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What is Fentanyl? Is It Addictive?

This entry was posted in Fentanyl and tagged is fentanyl addictive, what is fentanyl on January 15, 2023 by Justin Baksh, MS, LMHC, MCAP, Chief Clinical Officer.

Fentanyl is a hot topic in the news and in the medical field, with good reason: It is fueling the ever-increasing overdose death rate, can be found in nearly every type of street drug and has even been made to look like candy to appeal to young adults and children.

Chances are, someone close to you – or close to someone you know – is vulnerable to fentanyl overdose. Nearly one in three Americans (32 percent) report that drug abuse has impacted their family.

What is Fentanyl?

Fentanyl belongs to a class of drugs called opioids. Opioids act on opioid receptors in the brain to block pain signals. They can also produce a high, or euphoria.

Opioids are either derived from the opium poppy plant or synthesized in a laboratory. Naturally occurring opioids are called opiates. They include codeine, heroin, and morphine.

Fentanyl, however, is a synthetic opioid. It was first created in the 1960s as a pain relief medication. Although it acts on the same parts of the brain that natural opioids target, fentanyl is much more potent than naturally occurring opioids. In fact, it is 50 to 100 times more powerful than morphine.

What is Fentanyl Used For?

Fentanyl is produced both for pharmaceutical and illicit purposes.


Pharmaceutical fentanyl is used for the management of pain, whether it be breakthrough pain, pain reduction after surgery or injury, or chronic pain management for cancer patients. Fentanyl is administered through a variety of routes such as skin patches, lozenges, and injections. These fentanyl medications are monitored and maintain the appropriate dosage of the drug to be administered safely, under medical guidance. Most are indicated for the treatment of breakthrough pain in cancer patients.

Illicit fentanyl is not manufactured under the same quality or standards as pharmaceutical fentanyl. It is made on the black market, often in Mexico or China, and brought into the US through various drug trafficking methods. Because illicit fentanyl often varies in potency from batch to batch, buyers do not know the quality or dosage they are receiving. It is also often cut with other street drugs such as heroin, cocaine, and MDMA, without a user’s knowledge. This inconsistency and lack of awareness are major contributors to overdose deaths.

Illicit fentanyl

It’s important to remember that all opioid drugs – both legal and illegal – have a potential for dependency and can lead to opioid use disorder.

How Does Fentanyl Effect the Brain?

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Fentanyl attaches to the brain’s opioid receptors, which regulate pain and emotion. When fentanyl is introduced into the brain, a flood of dopamine is released, dominating the brain’s reward centers. The result is pain reduction and an overwhelming sense of euphoria and relaxation.

It is important to remember that opioid receptors are also responsible for and aid in respiration. High doses of fentanyl slow the breathing rate and can halt it completely, resulting in death. In this way, fentanyl obtained or used illegally is more dangerous than pharmaceutical-grade fentanyl taken as directed.

RELATED: How Drugs Affect the Brain.

Fentanyl Side Effects

Fentanyl affects more than just breathing and diminished pain. Here is the full list of fentanyl side effects.

  • Confusion and decline in cognitive functions
  • Dizziness
  • Drowsiness
  • Euphoria (extreme pleasure/happiness)
  • Nausea and Vomiting
  • Pain Relief
  • Pupillary Construction
  • Relaxation
  • Respiratory Depression and Distress
  • Sedation
  • Unconsciousness
  • Urinary Retention

Fentanyl Street Names

Outside of the medical community, fentanyl goes by many names such as:

  • Apache
  • Blue Dolphin
  • Blue Diamond
  • Blues
  • China Doll
  • China Girl
  • China Town
  • China White
  • Chinese Buffet
  • Crazy One
  • Dance Fever
  • Dragon’s Breath
  • F
  • Fent
  • Fenty 
  • Fire
  • Freddy
  • Friend
  • Fuf
  • Goodfellas
  • Gray Stuff
  • Great Bear
  • Heineken
  • He-Man
  • Jackpot
  • King Ivory
  • Lollipop
  • Murder 8
  • Nal
  • Nil
  • Opes
  • Pharmacy
  • Poison
  • Rainbow Fent
  • Snowflake
  • Tango and Cash
  • TNT
  • White Girl
  • White Ladies

Fentanyl Overdose

Fentanyl and other synthetic opioids are the most common cause of death due to overdose. Fentanyl has no discernible odor, nor does it change the appearance of drugs it is cut into. It is difficult to know when other drugs have been laced with fentanyl, which can lead to a lethal outcome. Even a small dose – as little as two milligrams – can be lethal.

Fentanyl Overdose Symptoms

The signs of fentanyl overdose include:

  • Choking or Gurgling Noises
  • Cold, Clammy Skin
  • Discolored Skin (blue or purple, especially nails or lips)
  • Inability to Communicate/Unresponsiveness
  • Slurred Speech
  • Small (Constricted) Pupils
  • Falling Asleep or Passing Out
  • Slowed, Shallow, or Stopped Breathing
  • Limpness in Arms and Legs
  • Vomiting

How to Treat Fentanyl Overdose

Fentanyl overdose can be treated by a drug called Naloxone; however, this drug needs to be administered as quickly as possible. Naloxone works to control opioid receptors and block opioid drugs. Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine, thus multiple doses of naloxone may need to be administered to reverse a fentanyl overdose.

Remember, Fentanyl may be mixed (laced) into other drugs such as cocaine, heroin, or MDMA. This can lead to a delay in treating a fentanyl overdose, as users or medical personnel aren’t immediately aware of or able to identify the source of the overdose.

Fentanyl Withdrawal Symptoms

Withdrawal from fentanyl is much like any other opioid drug. Detoxification assistance under medical supervision is highly recommended.

  • Anxiety
  • Cold Flashes (Chills)
  • Diarrhea
  • High Blood Pressure
  • Inconsistent Sleep Patterns
  • Increased Heart Rate
  • Intestinal Issues (Diarrhea, Vomiting, et al.)
  • Muscle and Bone Pain
  • Nausea
  • Rise in Body Temperature
  • Severe Cravings
  • Trouble Sleeping (Insomnia)
  • Uncontrollable Muscle Movement
  • Vomiting

Is Fentanyl Addictive?  

As fentanyl impacts the part of the brain controlling emotion and pain and produces a euphoric effect, there is a high risk for dependency when using this drug.

Just as with other opioids, continuous usage of this drug drastically diminishes its effects and sensitivity, causing pleasure receptors in the brain to crave more and more to achieve a high. This continuous pattern of usage can lead to SUD (substance use disorder) and addiction to fentanyl.

Fentanyl Addiction Treatment

Addiction is a disease — a disease in which treatment is often required.

It is within an addiction rehabilitation facility that individuals with SUD have the greatest chance at gaining the knowledge and support to become sober. In these safe spaces, individualized treatment and the construct of an individualized treatment plan can be achieved. There are also many add-ons to support the individualized treatment received at an addiction treatment center, including 12-step programs, therapy modalities, medication management and other peer support groups.

The help is there, and the hope is that those caught up in fentanyl addiction will reach out for it… before it is too late.

RELATED: Is Addiction a Disease?
Inpatient vs. Outpatient Addiction Rehab: Which is Right for You?
Can You Force an Addict Into Rehab?


Centers for Disease Control and Prevention. (2021, September 20). Fentanyl

National Institute on Drug Abuse. (2021, June 1). Fentanyl DrugFacts. National Institute on Drug Abuse; National Institute of Health.

Statista. Retrieved January, 2023, from

United States Drug Enforcement Administration. (2000). Fentanyl.


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