31 May Fentanyl Withdrawal Timeline
Fentanyl (also known as Subsys, Onsolis, Lazanda, Fentora, Duragesic, and Abstral) is one of the strongest synthetic opiate painkillers available. In fact, the drug is 50 to 100 times more powerful than morphine. Due to its strength and effectiveness as a painkiller, nurses and physicians often use Fentanyl to treat chronic pain, manage discomfort after surgery, and help patients who have developed a tolerance to other medications for pain. Additionally, Fentanyl can help cancer patients who experience breakthrough pain while taking another opioid painkiller.
Fentanyl is available in multiple forms, because some patients may be unable to swallow a pill or a liquid. As a result, Fentanyl comes in the form of a lollipop, a transdermal patch, a piece of film that dissolves under the tongue, a pill that dissolves in the cheek, a nasal spray, and an injection. Regardless of its form, Fentanyl binds to opioid receptors in the brain very quickly, providing powerful pain relief within minutes.
Since Fentanyl is so fast-acting and strong, medical professionals need to take great care in administering it to avoid unpleasant and dangerous side effects, as well as accidental overdoses. The potency of Fentanyl also presents another problem – addiction.
Fentanyl is in the same class of drugs as heroin, because both are synthesized from the poppy plant. Drugs that are derived from this plant produce an addictive high that is described as euphoric and relaxing. As such, people who abuse Fentanyl are very likely to develop a tolerance and dependence to the drug, resulting in a Fentanyl addiction.
It can be very difficult for someone with a Fentanyl addiction to get sober, but it is possible with the appropriate combination of medical detoxification, counseling, and support. The first step in this journey is detoxification, or detox, but it can be very difficult, due to withdrawal symptoms. To prepare for Fentanyl detox and treatment, it’s important to understand the withdrawal symptoms and the Fentanyl withdrawal timeline.
Understanding Fentanyl Addiction
When someone abuses Fentanyl, they may experience feelings of euphoria and sedation. Since these feelings are pleasant, people continue to use Fentanyl. Over time, people who abuse Fentanyl develop changes in their brains that impact the central nervous system and neurotransmitters. These changes result in two conditions known as dependence and tolerance.
- Dependence means that a person needs to keep taking Fentanyl to prevent the onset of uncomfortable and painful withdrawal symptoms. When someone is dependent on a drug, their body can’t function normally without it.
- Tolerance means that a person needs to take more Fentanyl over time to achieve the same effect. With Fentanyl, someone can develop a tolerance to high doses of the drug in just a few days. For example, a person might need more Fentanyl on a Friday than they needed to get high on a Monday.
Both dependence and tolerance work together to maintain the vicious cycle of addiction. Dependence motivates the person to continue taking Fentanyl in order to avoid withdrawal symptoms, while tolerance forces them to take more and more of the drug as time goes on.
Fentanyl Withdrawal Symptoms
When a person with an addiction tries to stop abusing Fentanyl, they will experience what are known as withdrawal symptoms. Since Fentanyl is an opiate, it shares withdrawal symptoms with other drugs in this class. However, Fentanyl is much stronger than other related drugs like heroin and morphine. As a result, the symptoms of Fentanyl withdrawal can be much stronger.
The most common symptoms and side effects of Fentanyl withdrawal include:
- Cognitive Issues
- Cravings for Fentanyl
- High Blood Pressure
- Mood Swings
- Muscle Pain
- Nausea and Vomiting
- Runny Rose
- Stomach Cramps
- Watery Eyes
It’s important to note that not everyone will experience all of these symptoms. The severity and type of withdrawal symptoms that someone experiences vary based on certain factors, including their overall health, age,the length of Fentanyl use, amount of Fentanyl use, and the presence of co-occurring psychological disorders and addictions.
Fentanyl Withdrawal Timeline
Withdrawal symptoms occur when a person’s body and brain try to restore equilibrium after the person stops taking a substance that they have become dependent on. While the symptoms of Fentanyl withdrawal are unpleasant, they are rarely life-threatening. The biggest risk is generally dehydration due to diarrhea and vomiting, but this problem can be managed with medication.
Although Fentanyl withdrawal symptoms are not dangerous, they can cause enough discomfort to make a person relapse and begin taking Fentanyl again. A relapse can be very dangerous, because it can lead to an overdose. When someone stops taking a drug like Fentanyl, their tolerance for the substance decreases.
If a person starts taking the drug again, they may not realize that they don’t have the same tolerance. As a result, they can easily take too much of the drug, resulting in an overdose and even death. To avoid this potentially life-threatening situation, patients should undergo medically-supervised detox when they are trying to stop taking fentanyl.
The severity and length of the withdrawal process tends to vary among patients. A number of factors, including the age, overall health, and Fentanyl use of each patient, influence how the withdrawal process manifests. For example, someone who has abused Fentanyl for an extended period of time or in large quantities will likely experience stronger withdrawal symptoms that last for a longer period of time.
Although there is variation among patients, the Fentanyl withdrawal timeline has three stages:
- Early Stage: It can take several hours for someone to feel Fentanyl withdrawal symptoms. As such, mild symptoms tend to start 12 to 30 hours after the last dose of Fentanyl. When a patient begins to experience symptoms depends on the amount of the last dose and whether it was in a time-release form like a transdermal patch. Thisfirst stage tends to last no more than two to three days, and it peaks with symptoms like agitation, insomnia, muscle aches, runny nose, and sweating. Due to these symptoms, many patients describe the first stage as feeling like a mild flu.
- The Peak:Patients will experience the worst physical symptoms on days three through five. These unpleasant symptoms include gastrointestinal problems like diarrhea, nausea, and vomiting, as well as muscle and bone pain, runny nose, and watery eyes. Patients also start to feel intense psychological symptoms at this point, including anxiety, depression, and mood swings. Luckily, these symptoms will start to decrease after the fifth day. At this point, the brain is beginning to restore balance.
- Long-Term: After one to two weeks, the physical symptoms of Fentanyl withdrawal should dissipate. However, some psychological symptoms, including cravings and depression, can still remain. At this point, the risk of relapse is high and patients should continue to seek medical support to manage their remaining symptoms.
The Risk of PAWS
When a person is addicted to alcohol, benzodiazepines, or opiates like Fentanyl for a long period of time, they can experience post-acute withdrawal syndrome (PAWS). PAWS refers to intensified and protracted withdrawal symptoms that last for weeks or months. Cravings, depression, mood swings, and sleep problems are among the most common symptoms, while some people may also experience seizures.
The length and nature of PAWS makes it more likely that patients will relapse in an attempt to avoid the unpleasantness and discomfort of the symptoms. However, as mentioned above, relapse is very dangerous, so it’s critical to find an addiction treatment program that can provide medically-supervised detox.
Treating Fentanyl Addiction and Withdrawal
Many people might feel as though it’s impossible to break free from an addiction to Fentanyl, but it is possible to overcome addiction with the right treatment and support. It is very important to select a drug treatment program that is experienced in helping patients recover from Fentanyl addiction, since this type of addiction has a high relapse rate. It is equally critical for a patient to determine if they need to attend an inpatient or outpatient treatment program. Due to the severity of Fentanyl addiction, inpatient treatment is often recommended for patients.
Once a patient finds the right treatment program for them, the first step in the process is to remove Fentanyl from their body through the process of detox. With Fentanyl, professionals recommend slowly tapering the dose of the drug, rather than stopping the drug “cold turkey.”
Everyone is different, so a doctor will work with each patient to create a customized tapering schedule, which is typically a 25-50% reduction in Fentanyl each week until the detox process is complete. Not only does tapering ease withdrawal symptoms, it also slowly teaches the brain how to release its own neurotransmitters again – without the aid of Fentanyl.
In order for tapering to be an effective approach to Fentanyl detox, it must be performed under close medical supervision. Additionally, the tapering schedule needs to be tailored to each patient’s needs, taking into account a number of factors, including the level of dependence, co-occurring addictions and disorders, and the length of Fentanyl use.
Again, since Fentanyl can produce intense withdrawal symptoms, addiction specialists often recommend residential, inpatient detox programs for people struggling with an addiction to Fentanyl. In a residential program, professionals can provide 24/7 physical and mental health support to make the process more comfortable, and ultimately more successful.
The length of detox varies based on individual need, but all inpatient detox programs will involve monitoring a patient’s vital signs and administering medications to manage withdrawal symptoms. Medications like methadone and buprenorphine can act as a substitute for Fentanyl, which can reduce symptoms and cravings for the drug during the withdrawal process. However, it is important to only take these medications under strict medical supervision, because they too can be addictive.
There are also drugs to manage specific symptoms of withdrawal. For example, Clonidine can treat anxiety, cramping, runny nose, and sweating. Additionally, there are medications that can control symptoms like nausea and vomiting, while ibuprofen can manage aches and pains. Physicians and nurses can also administer supplements and fluids to help replenish a patient’s body. Together, all of these treatments increase a patient’s likelihood of successfully completing the detox process.
After detox, the patient will begin psychological counseling, taking time to explore the underlying reasons for their Fentanyl addiction. With this knowledge, a therapist will help the patient develop important skills and strategies, including coping mechanisms, stress management strategies, mindfulness, sober social skills, and relapse prevention plans. These tools are designed to help patients manage daily stressors without help from the drug they once relied on.
The way that counseling is delivered varies. Patients can attend one-on-one sessions with a therapist or they can go to group sessions with other patients or their family members. Attending therapy with other patients who are in recovery can be beneficial, because it is an opportunity for patients to learn from each other, while also receiving emotional support. When family members are involved in counseling, it is a chance for them to learn how they may have contributed to the patient’s addiction and how they can support their recovery efforts and sobriety.
A final component of Fentanyl treatment involves ongoing support from medical professionals and loved ones. Recovery isn’t easy and roadblocks may tempt patients to give up and fall back into addiction. In these situations, a strong support network can help a patient remember their goals and stay on track with recovery.