Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body’s opioid receptors, which are found in areas of the brain that control pain and emotions. According to Medical News Today, the difference between a therapeutic dose and a deadly dose of fentanyl is very small. In fact, according to the same source oral formulations of fentanyl contain an amount of the drug that can be fatal to a child.
Fentanyl use can result in accidental death even with just one dose, especially common in cases where it is taken unknowingly after being cut into a more mainstream recreational drug or manufactured as a counterfeit pill. Given the drug’s heavy sedative effect breathing can slow or stop. A condition called hypoxia in which the brain is starved for oxygen can occur. Hypoxia can lead to a coma, brain damage that can be severe and permanent, or death.
Signs of an overdose include:
- general slowing of respiration including heart rate and breathing
- trouble walking or talking
- faintness and/or confusion
- severe sleepiness
- cold, clammy skin
- unresponsiveness or unconsciousness
Although overdose may be treated through administration of naloxone, in a moderate to severe overdose coma and death can occur in minutes.
After taking opioids many times, the brain adapts to the drug, diminishing its sensitivity, making it hard to feel pleasure from anything besides the drug. As with any addiction, drug seeking and drug use takes over lives.
According to the National Institute on Drug Abuse, addiction is a severe long term side effect of fentanyl use, primarily because withdrawal is difficult. Withdrawal symptoms can begin as soon as a few hours after last use of the drug. This presents particularly daunting problems for people who have been exposed unknowingly and become addicted in the process.
Symptoms of withdrawals include:
- muscle and bone pain
- sleep problems
- diarrhea and vomiting
- cold flashes with goose bumps
- uncontrollable leg movements
- severe cravings
NIDA reports there are medicines being developed to help ease withdrawal from fentanyl and the FDA has approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms.