What is Fentanyl?
Fentanyl is a potent opioid medication that is classified as a Schedule II drug by the Drug Enforcement Administration, meaning it has a high potential for misuse.1, 2 Licit fentanyl is used for pain relief following surgery and, occasionally, for other severe pain situations. Like other opioid drugs, fentanyl is capable of producing a rewarding, euphoric sensation by increasing the levels of dopamine in the brain.1
People who repeatedly seek to achieve these effects may develop an addiction. If they quit fentanyl, they may experience fentanyl cravings, or an overwhelming desire to use fentanyl.2
What Are Fentanyl Cravings?
When people who misuse fentanyl try to stop using it, they frequently experience intense cravings or urges to use fentanyl, despite the negative consequences associated with the drug.2 Opioid cravings like fentanyl stem from having developed a physiological dependence on fentanyl, which is a driving factor of addiction.2, 3
Triggers, the cues that can lead a person to desire to use fentanyl again, are one cause of cravings. They can be events, people, or places. For many people, a trigger can be as simple as going to a location where they used or obtained drugs in the past.6
Fentanyl withdrawal symptoms can occur at varying times depending on the person.4 However, some people may continue to experience withdrawal symptoms like fentanyl cravings long after they quit.
The length and severity of these cravings vary from one person to another and depend on a number of factors, including:4
- The typical dose that was taken.
- How often the drug was used.
- How long it was used.
- Individual factors, such as physiology and psychology.
- Routh of administration (how the drug was taken).
Treatment for Fentanyl Cravings
There are various ways to help a person struggling with fentanyl cravings, including medication and behavioral therapy. However, as with any addiction treatment, it should be individualized to support each person to ensure appropriate treatment and recovery interventions.7
Treatment for fentanyl addiction involves dealing with cravings as part of the recovery process. Types of treatment programs include:9
- Inpatient recovery programs: Inpatient or residential programs are live-in programs where the user often undergoes medically assisted detox and then transitions into a treatment program that includes individual and group counseling, 12-step meetings, medical supervision, and aftercare planning. Programs can last from a few weeks to a few months. People who are working to overcome fentanyl addiction and cravings can receive a high level of support and care in a substance-free environment.
- Outpatient recovery programs: Outpatient recovery programs also include individual and group counseling but do not require the person to live at the treatment center. The amount of time needed to dedicate to outpatient recovery will depend on the intensity of the particular outpatient program. In general, counseling appointments and other outpatient treatment sessions are scheduled for a few hours a day, several days a week, and the person returns home after that day’s treatment sessions have concluded.
- Dual diagnosis: Some people seeking treatment for fentanyl addiction also suffer from a co-occurring mental health disorder, such as depression, bipolar disorder, or schizophrenia. These people have what is known as a dual diagnosis and need a treatment program that can address both the addiction and the mental health disorder in an integrated, holistic way.
- 12-step meetings: Twelve-step recovery meetings are a very important aspect of maintaining a drug-free lifestyle after completing inpatient and/or outpatient treatment for drug addiction. Narcotics Anonymous (NA) is the most well-known of these groups that can help a person recover from fentanyl addiction. People can discuss their cravings at meetings, receive tips for how to manage cravings, and call their sponsor if they feel an urge to use.
- Group counseling: Group counseling has been shown in research studies to be effective with people in substance misuse treatment. Group therapy provides support to other people who are going through the same issues in recovery from drug abuse. The social interaction in a healthy, drug-free setting is also beneficial to people who typically have isolated themselves during active addiction or have associated predominantly with other people who were using drugs.
- Individual counseling: Individual therapy for substance misuse treatment typically involves cognitive behavioral therapy, which includes learning new ways of thinking and behaving to help avoid falling into old patterns that can lead to drug use. These new patterns of thinking can help a person in recovery to learn ways to avoid relapse.
Cognitive behavioral therapy (CBT) is one of the most common behavioral therapies used to treat substance use disorders and help people manage cravings.5 The major focus of CBT is to identify and understand the thoughts and behaviors that lead a person to continue to use fentanyl and other drugs.5
In CBT, participants are taught techniques to “recognize, avoid and cope” as a way to identify triggers, avoid them and cope with unavoidable triggers.
Contingency management is also used in some therapy programs, which uses incentives and rewards when a person exhibits positive behaviors that support their recovery.8
Medications Used to Curb Fentanyl Cravings
Medications can be used to help a person detox from fentanyl, help ease cravings during withdrawal, and also be useful in long-term recovery from fentanyl addiction.
- Buprenorphine is an opioid medication that can be used to help a person detox from fentanyl, avoid uncomfortable withdrawal symptoms, and control cravings. For the treatment of opioid dependence, buprenorphine is available as a sublingual tablet and, in combination with the opioid antagonist naloxone, as the brand formulation known as Suboxone. Until fairly recently, buprenorphine was marketed under the trade name Subutex.10
- Methadone is often used for people who are going through fentanyl withdrawal and can block fentanyl cravings and withdrawal symptoms. Methadone is highly regulated and procedures must be followed in the prescribing and dispensing of it. It can only be given in specially licensed facilities or if someone is in a hospital receiving care for another medical condition.10
- Naloxone can be used as a nasal spray or injection to help reduce cravings.10
Cravings and Relapse
Cravings for fentanyl can lead to relapse if they are not managed properly. Cravings are a normal part of recovery, and a person in recovery can benefit from a relapse prevention plan.
Many recovery programs will help you create an aftercare plan that includes ongoing support after you leave the treatment center. Aftercare can include programs such as 12-step meetings, sober living homes, medication, therapy, or individual and group counseling.
Relapse warning signs can include:11
- Hanging out with people you used drugs with: Many people in recovery can feel lonely and miss the friendships they used to have. They may believe that they can maintain these friendships while remaining sober. But instead of associating with these people, a recovering user should build a new network of sober friends and family.
- Dealing with a crisis: The stress of a crisis can increase the risk of relapse. A plan of aftercare should assume that major crises, such as a death in the family or the loss of a relationship, will happen. In order to avoid letting life events trigger a relapse, a person in recovery should work out a plan in case these types of situations occur.
- Becoming isolated: Apathy can set in after people have been sober for months or even years. They may begin to get bored with their 12-step meetings or think that they no longer get anything out of the meetings. They may begin to isolate themselves, and loneliness can set in, which can trigger a relapse.
- Stopping treatment medications that are used to help reduce cravings and limit the effects of opioids.
Preventing relapse requires a proactive plan for recovery. Continuing to participate in aftercare activities provides a person recovering from fentanyl addiction with help to cope with cravings and avoid relapse when they feel overwhelmed by life events or feel isolated.
Find Fentanyl Rehab Centers Near Me
If you have concerns about your own addiction to fentanyl or are seeking help for a family member or friend, call today. American Addiction Centers’ (AAC) recovery support specialists will help you locate a treatment center in your area based on your insurance coverage.
If you don’t have health insurance, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP (4357) for referrals to low-cost or free programs in your area.