Fentanyl Withdrawal Medication
Fentanyl is a powerful synthetic opioid that shares many characteristics with morphine. Here's what you need to know about withdrawal medication.
Fentanyl is a powerful synthetic opioid that shares many characteristics with morphine, but is 50–100 times more potent. It is a Schedule II narcotic and is prescribed to treat severe pain, but it is also found on the street as a heroin additive.1
Quitting fentanyl cold turkey can lead to dangerous complications. A withdrawal treatment program can help you detox safely under the supervision of medical professionals. Medical staff at these programs can prescribe medications to help ease the uncomfortable symptoms of withdrawal.
Your doctor can also help you slowly taper your dose and prescribe medications to make the process bearable.
Should You Go Cold Turkey?
The idea of withdrawal in the comfort of home may sound appealing. But it can be risky.
For one thing, many people experience mild to severe anxiety and agitation during detox, which can be very difficult to handle without help. Other unpleasant symptoms include nausea, vomiting, and insomnia.3
Further, people who use fentanyl daily or consistently develop a tolerance to it. 3 This means they have to take increasingly larger doses to achieve the desired effects. According to the World Health Organization, detoxification from opioids can decrease tolerance and increase the risk of overdose if someone relapses and uses the same dose as before.
A fentanyl withdrawal treatment center can keep you away from temptations and temper cravings with medications. You can also receive care for medical or mental health problems and learn how to rebuild your life without drugs.
Centers that provide help for fentanyl withdrawal often offer a medically assisted detox program. For most people starting recovery, detox is the first step. Fentanyl detox should be immediately followed by a comprehensive addiction treatment program that uses behavioral therapies.
Examples of common medications used in opioid detox and addiction treatment include:
- Methadone. This is a long-acting opioid that can dampen withdrawal symptoms and cravings. It does not produce a pleasurable high when taken correctly. Only approved outpatient treatment clinics can dispense it.2
- Buprenorphine. This opioid medication can also lessen cravings without producing a “high.” Suboxone is a newer medication that contains both buprenorphine and naloxone. It is FDA-approved, and specially certified physicians can prescribe it.2
- Clonidine. This is a blood pressure medication that can reduce some symptoms of withdrawal, such as anxiety, piloerection (goose bumps), and high blood pressure. 4
- Benzodiazepines. These are sometimes used to treat mental symptoms of withdrawal, such as anxiety, paranoia, and agitation. 4
- Loperamide (Imodium) and anti-emetic medications. These can be used to treat diarrhea, nausea, and vomiting. 4
Withdrawal Treatment Programs
There are several different types of fentanyl withdrawal treatment programs. No single treatment option works best for everyone. The right treatment program for you will depend on many factors, including:
- How long you have been using.
- How much you have been using.
- Whether you also use other drugs or alcohol.
- The presence of mental health issues.
- Pre-existing medical conditions.
- Where you live and how far you can travel.
- Your financial and legal situations.
- Whether you have insurance.
If you do have insurance, you may find that some treatment options are fully or partially covered. If you don’t carry insurance, there are many other ways to finance your addiction treatment.
The different types of treatment facilities for fentanyl detox include:
- Hospital setting. People with a history of severe withdrawal symptoms or a pre-existing medical condition may be safest in a hospital setting where they can be continuously monitored.
- Inpatient detox. Inpatient programs allow people to live at a facility where they are supervised by professionals and can receive treatment for drug addiction. These centers often provide medically assisted detox support.
- Outpatient detox. Specialized detox and recovery programs are also available on an outpatient basis, meaning that you continue to live at home while visiting a center a few times per week. These include opioid treatment programs that dispense withdrawal medications such as methadone and buprenorphine.
- Doctor’s office. Some people benefit from outpatient detox assistance from their primary care doctor or psychiatrist. This is similar to an outpatient detox center. However, in this case, you will not be provided with group therapy but instead simply meet with your doctor a few times per week to ensure that the detoxification process is going smoothly.
Tapering Off Fentanyl
Tapering off means very gradually taking smaller doses of a drug until you are finally ready to stop. Rather than shocking your body by abruptly stopping your fentanyl use, you can find someone to help you taper the dose.
The process is best accomplished with the help of a doctor or other professional. Your family physician, pain management specialist, or psychiatrist can help you taper off fentanyl on an outpatient basis. Fentanyl detox treatment centers and substance abuse programs can also help you slowly taper your dose.
Only a physician can decide whether fentanyl tapering is right for you.
Most opioid detox programs will first switch you to a long-acting opioid such as methadone or buprenorphine. If you were prescribed fentanyl, some programs may allow you to taper off with increasingly smaller prescribed doses. Tapering fentanyl is not always the best option and may suit some people better than others. Only a physician can decide whether fentanyl tapering is right for you.
Your doctor will make a decision that is based on many factors, such as your sex, age, length of addiction, and history of multi-substance abuse. When you enter a detox facility, your medical provider will perform a comprehensive mental and physical assessment and then decide which fentanyl withdrawal medications are best for your unique circumstances.
- National Institute on Drug Abuse. (2016). Fentanyl.
- National Institute for Drug Addiction. (2016).What Are Treatments for Heroin Addiction?
- Food and Drug Administration. (2003). Duragesic (Fentanyl Transdermal System).
- Schuckit, M. (2016). Treatment of Opioid-Use Disorders. New England Journal of Medicine 375:357-368.