Fentanyl Detox

What fentanyl withdrawal is, and why it feels different

When the body has adapted to fentanyl and use stops or drops sharply, withdrawal follows. Uncomplicated opioid withdrawal is generally not life-threatening the way alcohol or sedative withdrawal can be, but it isn't risk-free. In some cases, vomiting and diarrhea can lead to dehydration. Heart or other medical conditions, pregnancy, or withdrawing from more than one substance can make it riskier. Withdrawal can also be so uncomfortable that it is a big reason many people find it hard to stop using opioids.

Fentanyl is a synthetic opioid. The CDC describes it as up to 50 times stronger than heroin and 100 times stronger than morphine. Doctors prescribe fentanyl for severe pain, such as after surgery or for advanced cancer. It is also made illegally and pressed into fake pills or mixed into other drugs, and many people do not know their drugs contain it.

Signs of fentanyl dependence

Fentanyl's strong effects can lead to physical dependence quickly. Common signs include:

• Strong cravings for fentanyl
• Needing more to feel the same effect, which raises overdose risk
• Trying to cut down or stop and not being able to
• Letting work, family, or other responsibilities slide to get or use fentanyl
• Feeling sick when it wears off

Fentanyl withdrawal symptoms

Fentanyl withdrawal produces the same family of symptoms as other opioid withdrawal, often at full strength. The National Institute on Drug Abuse lists fentanyl withdrawal symptoms including muscle and bone pain, cold flashes with goose bumps, cramps, diarrhea, vomiting, restlessness, involuntary leg movements, and trouble sleeping. Pain that fentanyl had been masking can also come back.

Medical detox for fentanyl at Spring Grove Recovery

At Spring Grove Recovery, withdrawal management is medically supervised, with 24/7 nursing support. Qualified medical providers evaluate medication needs and tailor medical care to each person, and withdrawal symptoms are monitored rather than simply endured. Length of stay is determined by medical necessity and is individualized.

What supervised withdrawal management involves

Supervision means catching problems early and treating symptoms as they come, not waiting them out. Discharge planning begins on arrival as part of the treatment plan. Care includes:

• Regular checks of vital signs, hydration, and withdrawal symptoms by nursing staff
• Medication for specific symptoms such as nausea, diarrhea, muscle aches, anxiety, and sleep problems, when a qualified medical provider determines it is appropriate
• Fluids and easy-to-digest food to counter dehydration and nausea
• Rest, gentle movement, and a calm daily routine while the body readjusts
• The start of a plan for what comes after detox

Medication-assisted treatment for fentanyl

Medication-assisted treatment (MAT) pairs FDA-approved medication with counseling and therapy. The National Institute on Drug Abuse states that "medications are the standard of care for opioid use disorder," and that the medications approved by the FDA (methadone, buprenorphine, and naltrexone) "can reduce the risk of return to drug use and of overdose death." Medication is not trading one addiction for another. It is prescribed and monitored by qualified medical providers as part of a treatment plan.

Spring Grove Recovery offers medication-assisted treatment including Suboxone, buprenorphine (Subutex), and Vivitrol, where qualified medical providers determine it is appropriate.

Overdose risk after fentanyl detox

One of the greatest dangers comes after withdrawal ends. Tolerance drops once someone stops using. An amount that was tolerated before detox can be enough to cause an overdose afterward. SAMHSA's overdose-prevention toolkit lists using after a period of abstinence, when tolerance is lower, as an overdose risk factor. Street fentanyl is unregulated, so the strength of any pill or powder is unknown and can vary widely, which makes that risk harder to judge.

If you think someone is overdosing, give naloxone if you have it and call 911. Naloxone can reverse an opioid overdose. In Colorado you can get it at a pharmacy without a prescription, either over the counter or through the pharmacy's standing order. If you're thinking about suicide or self-harm, call or text 988.

Preventing relapse after fentanyl detox

Preventing relapse starts during detox and continues long after it. Relapse prevention therapy is part of care at Spring Grove Recovery. A relapse prevention plan covers:

• Triggers: the people, places, and feelings that bring on cravings, and how to handle them
• Coping skills: ways to manage stress, such as breathing exercises, mindfulness, and journaling
• Support: recovery groups and regular contact with a counselor
• A plan for hard moments: trusted contacts, crisis numbers, and what to do when cravings hit
• Medication: whether medication-assisted treatment continues after detox, decided with a qualified medical provider

Treating mental health alongside fentanyl use

Many people living with fentanyl use disorder also live with anxiety, depression, trauma, or another mental health condition. Spring Grove Recovery treats co-occurring conditions as part of the same treatment plan, rather than something to address later. These include anxiety, depression, post-traumatic stress disorder (PTSD), bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and personality disorders.

• Mental health and addiction care planned together
• Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT)
• Trauma therapy and trauma-informed care
• Medication needs evaluated by qualified medical providers