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Fentanyl Withdrawal

According to the National Institute of Drug Abuse (NIDA), Fentanyl is a cogent drug prescribed as an opiate. It has more potential as compared to morphine. Fentanyl can be concocted in various ways. It can be manufactured in trans-dermal patches known as Duragesic, in the form of a lozenge, usually called “lollipops” (Aqtic), also in an injectable form known as Sublimaze. A lot more dynamic drug than the illegal heroin, Fentanyl follows an identical action method as heroin.

The abuse of Fentanyl has ascended in the recent years as stated by The Drug Enforcement Administration (DEA). The excessive abuse of the drug has led to frequent visits to the emergency department, seizures caused by drugs, and death caused by an overdose of the drug. Fentanyl patches should not be taken by people who have already grown a tolerance towards auxiliary opioid drugs, as well as the ones who require constant management of pain, for example, patients suffering from cancer. When you have taken opioid drugs for a considerable amount of time and it ceases to function the way it used to at the beginning, a tolerance towards opioid grows. There may be symptoms of severe pain and you may have to resort to taking pain-killers for relief.

Fentanyl Withdrawal

Opioid drugs alter the brain’s chemistry. Drugs fill the receptors of opioid along the central nervous system and alter a few messengers of the brain, or the neurotransmitters, move around. The brain will stop making neurotransmitters by itself and depend on Fentanyl, thereby, causing a dependence on the drug. Symptoms from opioid withdrawal will start surfacing as soon as the drug intake is terminated. There can be both physical and psychological withdrawal symptoms. These symptoms can be experienced by both the people who were consuming the drug legally, with a well-founded medical prescription, and by the people who were taking it for recreational purposes. Terminating the drug “cold turkey” without professional medical aid is never recommended. It is always advised to follow a narrowing or tapering schedule or undergoing medical detox to avoid adverse withdrawal symptoms.

FENATNYL WITHDRAWAL TIMELINE AND SYMPTOMS

Withdrawal symptoms from opioid usually mount within twelve to thirty hours of the last dose. When taken in the form of a patch, the effects of Fentanyl may continue to peak for the first twelve to twenty four hours of wearing it, as the National Library of Medicine reports. Fentanyl has a half-life of seventy two hours after the patch has been removed. Withdrawal will commence a day or two after taking the patch off.

 

As reported by the US Food and Drug Administration, the aftermath of opioid withdrawal symptoms is:

  • Restlessness
  • Sweating
  • Yawning
  • Back ache
  • Chills
  • Runny nose
  • Tearing up
  • Bristling
  • Stomach cramp
  • Pain in the joint or muscles
  • Diarrhea
  • Anorexia
  • Vomiting
  • Hypertension
  • Sleeplessness
  • Increased heart rate
  • Increased respiratory level
  • Pupil dilation
  • anxiety

Psychological aftermath of withdrawal from opioids includes drug cravings, depression, and difficulty in feeling pleasure as the dopamine is disrupted. Psychological symptoms may last a little longer.

COLD TURKEY VERSUS WEANING

Abruptly discontinuing Fentanyl may activate severe withdrawal symptoms. Thus, you may want to slowly diminish the intake of the drug. The gradual cleansing of Fentanyl from the system is referred to as tapering. In colloquial terms, it is known as weaning. Tapering should not be performed without medical aid. A narrowing schedule must be prepared, which will prevent the manifestation of the withdrawal symptoms. The schedule of tapering will keep a little amount of opioid drug in the body. If you do not stop cold turkey and gradually remove the drug, withdrawal from opioid may be controlled.

Tapering off Fentanyl may begin by switching to other opioid like morphine or methadone, which has a longer lasting effect. After switching over, the dosage of opioid is reduced by 20.50% daily till the dosage reaches 30mg per day for methadone or 45mg per day for morphine. After this, the dosage can be significantly minimized by 15mg every two to five days for morphine and by 5 mg every three to five days down to 10 mg per day. This will be followed by a reduction of 2.5 mg every 3-5 days down to 0 for methadone.

Narrowing may vary from person to person, and various schedules must be undertaken. The various factors which determine the tapering schedule are:

  • Dependence level on Fentanyl: The tapering schedule will take longer if the dependence on the drug was very strong.
  • Abuse of Fentanyl: residential detox program will be the most useful for the person who had been taking Fentanyl for recreational reasons, or who had been suffering from obsessive behaviors due to overuse of the drug.
  • Suffering from other disorders: If the individual had been suffering from any disorder pertaining to mental health, they may take medicines to adequately manage the narrowing schedule.
  • Time period of taking Fentanyl: the narrowing schedule will be slower if the individual had been taking Fentanyl for a very long period of time.
  • Addiction to other drugs or alcohol: Other addictive substances may collaborate with Fentanyl and enhance the dependence level. It may also cause a cross-tolerance. Thus, dependence on both the things will have to be managed separately.

MEDICAL DETOX

Detox is the process of eliminating Fentanyl from the body. Medical detox is implemented in a functional treatment center. Residential detox is commonly known as medical detox. In medical detox, highly trained professionals provide medical and mental health support. Individual’s safety is monitored by closely observing the vital signs like blood pressure, respiratory rate, heart rate. Medications are used to control physical and emotional indications of withdrawal. As Fentanyl is a cogent opioid, residential detox is highly sanctioned. Customarily, medical detox has longevity of five to seven days. However, it can last for up to ten days. Detox is exclusive for each person, thus, the time required for complete detoxification will vary from person to person.

Replacing opioid with Buprenorphine products is another process followed by medical detox. As a partial opioid, Buprenorphine treats opioid dependence. It comes under the brand name of Bunavail, Suboxone, and Zubsolv. These also act on the opioid receptors in the brain but to a lesser degree. Without producing the euphoric “high”, the action of these drugs will help to reduce withdrawal symptoms. On the contrary, Naloxone has a reverse effect as it blocks opioid receptors from receiving opioids. After Fentanyl and other opioids are completely out of the system, such combination medications can be saved for post detox.

Supplementary medications like anti-depressants can be helpful in treating depressive symptoms. Antihistamines will help you deal with insomnia or restlessness. Nausea, cramps, and diarrhea can be eased by gastro-intestinal medications. Clonidine, the blood pressure medication, will regulate heart rate and blood pressure, and help to treat opioid withdrawal symptoms. Medical detox will go a long way in smoothly flushing out Fentanyl from the body. This will help the body in regaining the physical balance. Cravings and other unfavorable psychological symptoms of Fentanyl abuse and addiction can be managed by medical detox.