Fentanyl is a synthetic opioid that is prescribed to treat severe pain. Unfortunately, fentanyl is a powerfully addictive drug that is around 50 times more potent than heroin. Fentanyl abuse and addiction have devastating consequences, and many medical experts cite fentanyl as a primary driver of the astonishing increase in opioid-related deaths in recent years.
Fentanyl has proven to be easy to obtain illicitly and it is less expensive than heroin, so it is often used to adulterate heroin and other illegal drugs in order to increase the effective “high” delivered while also increasing the profit margin for the dealer. However, 3 mg of fentanyl (approximately the same size as a few grains of sand) can kill an adult man.
How Long Does Fentanyl Stay in Your System?
The fentanyl half-life varies quite a bit, depending on the formulation and the route of administration. There are three types of fentanyl: Pharmaceutical fentanyl, derivatives of pharmaceutical fentanyl and non-pharmaceutical (illicit) fentanyl, which all have different half-lives.
Broadly speaking, intravenously administered pharmaceutical fentanyl has an average half-life of 7 hours, but the range spans from 3-12 hours. Transdermal fentanyl patches administer fentanyl through the skin, slowing the metabolic half-life to 20-27 hours. Derivatives and illicit fentanyl have shorter half-lives than pharmaceutical fentanyl.
Fentanyl Withdrawal Symptoms
Acute fentanyl withdrawal is characterized by physical and psychological symptoms. Physical symptoms of fentanyl withdrawal include:
- Fentanyl Physical Withdrawal Symptoms
Muscle cramps or spasms
Psychological symptoms of fentanyl withdrawal include:
- Fentanyl Psychological Withdrawal Symptoms
Dysphoria (a general state of unease/discontent)
Anhedonia (inability to experience pleasure)
Some people in recovery experience something called the “pink cloud syndrome,” which was initially described by members of Alcoholics Anonymous. The pink cloud is a state of euphoria that can accompany recovery and, although feeling healthy and confident are incredibly positive rewards associated with overcoming addiction, irrational enthusiasm combined with a willingness to overlook responsibilities can set someone up for failure. People who have successfully achieved early recovery are urged to continue to participate in aftercare programs that can both celebrate successes and keep participants grounded.
Fentanyl Withdrawal Timeline
Withdrawal symptom onset and duration are partially a result of the half-life of a drug and thus the source of fentanyl can affect the withdrawal timeline. A very general outline of the fentanyl withdrawal timeline for pharmaceutical fentanyl taken orally or snorted can be described as follows:
- 2-4 Hours
Withdrawal symptoms begin.
- 1-2 Days
Peak symptom severity.
- 2-10 Days
Symptoms will gradually resolve.
People who have overcome chronic fentanyl use disorders may experience post-acute withdrawal syndrome. This is characterized by withdrawal symptoms that persist for well beyond the time that acute symptoms are expected to have resolved, often several months.
Factors Impacting Fentanyl Withdrawal
Fentanyl withdrawal is substantially influenced by a number of factors, including:
- Withdrawal Factors
Frequency of use
Route of administration
Polydrug abuse (abuse of fentanyl and other drugs or alcohol)
Health (physical and mental)
How to Cope with Fentanyl Withdrawal
Fentanyl withdrawal can be profoundly uncomfortable, especially for people who quit “cold turkey” without medical support. There are no shortcuts or easy fentanyl withdrawal remedies that can prevent symptoms. However, people who participate in supervised medical detox programs have access to 24/7 medical professionals who can address concerns as they arise and, if appropriate, administer pharmacotherapies to mitigate the severity of withdrawal symptoms.
Fentanyl withdrawal is best addressed in a professional rehab setting that includes medical detox. At the very least, someone facing fentanyl detox and withdrawal should seek professional assistance to obtain an appropriate tapering regimen.
The Dangers of Withdrawing from Fentanyl Alone
Fentanyl dependence is a consequence of the brain becoming adapted to its presence. When someone who has become dependent on fentanyl quits abruptly, their brain will attempt to rapidly restore normal functionality. Unfortunately, this is not always a smooth process and, as brain chemistry rapidly changes, the result can include dangerous physical and psychological symptoms like seizures and hallucinations.
For these reasons, quitting abruptly is never recommended for people who have developed a fentanyl dependence. It is strongly suggested that someone with a fentanyl use disorder consult with their doctor or an addiction specialist before they attempt to quit.
People who choose to detox without medical supervision should prepare ahead of time. Enlist a trusted friend or family member who can be a cheerleader, errand runner, and motivational speaker. Discuss with them why recovery is important and what the short and long term goals are. It can be very helpful if someone struggling to resist relapse is reminded of why they are pursuing sobriety. In addition, make sure the refrigerator is full of healthy food and water. Many people find that a quality multivitamin may help their symptoms.
Detoxing Off Fentanyl
Opioids are very challenging drugs to quit, especially if done without professional help. Some people believe that flushing fentanyl out of their system will speed detox and withdrawal. However, fentanyl dependence is a physical consequence of the brain becoming accustomed to the presence of the drug. If the drug is flushed out as quickly as possible, recovery symptoms will set in more quickly and be more severe. In cases of severe dependence, this can be dangerous and even lethal.
Medication-Assisted Detox vs Quitting Cold Turkey
Quitting cold turkey is rarely the most effective approach to overcoming substance use disorders and fentanyl is no exception. In milder cases of fentanyl dependence, a tapering protocol is a highly effective strategy for managing withdrawal symptoms, but in severe cases of dependence, opioid replacement therapy in the form of medication-assisted treatment (MAT) may be more appropriate.
MAT is a strategy that replaces fentanyl with other opioids that have longer half-lives and that do not deliver the euphoria that is associated with fentanyl abuse. The goal of MAT is to provide the brain with a substance that can mimic the chemical effects of fentanyl in the brain without delivering the sense of euphoria that perpetuates addiction. In other words, MAT tricks the brain into believing that it is receiving the drug it has become accustomed to without continuing to reinforce the pleasure that is associated with fentanyl use.
There are several drugs that are valuable MAT options for people recovering from a fentanyl use disorder, including methadone, buprenorphine, Suboxone and naltrexone.
When to Find Help: Fentanyl Rehab in Florida
While there are several options for drug rehab in Florida, they are not all alike. Things to consider when you are evaluating a program that will address a fentanyl use disorder include:
- Comprehensive programs that are tailored to suit your needs
- Multidisciplinary staff that can address physical and psychological aspects of recovery
- Ability to provide care through every stage of recovery, from detox to aftercare
- Ability to provide a dual diagnosis, if appropriate
Opioids are powerfully addictive drugs, and overcoming a fentanyl use disorder can be incredibly difficult without professional care. The Recovery Village Palm Beach at Baptist Health provides comprehensive rehab programs that can address every facet of your recovery. Call us today to learn how we can help you get on the road to recovery.
Bond, Allison. “Why fentanyl is deadlier than heroin, in a single photo.” Stat News, September 2016. Accessed September 21, 2019.
Bettinger, Jeffrey J.; et al. “Fentanyl: Separating Fact from Fiction.” Practical Pain Management, July/August 2018. Accessed September 21, 2019.
FDA.gov. “Duragesic Transdermal System: Highlights of Prescribing Information.” Revised July 2018. Accessed September 21, 2019.
Medical Disclaimer: The Recovery Village Palm Beach at Baptist Health aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.