complications. The primary goals of medical detox are to ensure the safety and comfort of the individual during withdrawal, manage the symptoms effectively, and lay the groundwork for ongoing addiction treatment.

It may take several weeks for some individuals. Professional doctors can prescribe medications to help eradicate fentanyl from your body and help promote a more comfortable recovery procedure. These medicines may relieve symptoms of withdrawal, such as craving, irritability, nausea, pain sensitivity, or vomiting.

Medication-Assisted Treatment (MAT)

MAT involves the use of medications to support individuals in their recovery from opioid addiction. Common medications for fentanyl addiction include:

Methadone: A long-acting medication that helps reduce cravings and withdrawal symptoms.

Buprenorphine: Used to alleviate withdrawal symptoms and cravings associated with opioid dependence.

Naltrexone: Blocks the effects of opioids, discouraging relapse.

Behavioural Therapies

Behavioural therapies are integral components of addiction treatment, addressing the psychological aspects of substance use disorders, including fentanyl addiction. These evidence-based therapeutic approaches aim to modify maladaptive thoughts, behaviours, and emotions associated with drug use, fostering healthier patterns and coping mechanisms. In the context of fentanyl addiction, behavioural therapies play a crucial role in helping individuals understand the root causes of their substance use, develop effective strategies for relapse prevention, and navigate the challenges of long-term recovery. Some key behavioural therapies commonly employed in the treatment of fentanyl addiction:

Cognitive-Behavioural Therapy (CBT): CBT is a widely used therapeutic approach that focuses on identifying and modifying maladaptive thought patterns and behaviours contributing to addiction. Through collaborative sessions, individuals learn to recognise and challenge negative thought patterns, develop healthier coping strategies, and acquire skills to manage stress without resorting to drug use.

Contingency Management: Contingency management incentivises positive behaviour by employing a system of rewards to reinforce positive behaviours, such as abstinence from fentanyl. Individuals earn tangible rewards for adhering to their treatment goals. This approach helps create positive associations with sobriety and encourages sustained recovery efforts.

Motivational Interviewing: Motivational interviewing is a client-centred therapeutic approach that aims to enhance an individual's motivation for change. Therapists use empathetic communication and active listening to explore and strengthen the individual's own motivation and commitment to overcoming fentanyl addiction, which is particularly effective in the early stages of treatment.

Behavioural therapies for addiction offer numerous benefits, including targeting underlying psychological factors contributing to substance abuse, developing practical coping skills to manage stress and cravings, and promoting lasting positive changes in thought patterns and behaviours. These evidence-based interventions empower individuals to navigate the challenges of addiction, enhance motivation for recovery, and contribute to a holistic, individualised treatment approach.

Structured Treatment

Residential treatment for fentanyl addiction provides individuals with a highly structured and supportive environment for intensive recovery. In a residential setting, a focused, therapeutic approach that addresses the physical, psychological, and social aspects of fentanyl addiction can be provided. With access to a team of healthcare professionals, including physicians, therapists, and counsellors, individuals engage in individual therapies, medical management, and holistic interventions. The residential setting also removes individuals from the triggers and stressors of daily life, facilitating a concentrated effort on self-reflection, skill-building, and the development of coping strategies essential for sustained recovery. This level of care ensures a holistic approach to drug addiction, fostering a transformative and supportive environment conducive to lasting positive change.

The Kusnacht Practice provides a 360-degree approach to individualised care tailored to your specific needs and goals. Our team of specialists in psychiatry and psychotherapy, BIO-R^® and nutrition, as well as in-house doctors and complementary therapists, are dedicated to your well-being, helping foster a positive environment for recovery.

As specialists in treating addictions and other mental health disorders, we can help you to recover safely. If you feel that you or a loved one have a problem with fentanyl that you cannot control or resolve, get in touch to find out how we can help.