Blog - Beach House Rehab Center
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October 19, 2018

Signs of Fentanyl Abuse

Fentanyl is an extremely potent, synthetic opiate analgesic widely considered to be one of the deadliest, most unpredictable drugs on the market. Its short duration “punch” was originally designed to help people manage pain as part of post-operative care, especially breakthrough pain— the pain that periodically surfaces in patients already using another opiate.

Although the effects of most illicit and legitimately prescribed fentanyl wear off quickly, time-release versions of the drug offer stronger, longer lasting pain relief. The fentanyl lollipop and transdermal patch both offer time-release treatment and, as a result of their efficacy and the powerful euphoria they provide, are popular on a growing black market.

Fentanyl is mass-marketed under brand names including Sublimaze, Actiq, Fentora and Duragesic. When prescribed through legitimate channels, fentanyl is available as a tablet, pill, patch, lozenge and spray. When hustled on the street, it also appears as a fine white powder laced with other illicit drugs or household ingredients and is popularly snorted, injected, smoked, or orally dissolved. Regardless of the form in which fentanyl appears, it remains a national health threat, known for causing fatal overdoses and producing a litany of other life-altering, physically and psychologically debilitating effects.


To better understand the signs and symptoms of fentanyl dependence, it is helpful to first understand the official diagnostic criteria used by mental health professionals. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) is considered the standard diagnostic tool by the mental health community and substance abuse treatment industry. It recognizes opiate dependence (fentanyl dependence, specifically) as a clinically significant disorder when at least two of the following signs and symptoms occur within a consecutive 12-month period:

  • Excessive time, money and effort are spent on activities related to obtaining fentanyl, using it, and recovering from its effects.
  • The affected individual experiences cravings, or strong desires to use fentanyl.
  • Fentanyl is taken in larger, stronger quantities and for a period of time longer than originally intended.
  • The affected individual has a desire to stop, or at least reduce, fentanyl abuse but is unable to.
  • As a direct result of chronic fentanyl abuse, the affected individual is not able to function adequately at home, work, school, or in other significant relationships.
  • Despite the intensifying problems caused by fentanyl abuse, the affected individual continues using the drug.
  • The affected individual withdraws from work, school, recreational or other opportunities and responsibilities in order to keep using fentanyl.
  • The affected individual continues using fentanyl despite obvious dangers that arise, such as driving while intoxicated.
  • The affected individual develops a tolerance for the drug and needs greater and stronger quantities to achieve the same high produced by earlier use.
  • Fentanyl use continues unabated despite obvious physical and psychological problems.
  • Withdrawal symptoms occur once fentanyl use stops, even if only for a short period of time, or when dosage is decreased.

In many fentanyl-dependent people, most, if not all, of the aforementioned signs and symptoms are apparent. Even in cases of casual recreational use, what usually begins as one or two signs/symptoms quickly spirals out of control and meets the full diagnostic criteria.  


Fentanyl dependence involves the psychological and behavioral dysfunction characteristic of other hard-core drugs. Although many people start using fentanyl with the relatively harmless intention of escaping from emotional or physical pain, trauma, or distressing life events, the drug’s sheer potency soon takes over and renders its victims increasingly irrational. Many are willing to take potentially deadly risks in order to sustain the same fleeting “high.” Over time, this leads to criminal or dangerously impulsive behavior that may manifest in the following ways:

  • Acquiring fentanyl through legitimately prescribed patients or trading with co-workers, friends, or classmates
  • Using social media or other internet connections to locate “safe” dealers
  • Theft of credit cards, cash, or other items in order to sustain a burgeoning habit
  • Associating with street chemists and other criminal aspects of hard-core drug culture
  • Sleeping all day, and withdrawing from social and professional responsibilities and/or commitments
  • Pathologically lying or exhibiting other deviant behaviors in order to avoid being exposed as fentanyl-dependent
  • Experiencing suicidal ideation, extreme anxiety, or clinical depression
  • Paralyzing fear of imprisonment or other legal consequences
  • “Anhedonia” (the loss of ability to experience pleasure and enjoy life)
  • Mental disorientation and increasing cognitive deficits


If you or someone you love is struggling with fentanyl addiction, consult a substance abuse professional today. Fentanyl is a killer that knows no social, professional, economic, religious, or racial boundaries. It can affect anyone, at any time, regardless of whether or not there is a known genetic proclivity for addiction or history of prior use.

Also remember that fentanyl overdose is a medical emergency requiring immediate treatment at a hospital emergency room. If you’re at risk of overdose, act now by seeking treatment, which is your best prospect of recovery.

For more about fentanyl addiction and recovery, check out these related articles:


The International Journal of Drug Policy. Fentanyl in the US Heroin Supply: A rapidly changing risk environment. Aug, 2017.

The Journal of Pain. The Fentanyl Story. Dec, 2014.

Indian Journal of Anesthesia. Transdermal fentanyl patch in post-operative pain management: Is it justified? Aug, 2017.

Journal of Emergency Nursing. Intravenous Fentanyl: Understanding and Managing the Risk. September, 2014.