Tag Archives: Fentanyl

Carfentanil Vs Fentanyl: Are They Different?

Despite the similarity of their names, carfentanil and fentanyl are two substances with differing effects on the human body. Though they share a similar opioid base, they have profoundly different medical applications.

Additionally, the illicit use of carfentanil and fentanyl highlight a few more differences between the two–namely, the fact that carfentanil is a significantly more potent substance than fentanyl. This distinction is important in the medical field, as well as illicit use.

Fentanyl Citrate, Duragesic, Sublimaze, Actiq – What Are They?

Fentanyl citrate is the citrate salt of fentanyl, a prescription pain medication that doctors prescribe under the brand names Duragesic, Actiq, and Sublimaze. Fentanyl belongs to a family of drugs called opioids, which include painkillers that suppress the brain’s release of noradrenaline.

Put simply, these substances cause the brain to produce less “wakefulness” neurotransmitters, and the body relaxes as a result. This is a helpful chemical process for killing pain in medical patients. However, the effect is also highly addictive, and opioid addictions are quick to form.

To get a clear perspective of just how powerful carfentanil is, it’s helpful to use related substances to describe a relative scale of potency.

If morphine is a “1” on the scale of potency, then fentanyl falls at around the “100” mark. For a patient to receive the same pain-killing effect that fentanyl produces in a single dose, they would need to have 100 doses of that size of morphine.

While opioids like fentanyl can be invaluable for killing pain, they are highly addictive

The main reason for the potency disparity between these two is the fact that morphine is derived directly from the plant while fentanyl is a further processed, synthetic form of morphine.

Manufacturers extract opium from the poppy plant to produce the basic form of morphine. Since morphine is derived directly from the organic matter, its strength is limited by natural growing factors.

Fentanyl, on the other hand, is synthetically produced through chemical means. Factories producing fentanyl do so for the express goal of making a pain-killing chemical.

While this potentially makes it a more effective treatment in its proper application, it also means fentanyl withdrawal is both more likely and severe.

Are Carfentanil and Fentanyl the Same Thing?

In a comparison of carfentanil vs fentanyl, the two drugs share some basic similarities, but are vastly different in application.

Like fentanyl, carfentanil is also in the opioid family. Studies have shown that there are small differences in how the brain responds to various types of opioids, but they affect the brain in the same basic way.

Both carfentanil and fentanyl are synthetic. Manufactured drugs are often more concentrated forms of the substance they are derived from–which means they are also more addictive.

This means that individuals who abuse the substance may be more likely to experience a fentanyl withdrawal or overdose.

The effects caused by fentanyl are 100 times more potent than those caused by morphine

Since more powerful substances require smaller amounts to reach overdose levels, it is all too easy for an addicted individual to mistakenly overdose on drugs like Duragesic, Sublimaze, or Actiq.

As the potency of the opioids becomes stronger and stronger, as little as a few micrograms could mean the difference between a life and death.

The main difference between carfentanil and fentanyl, however, is that of drug potency.

Going back to the scale where morphine is considered a level “1” in potency, and fentanyl is a level 100, carfentanil would be considered “100 times stronger” than fentanyl.

This means that it is 10,000 times more potent than morphine. Carfentanil’s intense power when compared to morphine makes the perspective incredibly difficult to convey.

It’s important to note that while fentanyl can be found in prescriptions like Sublimaze, carfentanil has no medical application in humans, but sometimes is used as a tranquilizer for herd animals or elephants.

Risks and Fentanyl Withdrawal

As with most substances, the risk involved when using fentanyl or carfentanil rises exponentially, especially in illicit circumstances.

These two substances are so powerful that individuals rarely consciously abuse them. However, drug distributors may mix either opioid with heroin or another substance, in order to produce an exceptionally strong drug.

This paves the way for many complex layers of addiction as users don’t truly know what they’re taking or how much. Additionally, the risk of overdose with even the most minute amount of fentanyl or carfentanil means that mixing them into heroin or other street drugs can be deadly.

As the potency of the opioids becomes stronger and stronger, as little as a few micrograms could mean the difference between a typical dose and an overdose

Fentanyl Withdrawal Symptoms

Whether someone has been using illicit forms of fentanyl or even prescription Duragesic, Sublimaze, or Actiq for a while, their bodies have likely formed a dependence. Full-blown addiction or not, they will likely experience some element of fentanyl withdrawal.

Common fentanyl withdrawal symptoms include:

  • Runny nose
  • Sweating
  • Weakness
  • Insomnia
  • Agitation and anxiety
  • Hot and cold flashes
  • Excessive yawning
  • Nausea and/or vomiting
  • Muscles aches and/or joint pain
  • Stomach cramps and/or diarrhea

Symptoms usually begin within hours of the last dose and dissipate within a week. Days 2-4 tend to be the time when symptoms peak.

Detoxing alone is strongly discouraged and can severely increase not only fentanyl withdrawal symptoms, but is also more likely to lead to relapse.

Getting Help

Opioid addiction can be severe and dangerous. Dependence upon an opioid only worsens over time. Furthermore, developing a tolerance means that a person needs more and more of the substance to get their desired effect.

Fentanyl withdrawal symptoms can make it extremely difficult to stop permanently. This is why it is so important to seek professional guidance in detox and recovery from opioid addiction.

If you think you or a loved one is suffering from a substance use disorder, contact us today. Or, if you would like to read more about substance abuse risks or get some more information, read our blog.

Why is fentanyl so dangerous?

America has been in the midst of an opioid epidemic since early 2017 and fentanyl has been at the forefront of this public health emergency. The amount of deaths caused by fentanyl begs the question why is fentanyl so dangerous?

What is fentanyl?

Fentanyl is a synthetic opioid which is 80-100 times more potent and powerful than morphine. It is a very effective pain reliever initially in use to treat cancer patients. When it was first discovered in the later half of the 20th century, pharmaceutical companies claimed that the drug would not be addictive. However, fast forward to 2016, where 42,000 Americans were killed by the drug. Many understood that the drug posed a major threat to public health and safety.

How does fentanyl work?

Like other opioids such as heroin, fentanyl works by binding to the opioid receptors in the brain. Opioid receptors are primarily responsible for the feelings of pain in the body, hence why it is a very effective pain killer. However, fentanyl also causes the release of dopamine. Dopamine helps encourage the repetition of behavior which we find appealing, such as eating, drinking or in this case, doing drugs. Fentanyl also creates a euphoric high which comes from the immense release of dopamine and pain-killing characteristics of the drug.

Fentanyl can also cause a variety of unpleasant side-effects such as:

  • Drowsiness 
  • Nausea
  • Vomiting
  • Dizziness
  • Insomnia 
  • Heachaches 
  • Diarrhea
  • Loss of appetite

More serious side effects include:

  • Breathing problems (shallow, raspy or no breathing)
  • Low blood pressure
  • Physical dependence and addiction

Fentanyl vs morphine

Fentanyl and morphine are chemically similar and are both opioids with effective pain relief abilities. The difference between the two and between fentanyl and other opioids is the strength of the drug. For example, codeine is a relatively weak opioid in comparison to morphine. Heroin is about two to five times stronger than morphine and fentanyl is approximately 80-100 times stronger than morphine. Not much else is stronger than fentanyl except for carfentanil which is an additional 100 times stronger than fentanyl and is typically an elephant tranquilizer. 

Fentanyl is categorized as a schedule II drug by the Drug Enforcement Agency (DEA) which means it has some potential for medical use but also has addictive qualities. 


Why is fentanyl so dangerous?

Fentanyl is a highly addictive substance. It can cause extreme physical and psychological dependence which can make it impossible to live without. While most people understand that it is dangerous, they may not understand why or how it is capable of killing. Opioids are central nervous system depressants similar to alcohol. It slows brain and nerve function which in turn can slow down critical organ function such as the heart and lungs. An overdose is the body’s adverse reaction to an overwhelming stimulus such as taking too much of a drug. The most common cause of death with fentanyl is a fatal overdose where the CNS becomes overwhelmed and the individual’s lungs stop functioning correctly. 

During the height of the opioid epidemic, drug dealers were lacing marijuana and cocaine with fentanyl without anyone knowing which caused a massive surge in fatal overdoses. Even a very small quantity of fentanyl laced in marijuana or cocaine can cause someone who has never had the drug before to experience an overdose. This is because our bodies build a tolerance or resistance to drugs and as time and usage increases, so will the dosage. 

fentanyl opioid overdoses

Fentanyl and alcohol

Mixing substance is polysubstance abuse and greatly increases the chance of experiencing a fatal overdose. In most polysubstance use cases, the secondary drug of choice is alcohol. Mixing alcohol and fentanyl can be extremely dangerous as they are both strong central nervous system depressants and the combined enhanced effects of the two drugs can overwhelm the body’s critical organs. The overwhelming depressant effects can cause breathing to completely stop and prevent oxygen from being circulated around the body. Even if the overdose does not become fatal, it can cause permanent brain and organ damage. 

How long does fentanyl stay in your system?

Fentanyl has a half-life of 8-10 hours which means it will take 8-10 hours for the initially ingested amount of fentanyl to reduce by 50%. In other words it will take 8-10 hours for 10mg to effectively reduce to 5mg in your body. While the half-life is only 8-10 hours, fentanyl can be detected in the body via blood, urine and hair tests much longer after that. 

why is fentanyl so dangerous


Why is fentanyl so dangerous? It is a highly addictive and powerful drug. Very small amounts are frequently in other drugs now and increase risk of overdose and death. Fentanyl addiction is difficult to overcome alone, if not entirely impossible for most. Withdrawal symptoms are severe and require professional treatement.

Most addiction is the result of mental health issues or vice versa. This is a co-occurring disorder. With co-occurring disorders, it is important that both the addiction and mental health issue be treated. Whether someone is coping with mental health and addiction, or just one, working with a professional will ensure that you receive the proper treatment you deserve. If you or a loved one is struggling with addiction, please contact us today.

The Dangers of Fentanyl Patch Abuse: Know the Signs

One of the most widespread problems when it comes to addiction and overdose deaths in America is fentanyl. What is fentanyl? This substance is a synthetic opioid similar to heroin, but capable of producing much more potent effects.

A sample of fentanyl could be as much as 100 times more powerful than heroin, and the lethal dose is much smaller than that of heroin. Some drug manufacturers provide fentanyl medications to ease certain types of pain, particularly chronic pain that hasn’t responded to other treatment methods.

It’s possible to take fentanyl:

  • Orally with a pill
  • Through an edible product such as a lollipop or lozenge
  • With a transdermal patch

Unfortunately, some people have started abusing fentanyl patches because of their potency and viability compared to other forms of opioids like heroin. It’s imperative for anyone with a valid prescription for any type of fentanyl-based medication to take precautions to prevent others from using or having access to it.

Coming into contact with the sticky side of a transdermal fentanyl patch can lead to serious medical issues. Overdose is one of those risks, especially if a child or a person with little tolerance for narcotics touches the patch.

Risks of Fentanyl Exposure

How long does fentanyl stay in your system? That generally depends on the delivery system. An injected dose will be very potent and fast acting, but may not last as long as a dose taken orally.

Fentanyl patches generally release a low dose of fentanyl into the bloodstream over several days. Duragesic, the leading manufacturer of fentanyl patches in the U.S., reports its patches last for about three days before they require replacement.

Unfortunately, it is very easy to manipulate these patches for enhanced effects. Therefore, some people are abusing them in lieu of street heroin. Others simply do not realize that they can be more dangerous than street heroin because they are technically legal with a prescription.

How Do People Abuse Fentanyl Patches?

A fentanyl patch is similar to an adhesive bandage, but the underside has a gel coating that contains the fentanyl. Some people who misuse fentanyl patches will remove the gel and immediately ingest the entire dose at once. This is equivalent to consuming a three-day supply instantly. Others may apply multiple patches at once to absorb more of the drug.

Some people remove the fentanyl gel from patches and combine it with water or melt it down to inject it directly into the bloodstream. It’s also possible to chew on the patches to release the layers of fentanyl quickly; the mucous membranes of the mouth will absorb it into the bloodstream. Fentanyl is incredibly potent, and any of these methods carries a significant risk of overdosing.

When fentanyl enters the bloodstream directly or through the digestive system after a person chews on a patch, the risk of overdose increases dramatically. The body cannot process fentanyl well in these circumstances because it absorbs it too rapidly – compared to transdermal absorption.

Even used patches can still be fatal after a few days. A fentanyl patch may still contain up to 50 percent of the original amount of the drug after three days.

Signs of Fentanyl Overdose

Opioid addiction is incredibly powerful and entails some of the most severe withdrawal symptoms of any form of substance abuse. Fentanyl withdrawal can entail:

  • Hallucinations
  • Extreme drug cravings
  • Musculoskeletal pain
  • Nausea
  • Confusion
  • Irritability
  • Several potentially fatal medical conditions

Some individuals may attempt to take more fentanyl than they can handle to stave off these symptoms, potentially opening the door to an overdose.

Some of the early signs of fentanyl overdose can include:

  • Extreme fatigue
  • Unresponsiveness
  • Loss of balance and coordination
  • Dizziness
  • Confusion
  • Difficulty breathing

Since many individuals prefer to use alone or in seclusion, there may not be anyone around to intervene in the event of an overdose.

Fatal Risks of Overdosing

A fentanyl patch may cause an overdose on its own merit, or an individual may manipulate the patch for a more potent dose and then experience an overdose. Any overdose has the potential to be fatal, and it’s imperative to seek medical treatment immediately if you or someone you know begins to display the signs of overdose.

In particular, a few very dangerous symptoms to stay vigilant for include:

  • Slowed breathing
  • Unconsciousness
  • Extreme sweating
  • Rapid heart rate
  • Muscle cramping

Falling asleep under the effects of fentanyl is also extremely dangerous, especially after taking a large or concentrated dose. The respiratory system naturally relaxes and breathing slows during sleep. Since fentanyl can easily cause respiratory depression, it’s possible for a user to fall unconscious and slip into respiratory failure without anyone else noticing.

Signs of Fentanyl Addiction

Many individuals receive prescriptions for fentanyl for legitimate medical reasons. Unfortunately, these medications are very powerful and easily habit forming.

It’s essential for anyone who takes fentanyl medications to heed the instructions from their prescribing doctors very carefully and to only take these medications exactly as directed. It’s also vital to remember that following a prescription’s directions to the letter isn’t a foolproof way of avoiding fentanyl addiction (or overdose).

A person who develops an addiction to fentanyl may start exhibiting strange behavior, and loved ones should pay close attention to the warning signs of fentanyl patch abuse. Some of the signs could include:

  • Using more than the prescribed dose.
  • Appearance of damaged or destroyed fentanyl patches around the patient’s home or in trashcans: This could indicate that someone is opening the patches to remove the gel for a stronger dose.
  • Wearing more than one fentanyl patch at a time: There is no reason to ever apply more than one patch, even for acute pain. Some people mistakenly believe they can apply a patch directly to a specific part of the body for more targeted pain relief, but this is generally not the case. Always follow the instructions that accompany any fentanyl prescription.
  • Purchasing fentanyl patches from other people who have prescriptions.
  • Displaying fear of running out of patches.
  • Declining performance at work or in school.
  • Neglecting household duties, chores and basic living needs, like making meals and cleaning clothes.

Your Role

Do you know a friend or loved one who takes a fentanyl medication for a medical issue or has taken it recently? It’s important to stay vigilant for any changes in behavior that might indicate addiction.

A person in the early stages of addiction may be in denial about his or her behavior, but it will be obvious to others who start noticing some of the telltale behaviors associated with addiction.

Intervention and Treatment for Fentanyl Patch Abuse

It’s possible to develop fentanyl addiction simply by taking one’s prescription as directed. Others can propel themselves further into addiction by taking more fentanyl medication than prescribed.

It is imperative to acknowledge the extreme dangers of fentanyl patch abuse to prevent overdose deaths. Additionally, some individuals need to confront their addiction and seek treatment before it’s too late.

Fentanyl Abuse Detox and Rehab

There is no need to wait to hit “rock bottom” before seeking addiction treatment. The sooner a person struggling with substance abuse enters rehab, the better their chances are of getting and staying sober.

Fentanyl is a powerful opioid, and its withdrawal symptoms can be severe. Medically assisted detox is the best way to start the recovery process. An intervention can help get the person to this stage if they will not go willingly.

The thought of entering rehab may be scary, but the alternative is much worse. Detox and rehab are hard at first, but going through the recovery process can potentially save your loved one’s life. Instead of risking addiction and possible death by overdose, it’s crucial to spot and address the early signs of fentanyl patch addiction, and then take appropriate action.

See Our Prescription Drug Fact Sheet

Everything You Should Know About Fentanyl

The opiate epidemic continues to rage across America. One of the main contributors to this problem is fentanyl. Unlike heroin, fentanyl may not be widely known to the public, but it is one of the most dangerous drugs to go from the pharmacy to the streets due to its high potency.

What Is Fentanyl? 

Fentanyl is a synthetic opiate, or opioid. Doctors prescribe fentanyl to cancer patients to manage their pain. Cancer patients use fentanyl when they are suffering from severe bouts of breakthrough pain while receiving regular pain management. These patients develop a high opiate tolerance and require fentanyl as a supplemental pain reliever. Fentanyl, like other opioids, binds to opioid receptor sites in the brain and spinal cord. This reduces the pain signal to the brain and changes the way a person experiences pain. Fentanyl is available in a variety of forms. Doctors can prescribe it in patches, tablets, and films. Cancer patients often use fentanyl patches that require constant attention and care.

Fentanyl Side Effects 

Closely related to heroin and other opiates, but far more potent, fentanyl is a highly addictive drug. When ceasing usage of fentanyl, severe withdrawal symptoms can appear. The withdrawal symptoms can include restlessness, runny nose, watery eyes, nausea, sweating, and muscle aches. For this reason, physicians prescribe fentanyl for very specific uses, and it is dangerous if not taken exactly as directed.

Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, dry mouth, and headache are all common side effects of fentanyl. Redness, itching, and irritation may occur at the application site if the patient is using fentanyl patches. More serious side effects include anxiety, depression, unusual dreams, agitation, confusion, hallucinations, swelling, stomach pain, chest pain, difficulty urinating, irregular heartbeat, loss of appetite, unusual tiredness, uncontrollable shaking of a part of the body, and weight loss. Seek immediate medical attention if someone is experiencing fainting, seizures, or extreme drowsiness.

Fentanyl Strength Comparison 

Many people wonder about morphine vs. fentanyl; which is stronger? Fentanyl is much stronger, and is, in fact, one of the most potent opioids in existence. In comparison to other opiates, it can be 10 to 100 times stronger. This fact, combined with its cheap manufacturing cost, makes it extremely dangerous. Here’s how 10 mg of morphine taken orally compare to the following drugs:

  • Hydrocodone is equal to morphine in potency.
  • Oxycodone is equal to 1.5 doses of morphine, or 6.67 mg.
  • Methadone (acute) is equal to 3 to 4 doses of morphine, or 2.5 to 33 mg. Methadone (chronic) is equal to 2.5 to 5 doses of morphine, or 3.33 mg.
  • Heroin is equal to 4 to 5 doses of morphine, or 2 to 5 mg.
  • Hydromorphone is equal to 4 doses of morphine, or 1.5 mg.
  • Oxymorphone is equal to 3 to 7 doses of morphine, or 1 mg.
  • Buprenorphine is equal to 40 doses of morphine, or 0.4 mg.
  • Fentanyl is equal to 50 to 100 doses of morphine, or 0.1 mg.

Different Brands Of Fentanyl 

There are several brands of fentanyl, and each manufacturer produces different forms of the drug for a different intake method. Drug companies manufacture fentanyl for cancer patients, many of whom must be able to take fentanyl in quickly to manage their pain. None of these brands is interchangeable. They are very high dose and can be fatal in children. All types of fentanyl are extremely addictive and have a high chance for overdose.


Abstral is an oral fentanyl tablet. The patient allows the tablet to dissolve under the tongue. Abstral is available is six strengths. Combined with another non-fentanyl narcotic, physicians use it to manage breakthrough pain in cancer patients. The narcotic used with fentanyl is taken in regular doses, while Abstral is for response to breakthrough pain.


Actiq is a transmucosal lozenge of fentanyl citrate used by cancer patients. To obtain Actiq, a patient must register to the Actiq REMS Program. When registering, patients fill out paperwork stating that they recognize the health risks and benefits of the drug.


Fentora is tablet that dissolves between cheek and tongue. The tablet begins a reaction when it comes in contact with saliva, producing carbon dioxide, and the fentanyl is absorbed via the mucosa. Like Actiq, Fentora is only available through a special program. When patients register with Fentora REMS or the FOCUS Program, they are agreeing to all the benefits and risks of the drug.


Onsolis is a buccal-soluble film. The film releases fentanyl when it comes into contact with saliva, releasing an amount of fentanyl in relation to the surface area on the film. Onsolis is only available through the same programs as Fentora.

The Dangers of Fentanyl 

Fentanyl is one of the largest contributors to the opioid problem. The cheap, potent drug has a heroin-like high that makes it highly sought after among drug users. Many heroin users are moving on to fentanyl to increase the high. Mexican cartels started trafficking it across the border to fill consumer demand. However, due to the potency of fentanyl, even an experienced heroin user can easily overdose. Not suspecting just how strong the drug is, hundreds of people without the opiate tolerance of a cancer patient take fentanyl and die of overdose every year. This number has been dramatically increasing in the past few years. Mexican cartels are even selling fentanyl as oxycodone or mixing it with cocaine and heroin.

Fentanyl Overdose 

An overdose of fentanyl is very fast-acting, due to the potency of the drug. Someone overdosing from fentanyl will suffer respiratory depression very quickly. The fentanyl causes the muscles around their lungs to stop moving. To reverse a fentanyl overdose, the victim needs a dose of naloxone. One dose may not be enough, depending on the situation. EMTs and other emergency responders now carry more naloxone due to the increase in fentanyl overdoses in recent years. Access to naloxone is a key factor in preventing death of fentanyl overdose.

Fentanyl Detox And Rehabilitation

Withdrawal from fentanyl begins 12 to 30 hours after the final dose. However, for someone using the fentanyl patch, the half-life is 72 hours, because the patch will increase the amount of fentanyl in the bloodstream for 12 to 24 hours. The detox timeline depends on other factors such as the level of dependency, dosage, length of addiction, and whether the patient abused other drugs and alcohol as well.

Once the fentanyl is out of the bloodstream, withdrawal symptoms will begin. Fentanyl withdrawal symptoms include yawning, sweating, restlessness, tearing up, runny nose, chills, backache, stomach cramps, joint or muscle pain, and goosebumps. The symptoms for fentanyl withdrawal are like those of most opioids. The symptoms are rarely life-threatening, but are extremely uncomfortable, especially considering the potency of fentanyl in comparison to heroin and other opiates.

The detoxification process will last five to 10 days, peaking at a few days in, and then leveling off. The safest and least uncomfortable way to go through withdrawal is through medically assisted detox. Medical professionals can assist in the process and relieve the painful symptoms. A medical professional will also manage the tapering down of opioids in the system. Quitting cold turkey is dangerous, so tapering down the dosage of opiates is recommended. Someone in detox will change from fentanyl to less potent opiates during tapering, such as methadone or morphine.

Seek Help Recovering From Fentanyl 

Recovery does not need to be a lonely process. Reflections Recovery Center, a fentanyl rehabilitation center, can help those struggling with fentanyl and other opiate addictions. Reflections is a male-only rehabilitation center that is not the typical rehab facility. One of its focuses is outdoor activity, and lots of it. The center offers opioid addiction treatment, using safe and reliable methods to promote recovery from this dangerous and deadly drug.

Learn About Our Detox Program