What Are the Long-Term Effects of Fentanyl?

Fentanyl is a synthetic opioid that’s garnered a lot of attention because of its potency and the increased prevalence of misuse and overdoses linked to it. Originally developed as a prescription pain medicine, the strength and potential for addiction have made it a central culprit in the opioid crisis.

The long-term effects of fentanyl can have serious implications on the body and mind. 

Understanding these long-term effects is crucial for healthcare providers and anyone impacted by it, whether it’s used medically or illicitly.

What Is Fentanyl?

A synthetic opioid pain reliever, fentanyl is more potent than most morphine and heroin—significantly so.

Fentanyl was first developed as a pain management option for cancer patients in the 1960s. Since then, it’s become a critical medication to treat severe pain.[1] However, because of its potency, it’s become a prominent drug of abuse, leading to a surge in overdose deaths around the world.

Fentanyl primarily acts on opioid receptors in the brain. These receptors serve as part of the reward system in the brain. As fentanyl binds to these sites, it triggers large amounts of dopamine to be released. The dopamine release creates a euphoric high, and it’s one of the main reasons it’s such an addictive substance.

Fentanyl can severely depress respiratory breathing, and that’s the most common reason for death in overdoses. It leads to slow or completely stopped breathing. 

Other effects of fentanyl on the body in the short term can include:[2]

• Pain relief.
• Sedation and drowsiness.
• Nausea and vomiting.
• Constipation.

Why Is Fentanyl Incredibly Addictive?

The high potency of fentanyl and its ability to create euphoria makes it very addictive. The effects can occur relatively quickly, especially if someone injects or smokes the drug, creating a reinforcement cycle.

Tolerance to fentanyl can also occur quickly. Someone would need bigger doses to get the same effects, fueling addiction.

Fentanyl’s differences with other opioids can include:

• It’s around 50 to 100 times stronger than morphine and has a potency of 50 times that of heroin.[3] Even small amounts can cause a deadly overdose.
•  Fentanyl has a shorter duration of action than a lot of other opioids, meaning faster pain relief but also a need for more frequent dosing. This raises the risk of abuse and addiction.
• Compared to other opioids, there’s a much higher likelihood of overdosing with fentanyl.
• Fentanyl is often found in illicit forms like powders and pills and mixed with other drugs like cocaine or heroin without the user knowing. This increases the risk of overdose.

Over the past decade, fentanyl’s role in the opioid epidemic has grown significantly.[1,3] As it became more accessible through prescription diversion and also illegal production, misuse started rising.

Illicitly made fentanyl is a main driver of overdose deaths. Drug traffickers frequently mix fentanyl with other substances to increase potency and profits. This has led to unintentional ingestion of the drug.

Short-Term Side Effects of Fentanyl

Along with some of the side effects of fentanyl already named above, in the short-term, the drug can cause:

• Constricted pupils.
• Sweating.
• Extreme drowsiness.
• Severe respiratory depression.
• Cold, clammy skin.
• Loss of consciousness.
• Slowed heart rate.

Most of the above are actually signs of a fentanyl overdose, which is a medical emergency requiring immediate attention.

Long-Term Effects of Fentanyl

The potential long-term effects of fentanyl include:

• Tolerance: Prolonged use can mean a person requires higher fentanyl doses to get the same impact, escalating the overdose risk.
• Dependence: The body starts depending on fentanyl for normal functioning, and if the drug is not present, withdrawal symptoms occur at this point.
• Respiratory problems: Chronic fentanyl can cause ongoing respiratory issues, including breathing trouble and reduced lung function.
• Gastrointestinal problems: Chronic constipation stemming from long-term opioid use can lead to bowel obstruction and other severe issues.[4]
• Immune system suppression: The prolonged use of fentanyl weakens the immune system, making individuals more likely to get infections and illnesses.
• Hormonal imbalances: Opioid use disrupts the endocrine system eventually, contributing to hormonal imbalances. Consequences of these imbalances can include sexual dysfunction, irregular menstruation and infertility.
• Heart problems: The long-term effects of fentanyl can include heart problems like low blood pressure, arrhythmias and a higher risk of experiencing a heart attack or stroke.[4]
• Muscle problems: Chronic opioid use can lead to muscle weakness and rigidity, impacting mobility and overall health.
• Dental problems: Opioid use contributes to dry mouth. This can lead to tooth decay and gum disease.[5]

Mental effects of long-term fentanyl use can include:

• Addiction: Substance use disorders include compulsive drug-seeking behaviors and not being able to stop using the drug even when facing the negative consequences associated with it.
• Mental health disorders: Chronic use of opioids like fentanyl can lead to impaired cognitive functions, including memory, attention and decision-making.[6]
• Behavioral changes: These can include social withdrawal and isolation, aggression and paranoia.

Social effects can include strained relationships, financial problems, and employment issues.

Long-term health complications might also include kidney and liver damage and permanent brain damage.

Additional Long-Term Considerations

Along with what’s detailed above, chronic fentanyl use tends to severely diminish quality of life. Someone who’s regularly using the drug may struggle to fulfill obligations in most areas of their life.

It can lead to a challenging withdrawal process that often requires a medically supervised detox.

The potency and addictiveness of fentanyl increase the risk of relapse. Long-term treatment plans are often needed for sustained recovery. An effective treatment plan for someone dealing with fentanyl addiction usually requires a comprehensive approach addressing physical dependence as well as the social, mental and environmental factors that contribute to addiction.

The long-term effects of fentanyl are far-reaching and profound. Chronic use can lead to severe mental and physical health disorders and complications and significant disruptions to personal and professional lives.

If you’re struggling with fentanyl personally, or you want to help someone you love, we have opioid addiction treatment programs at Archstone Behavioral Health. Reach out to learn more about these personalized, integrated programs.

References:

1. National Institute on Drug Abuse (NIDA): Fentanyl DrugFacts
2. United States Drug Enforcement Administration (DEA): Fentanyl
3. Centers for Disease Control and Prevention (CDC): Fentanyl
4. Dove Press: Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review
5. National Institute of Dental and Craniofacial Research: Oral Health & Opioids
6. Journal of Pain and Symptom Management: Neuropsychological effects of long-term opioid use in chronic pain patients