What are Fentanyl Exposure Symptoms

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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Exposure Symptoms Related to Fentanyl

The opioid overdose epidemic in the United States began in the 1990s. During the first wave, most opioid deaths caused by overdose were attributed to medications prescribed by healthcare providers. By 2010, heroin overdoses outpaced prescription opioid overdoses by a significant margin. The third wave, which began in 2013, was precipitated by the increase in the availability of synthetic opioids, especially those containing illegally manufactured fentanyl. Overall, 645,000 people died due to opioid overdose from 1999 to 2021.

Illicit fentanyl caused a sharp spike in opioid overdose deaths when it arrived on the scene because it is 50 times more potent than heroin and 100 times more powerful than morphine. As little as 2 mg can be fatal.

Types of Fentanyl and Exposure Risks

Healthcare providers administer the prescription variety of fentanyl for pain. It is helpful in pain management during surgery and cancer treatment. There is little risk of accidental prescription fentanyl exposure if the client secures it properly so that children and pets can not access it. 

However, The U.S. Food and Drug Administration warns that you should be vigilant if a doctor prescribes you a fentanyl patch. Because a child can be exposed by sucking on it or attaching it to their skin, it’s recommended that you use adhesive film to secure it. This extra step can ensure it does not fall off. In addition, when disposing of a patch, fold it in half with the adhesive part inside so that it sticks together and flush it down the toilet. 

Illicit Fentanyl is available in two forms: a liquid and a powder. The powdered form resembles cocaine. Accidental exposure is possible if it’s flung in the air and you breathe it in. Alternatively, unintentional exposure to the liquid type is highly unlikely because you would have to swallow or inject it for the drug to be potent. The idea that fentanyl is absorbed through the skin if you touch it or you can be exposed by touching someone who has used the drug is a myth. The majority of unintentional exposure to fentanyl results from people using other recreational drugs, such as cocaine and heroin, that have been laced with the substance by drug dealers. 


There are several symptoms associated with fentanyl use, whether a person takes it intentionally or is exposed accidentally. They include:

  • Breathing issues
  • Confusion
  • Dizziness
  • Euphoria
  • Nausea and vomiting
  • Unconsciousness
  • Pinpoint pupils

What to Do in An Overdose Situation

Fentanyl can kill in just minutes, so quick action is crucial. Call 911 immediately. Then, if Naloxone is available, give the person a dose. Naloxone is also called Narcan. Naloxone only stays in the person’s system for about a half hour, so you might have to administer a second dose to counteract the effects of an overdose, maybe even a third. While waiting for the paramedics to arrive, keep the person calm and keep an eye on the person’s breathing. Opioids kill by slowing down an individual’s breathing to the point that it stops, causing respiratory arrest. Have the person lie on their side to prevent choking if they throw up.

If you believe that someone has taken fentanyl and overdosed on it, then administer Naloxone no matter what, as long as some is available. It doesn’t matter if the person has overdosed or not because Naloxone won’t harm someone. It has no ill effects if the person hasn’t overdosed.

Chronic Use

About 3 million Americans misuse opioids in the United States. Unfortunately, because fentanyl is so potent, many users develop an addiction to it, more properly known as a substance use disorder (SUD). Developing a tolerance to fentanyl, as with any drug, is normal when a person uses it regularly. Because of fentanyl’s lethal potency, it’s readily apparent how dangerous building a tolerance to such a drug can be. However, fentanyl use disorder (FUD) is treatable. 

FUD Treatment

Fentanyl withdrawal generally begins between 12 and 30 hours after the last fentanyl dose. The withdrawal is unpleasant, and you’ll experience diarrhea, nausea, irritability, and overwhelming cravings for fentanyl. While it’s true that you might be able to taper its use gradually and successfully stop, the cravings make this approach challenging. More often, you’ll need a medication-assisted approach that a doctor oversees.

The medications used are generally either methadone or buprenorphine. The former is an agonist and blocks the receptors in the brain from creating the euphoria associated with the drug. The latter is a partial agonist, meaning that it takes the place of the fentanyl rather than simply blocking it. 

Potent opioids, such as heroin and fentanyl, create such powerful cravings in people experiencing FUD and other opioid use disorders that medication-assisted treatment is now the standard rather than treatment plans involving abstinence. Substance use specialists are realizing that medication-assisted treatment is the key to better success rates. 

The Importance of Psychological and Psychiatric Support

Therapy and counseling are both integral parts of ongoing treatment for FUD. The idea is to help clients develop coping mechanisms to deal with mental health stressors that occur in everyday life. This method may be effective because previous stressors were partly responsible for the client beginning to use fentanyl in the first place.

It’s tough to stay away from fentanyl if you have friends or family members who continue to use it. Not only is the drug itself a powerful draw, but if you are not receiving support at home or from your social network, it makes it difficult to embrace a sober lifestyle. Therapy sessions provide a safe environment. A therapist can also help you learn strategies to deal with people in your life who do not understand that you are abstaining from fentanyl to make positive life changes.

Kinds of Therapy

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is usually a short-term therapy where the chief focus is to teach you to think about your thoughts, feelings, and expectations in a healthy way. Your therapist will hone in on problem-solving skills as a method of handling your cravings. The approach of “thinking about thinking” is central to the therapy as you learn to craft coping mechanisms and other strategies so that you can support your own recovery. The relationship between therapist and client is necessarily close as you must share your innermost thoughts.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is an outgrowth of CBT. DBT is designed to lead you to accept that FUD is a mental health disorder. The idea is to enact change to bring yourself to a healthier spot. Your past and reasons for using fentanyl aren’t as important in this version of psychotherapy. You will learn interpersonal skills and how to manage your emotions better. The discipline came about when therapists noticed that, for some people experiencing borderline personality disorder, CBT was largely ineffective in treating them. People with borderline personality disorder have intense trouble managing their emotions, so the focus on controlling one’s emotions became the core of DBT.

Motivational Interviewing

Motivational interviewing is a client-centric therapy that is designed to combat ambivalence. The core concept is to ask probing questions about the client’s fentanyl use to gain the person’s perspective on it. Then, the therapist will move on to creating hope that the client can embrace a sober lifestyle. Rather than instruct clients regarding why using fentanyl is a bad thing, the therapist will encourage clients to develop their own “why” regarding their long-term recovery.

Eye Movement Desensitization and Reprocessing

Many times, trauma is one of the causes of people beginning to use fentanyl or other illicit substances. This trauma might also be a stumbling block when it comes to the person’s recovery. By lessening the effects of trauma through eye movement desensitization and reprocessing (EMDR), a therapist seeks to remove one of the obstacles to the client’s recovery.

It’s in a different category than the previous three forms of therapy. It’s not psychotherapy. Instead, it’s a method of dealing with trauma without the cognitive, dialectical, and motivational components. It involves using both steady and flashing lights of different colors and intensities to rewire the way the brain processes and stores memories.

Traumatic events cause the brain to create memories in a convoluted manner, which is why trauma stands out in the client’s memories. By using the lights and talking about the traumatic memories with the client, the therapist helps to recreate the memories in the “normal order.” This process makes the traumatic memories more like all of the client’s other memories, thus lessening the effect of the trauma event. 

A Combined Approach

No single one of these therapies, nor any other therapies, will usually be enough to support someone who is in lifelong recovery from FUD. The most effective method is the integration of treatment strategies. Whole-client wellness is the end goal, which includes improving mental health, helping a person learn ways to maintain sobriety, and increasing the general physical health of the client. 

Defining Wellness Centers

At Defining Wellness Centers, we strive to treat the whole client with a customized treatment plan based on that individual’s needs. We realize that there are no absolutes when it comes to treating FUD. We feature medical detox and on-site and off-site treatment programs. You don’t need to proceed toward recovery on your own. We’re here to help, so if you are seeking treatment for FUD or any other SUD, give us a call so that you can begin your recovery journey today.

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If you are ready to take the step towards a new life, call Defining Wellness today and learn more about how we can help you.