Fentanyl has recently gained attention as a synthetic opioid that is much more potent than other opioids, including heroin. These drugs have contributed directly to the nationwide opioid crisis, which has devastated both small and large communities across America.
Here is how intravenous (IV) fentanyl stacks up compared to similar opioids:
- Codeine, oral: 4,000 times more potent
- Morphine, oral: 1,200 times more potent
- Hydrocodone, oral: 400 times more potent
- Oxycodone, oral: 200 times more potent
In medicine, potency is a comparison of how much of each substance is needed to accomplish the same thing. For example, 1 mg of fentanyl will have the same pain-killing effects as 4000 mg of codeine.
This property can be incredibly useful in certain circumstances. If someone is going into surgery, it is easier and safer to inject 0.1 mg of fentanyl than make someone drink 400 mg of codeine. Fentanyl’s potency also means it tends to work faster.
Like all opioid drugs, fentanyl is very addictive. Fortunately, fentanyl treatment and rehab programs are already in place, as pre-existing opioid treatment programs are capable of performing fentanyl addiction treatment.
Fentanyl Addiction Treatment and Rehab Options
The property that makes fentanyl so useful in a hospital setting is unfortunately what makes it ideal for misuse. Higher potency means less product to store and transport for drug dealers. Compared to similar opioids like oxycodone and hydrocodone, dealers can charge the same amount for much less of the substance. A small bag of fentanyl can replace a whole bottle of pills.
For people who need fentanyl addiction treatment, any opioid treatment program (OTP) is already equipped to handle the complex nature of fentanyl rehab.
Inpatient rehab is carried out in a 24-hour hospital setting. Inpatient is most appropriate for people who are an immediate danger to themselves or others. It is also useful for people who need a more structured rehab environment.
Inpatient drug rehab consists of a treatment team with a primary care provider, a psychiatrist, a social worker and counselors with different types of therapy training.
Outpatient rehab occurs outside of a hospitalized environment. Someone in outpatient treatment can function in their regular life and job roles, but they need treatment for opioid misuse.
Outpatient drug rehab typically consists of weekly counseling sessions and classes. Counseling can be individual or group therapy, depending on the needs of the patient.
What is partial hospitalization? Partial hospitalization is a relatively new treatment option for psychiatric care. A partial hospitalization program (PHP) is a hybrid between inpatient hospitalization and outpatient treatment.
A PHP requires patients to attend several days per week (sometimes Monday through Friday) for most of the day. In exchange for regular attendance, the person does not need to enter inpatient treatment, which is a 24-hour on-site treatment situation. Simply put, PHP can be thought of as partial inpatient treatment.
PHPs are suitable for psychiatric illness that does not present immediate harm to self or others. Most insurance plans pay for this type of treatment.
Medication-assisted treatment (MAT), or medication-assisted therapy, is the use of medications to treat opioid addiction. MAT is considered first-line treatment for opioid use disorder and should be considered for every patient with the condition.
Not everyone benefits from MAT, but evidence strongly supports that MAT has better outcomes than drug-free treatment.
The three primary goals of MAT are to conduct daily living activities without:
- Experiencing withdrawal symptoms
- Cravings for opiates
There are several types of medications that are used:
- Methadone is an opioid medication that works to block opioid receptors in the body. Methadone is thought to work similarly to a nicotine patch: It prevents cravings and withdrawal but does not cause pleasurable feelings that encourage addiction. Methadone is obtained daily at methadone clinics.
- Buprenorphine is another opioid medication that helps to prevent cravings and withdrawal without causing pleasure in people with addiction. An advantage of buprenorphine is that it can be obtained at any pharmacy.
- Suboxone is the brand name for combination buprenorphine and naloxone. This formulation prevents diversion, which is when someone attempts to misuse or sell their buprenorphine. A common method of diversion is to crush and inject buprenorphine, which can be prevented by formulating it with naloxone. Naloxone binds to opioid receptors more strongly than buprenorphine, preventing misuse.
- Naltrexone works differently from methadone or buprenorphine because it is not an opioid. Naltrexone blocks opioid receptors completely, so if a person tries to take fentanyl while taking naltrexone, the fentanyl will not work. A disadvantage of naltrexone is that the person must go through withdrawal before they begin taking it.
- Clonidine is not a MAT, but some evidence has shown it to be useful in managing cravings for opioids and other addictive substances.
Co-occurring disorders, or dual diagnosis, is when someone has both a drug addiction and a psychiatric condition like schizophrenia or bipolar disorder. Dual diagnosis rehab requires a treatment team that can address both the addiction and underlying psychiatric condition. Most rehab centers provide this, but not all do. Some are only equipped to treat addiction.
Choosing a Rehab Center for Fentanyl Addiction
If you or someone you know is considering inpatient treatment, consider several factors when making a choice. Many people try to dive into rehab headfirst without asking the right questions and without knowing how to choose a rehab center. Here are some factors to consider:
- Location: People who want family and friends involved may consider inpatient drug rehab nearby. However, some people prefer a more private experience, and inpatient rehab near friends and family could make treatment more difficult.
- Cost: How much does rehab cost? Insured patients should call the number on the back of their insurance to determine if rehab treatment is covered. Cash patients should call the desired clinic to inquire about the cost of inpatient rehab and other types of treatment.
- Treatment options provided: Each rehab center offers different programs and options. Some are outpatient only, some only have inpatient and some have both.
Staff-to-patient ratio: This ratio is an important consideration that many people do not ask about before entering treatment. A typical nurse-to-patient ratio is one to five. Doctors each tend to care for between 25 to 30 patients.
Paying for Fentanyl Addiction Treatment
Many people wonder about how to pay for drug rehab. Paying for drug rehab depends on each person’s unique situation. Many insurance programs cover rehab treatment, so people should always call their insurance carrier to ask about treatment centers in their network and out-of-pocket costs.
Cash patients may be more limited in their treatment locations. However, many states have free and low-income rehab treatment options available.
Will Insurance Cover Rehab?
Does health insurance pay for rehab? Coverage depends entirely on insurance. An insurance company should provide a phone number on the back of the insurance card to call a benefits line. Calling this number will usually put a person in touch with an insurance specialist who can answer this question.
Some people will need to know how to pay for drug rehab without insurance. Before a person gets to this stage, they have usually already met with an addiction specialist or social worker who can help them answer this question. Free and reduced-cost rehab options are available in most states.
Key Points: Understanding Fentanyl Addiction Treatment & Rehab
Information about fentanyl addiction treatment can sometimes seem overwhelming or confusing. Here are some key points to remember:
- Fentanyl is a potent opioid that has become popular in the last few years
- Less fentanyl is required to achieve the same effect as other opioids because fentanyl is more potent
- Addiction to fentanyl is called opioid use disorder (OUD)
- OUD can be treated with inpatient rehab, outpatient rehab or partial hospitalization
- Medication-assisted treatment is the primary treatment for OUD and has very good evidence to support it
- People should know the right questions to ask before choosing a rehab center
- Most insurance carriers pay for rehab, and cash patients may have free and low-cost options available
If you or someone you know is suffering from a fentanyl addiction, The Recovery Village Palm Beach is here to help. We have a variety of treatment plans that can suit your needs and helpful professionals who can find you the best options available. Contact us today to learn more and begin the path to recovery.
DEA Diversion Control Division. “Fentanyl.” 2016. Accessed July 17, 2019.
eMedicineHealth. “Opioid Potency Comparison.” 2019. Accessed July 17, 2019.
MedlinePlus. “Fentanyl: MedlinePlus Drug Information.” 2018. Accessed July 17, 2019.
SAMHSA. “Medication-Assisted Treatment (MAT).” 2015. Accessed July 17, 2019.
Stuart, Gregory; et al. “Empirical Studies Addressing the Opioid Epidemic: An Urgent Call for Research.” Substance Abuse: Research and Treatment, 2018. Accessed July 17, 2019.