Opioid Crisis Report: Need for Fentanyl Detox Increases

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Last month, public data posted by Google Trends showed that for the third time in the past three years – and for the entire month of September – online searches for the phrase “fentanyl detox” outpaced online searches for the phrase “heroin detox.”

This means the dire warnings issued by the DEA about the influx of fentanyl into the U.S. over the past several years and the potential negative impact of fentanyl on people who use drugs were not alarmist at all, but wholly warranted. Rates of fentanyl addiction – a specific subtype of opioid use disorder (OUD) – have increased rapidly since 2018, and now individuals who developed OUD using fentanyl as a result of the surge in availability need help and support entering recovery.

That’s why they’re online, typing in the search term “fentanyl detox.” They want to move out of the cycles of opioid addiction and move forward to a life without drugs.

Perhaps their loved ones are online searching. In any case, each search means there’s someone out there who knows something need to change, in their life of the life of a loved one. We know opioid addiction disrupts relationships, impairs school and work performance, and causes physical, psychological, and emotional problems.

Opioid addiction also includes a very real risk of fatal overdose – one which fentanyl exacerbates dramatically.

That’s another reason these individuals online – whether they have OUD or a loved one has OUD – search for fentanyl detox. They’ve read the warnings and they know the dangers.

They know they need help, and that’s what they’re looking in these searches. They know they need a medically monitored detox program with clinical staff experienced in fentanyl detox, which means a program well-established, reputable treatment center with a proven track record and that focuses on opioid use disorder and opioid detox.

The Facts on Fentanyl

We’ll start with the data from the DEA we mention above. We retrieved these figures from their publication called One Pill Can Kill. That title may sound extreme, but once you read the facts, you’ll understand why it’s not extreme, but accurate.

Between May 23rd and September 8th, 2022, the DEA:

  • Seized 10.2 million fentanyl pills
  • Seized 980 pounds of fentanyl powder
  • That’s the equivalent of 36 million lethal doses of fentanyl

Now we’ll offer this reminder about exactly why fentanyl is so dangerous:

  • It’s 50 times stronger than heroin
  • It’s 100 times stronger than morphine
  • One dose is enough to cause fatal overdose

Here’s what the DEA wants everyone to know about how drug traffickers and dealers distribute fentanyl:

  • They produce large numbers of fake pills and sell them as legitimate prescription medication
  • These fake, illegal pills are easy to find and may contain fentanyl or methamphetamine, as opposed to the medication people think they’re buying, legally or illegally
  • Traffickers sell fake illicit pills on e-commerce platforms and social media sites, increasing their availability to all demographics, including minors
  • Traffickers design fake pills to closely resemble:
    • Oxycontin®
    • Percocet®
    • Vicodin®
    • Xanax®
    • Adderall®

That’s the information the DEA wants us all to know. Fentanyl is here, it may be in any pill you buy illegally, and it one dose can kill you.

Now let’s look at the overdose figures from the Centers for Disease Control (CDC) on fentanyl-related overdose:

  • Fatal overdose involving synthetic opioids such as fentanyl increased 56% from 2018 to 2020
  • In 2020, 56,000 people died from overdose involving synthetic opioids
  • Fentanyl-involved overdose deaths increased during the COVID-19 pandemic

One thing driving these overdose deaths is how traffickers use fentanyl: its presence in non-opioid drugs creates serious problems that increase overdose risk.

To learn more about fentanyl, please read this CDC Fentanyl Fact Sheet and this DEA Fentanyl Fact Sheet.

Why Fentanyl Detox?

Fentanyl detox – if indicated after a comprehensive biopsychosocial assessment administered by a licensed and qualified treatment professional – is the first step in treating opioid use disorder (OUD) for fentanyl.

When people with OUD decide to stop using opioids, they enter withdrawal. Withdrawal is a physical reaction to the absence of a substance of chronic use or misuse. When a person who uses opioids for an extended period of time stops using opioids, they typically experience the following symptoms:

  • Nausea/vomiting
  • Muscle/joint aches/ pains
  • Abdominal cramps
  • Increased blood pressure
  • Elevated heart rate
  • Anxiety
  • Panic Attacks
  • Depression
  • Excessive sweating
  • Constipation
  • Insomnia
  • Intense cravings for opioids

While opioid/fentanyl detox is rarely deadly, in some cases, complications can lead to death. Overall, however, opioid withdrawal is extremely uncomfortable, very difficult to get through alone – which we do not advise trying – and one of the primary reasons people who want to quit using opioids don’t quit: withdrawal is simply too hard.

That’s why medically monitored detox programs for opioids exist: to help people with OUD make it through withdrawal so they can start treatment and begin their recovery journey.

What is Medically Monitored Fentanyl Detox?

We mention it briefly above, but now we’ll expand. Withdrawal is a physical condition that begins 24-48 hours after a person with OUD stops using opioids. Opioid/fentanyl withdrawal typically involves physical, psychological, and emotional symptoms that peak at around day two or three then gradually fade after about a week. However, psychological and emotional symptoms may persist far longer than the physical symptoms.

The goal of medically monitored detox is to mitigate or eliminate the symptoms of withdrawal under the supervision of qualified clinicians – most often physicians and nurses – in order to prepare an individual for treatment.

Medically monitored detox occurs in three stages:

1. Evaluation

Treatment professionals assess the severity of SUD, screen for co-occurring mental and physical conditions, and assess psychological and social factors that affect the course of treatment after the detox process.

2. Stabilization

The stabilization stage involves ushering the individual from a state of intoxication, through a state of withdrawal, to a safe, stable, substance free state. The entire process takes place under close medical supervision with 24/7 monitoring and support.

3. Preparing for Treatment

Once a person in detox is in a mental state that permits typical interaction and communication with medical personnel, they receive advice about their next step. In most cases, the medical staff will recommend immersive treatment for SUD. This may be residential treatment, partial hospitalization treatment (PHP), intensive outpatient treatment (IOP), and in some cases, outpatient treatment.

Patients in fentanyl detox often receive a diagnosis for opioid use disorder (OUD), and after detox, receive a referral for medication-assisted treatment (MAT), which evidence shows is the most effective treatment available for OUD.

The Benefits of Medically Monitored Fentanyl Detox

The first and possibly most important benefit of medically monitored fentanyl detox is safety. Although detox from opioids is not as dangerous as detox from chronic alcohol use, it can be. In some cases, medical comorbidities may increase risk of complications. The best way to avoid potentially fatal, detox-related complications is with medical supervision, and the presence of a medical team ready to act immediately in case of emergency.

Therefore, the first benefit of medically monitored fentanyl detox is staying alive.

The second benefit of medically monitored fentanyl detox is that it prepares an individual with OUD for treatment, which can lead to long-term, sustainable recovery. Most clinicians in medically monitored detox programs begin talking about treatment as soon as possible. This is an important window in the life of a person with OUD: for the first time – possibly in years – they may be in a physical, emotional, and psychological state where they’re willing and able to engage in treatment.

And if they’re in a medically monitored detox program, it’s likely they’re also already at a physical location that offers residential treatment. This is what we call a warm handoff: when a person can transition from one phase of a therapeutic process to another – in this case, from detox to treatment – in the presence of clinicians from both phases of the process.

In other words, the person in fentanyl detox can meet with the clinician supervising their detox in the same room with the clinician who will supervise their treatment for OUD. And if they’re ready and willing, they can start treatment right away. Evidence shows this personal approach and immediate transition from detox to treatment can improve treatment engagement and initiation, which is an important step on the road to sustainable, lifelong recovery.

The materials provided on the Pinnacle Blog are for information and educational purposes only. No behavioral health or any other professional services are provided through the Blog and the information obtained through the Blog is not a substitute for consultation with a qualified health professional. If you are in need of medical or behavioral health treatment, please contact a qualified health professional directly, and if you are in need of emergency help, please go to your nearest emergency room or dial 911.