According to the U.S. Department of Health and Human Services (HHS), in 2021, 61.2 million or 21.9% of Americans 12 years old and older used illicit drugs. Out of the 61.2 million people who engaged in substance use, 9.2 million people misused opioids. Moreover, as noted by the National Institute on Drug Abuse (NIDA), in 2020, 91,799 people reportedly died from a drug overdose. By 2021, those numbers rose to 106,699 lives lost from a drug overdose, which is almost 15,000 more deaths than the year before. Furthermore, out of more than 106,000 overdose-related deaths, 70,601 deaths were a result of Fentanyl use – highlighting the fentanyl crisis.

Having a loved one with a substance use disorder (SUD) or losing a loved one to SUD is devastating. There are an unimaginable number of complex and intersecting, fears, feelings, beliefs, and questions that loom over SUD. It can be difficult to know how to respond to the consequences of substance use in the lives of the people you care about. The fentanyl crisis has further showcased how quickly individuals, families, and communities can be ravaged by SUD.

At The Guest House, we know how dangerous drugs like opioids can be as the addiction builds quickly and quietly. Opioids associated with the fentanyl crisis are frightening in their subtlety. Fentanyl, in particular, can cause rapid changes to the brain’s tolerance levels. Therefore, we are committed to uncovering the roots of self-defeating behaviors to support you and your loved one’s recovery. While the fentanyl crisis has had a traumatic impact on many lives, healing is possible.

Understanding the roots of self-defeating and self-destructive behaviors is an important step in building supportive tools for long-term recovery. However, seeing, hearing, and listening to the countless images, soundbites, and headlines in the media can be overwhelming and confusing. You may find yourself wondering what is fentanyl. Further, as the Centers for Disease Control and Prevention (CDC) notes, you may question how fentanyl has become the main driver of drug overdose deaths in the United States.

What Is Fentanyl?

As stated by the NIDA, fentanyl is a synthetic lab-made opioid that has had similar medical applications as morphine. However, unlike morphine, fentanyl is 100 times more potent. Further, as the CDC notes, fentanyl is typically broken into two types, pharmaceutical fentanyl and illegally manufactured fentanyl (IMF). While both are still synthetic, as another NIDA article notes, pharmaceutical fentanyl is an approved medication by the U.S. Food and Drug Administration (FDA). Prescription fentanyl is typically used as a pain relief in the following circumstances:

• Severe pain after surgery
• Chronic pain with tolerance to other opioids
• Complex pain conditions
• Advanced cancer

Moreover, prescribed fentanyl can be administered as a shot, patch, or lozenge. Illegal or illicitly manufactured fentanyl, on the other hand, is typically found in illegal drug markets as a powder or liquid. IMF can also be found in eye droppers, nasal sprays, and counterfeit pills made to look like other prescribed opioids. In addition, IMF poses an additional risk for users as its potent nature means it takes much less to experience its effects. Thus, as a cheaper option to make, IMF is often unknowingly consumed when it is mixed with other drugs like:

• Heroin
• Cocaine
• Counterfeit pills
• Methamphetamine
• MDMA

The ways IMF can be knowingly and unknowingly consumed highlights the various means of escalation for the fentanyl crisis. Anyone can easily unknowingly put themselves at risk for an overdose. The ease with which lethal doses of fentanyl can be taken further illustrates the need for increased awareness of the risk of misuse.

With such a heightened risk of injury and death, you may question how you can protect yourself and your loved ones. Learning to recognize the signs and symptoms of opioid use could give you the necessary knowledge to know when a loved one might be at risk.

Signs and Symptoms of Opioid Use Disorder

In the publication titled Opioid Use Disorder by Dydyk et al., opioid use disorder (OUD) is defined as the specific chronic misuse of opioids that causes significant distress and impairment in your life. There are a vast array of well-known opioids other than fentanyl that continue to negatively impact people’s lives, including:

• Morphine
• Codeine
• Oxycodone
• Heroin

Considering the shortlist of well-known opioids underscores the interconnected relationship between prescription opioid misuse and pain-related conditions. With over 16 million people worldwide and 2.1 million Americans impacted by OUD, conversations about pain management and medication management have grown. However, many of the opioids that have led to OUD have also been sourced by illegal means. Thus, with the rise of the fentanyl crisis, recognizing opioid misuse has become more important than ever for ensuring the health and safety of individuals everywhere.

OUD shares many similarities with other forms of SUD, such as:

• An overwhelming desire to consume the substance
• Increased tolerance for the substance
• Withdrawal syndrome

Despite these similarities, there are some other key characteristics of OUD to look out for. Listed below are some of the common and distinctive signs and symptoms of OUD for prescription and illegal misuse:

• Drug-seeking behaviors
• Social and interpersonal consequences of opioid use
  • Conflict with family and friends
• Decreased participation in social and recreational activities
• Difficulties fulfilling responsibilities and obligations
  • Work
  • School
• Spending an excessive amount of time seeking opioids
• Taking an extended about of time to recover from misuse
• Experiencing legal issues from opioid use
• Seeking multiple opioid prescriptions from different physicians
• Continued misuse even as physical and psychological health worsens
• Taking more opioids than you intended to
• An inability to reduce the amount of opioids being used
• Continued misuse despite exposure to physically dangerous settings
• A rapid increase in tolerance
• Experiencing cravings for opioids
• Withdrawal symptoms
  • Anxiety
  • Agitation
  • Cravings
  • Elevated blood pressure
  • Sweating
  • Elevated heart rate
  • Goosebumps
  • Shaking
  • Tearing
  • Sneezing
  • Runny nose
  • Muscle pain
  • Pupil dilation
  • Stomach cramps
  • Diarrhea
  • Insomnia

In addition to addictive and withdrawal symptoms, people with OUD can also experience opioid intoxication symptoms. According to Medline Plus, opioid intoxication symptoms happen when you experience physical symptoms along with opioids’ typical psychological effects like euphoria. The combination of body and brain symptoms found in opioid intoxication leads to illness and impairment for the user. Moreover, for people misusing opioids, intoxication can happen when you:

• Take too many opioids
• Use an opioid with certain other drugs
  • Sleep medication
  • Alcohol
• Consume opioids in ways that are not advised
  • Smoked
  • Inhaled through the nose

While the symptoms of opioid intoxication can vary depending on how much is used, some symptoms can include:

• Miosis
  • Small pupils
• Nausea and vomiting
• Difficult breathing
  • Slow breathing
  • No breath
• Hypersomnia
  • Extreme sleepiness
  • Excessive tiredness during the day
  • Sleeping longer than usual at night or bedtime
• Lack of alertness
• Decreased perception of pain
• Altered mental state
  • Confusion
  • Delirium
  • Decreased awareness and responsiveness
• Euphoria
• Constipation

The ability to recognize signs that a loved one might be using opioids could help you know when to reach out. Offering loved one’s support in seeking help to end their substance use could be a step toward decreasing the number of lives that have been lost to the fentanyl crisis. However, the United States Drug Enforcement Administration (DEA) states, only two milligrams of fentanyl can be lethal to a person. While a person’s body size, tolerance, and past usage can impact the amount of fentanyl needed for an overdose, many counterfeit pills exceed two milligrams.

According to an analysis from the DEA, most fentanyl-laced counterfeit pills range from .02 to 5.1 milligrams per tablet, which is more than twice the lethal dose. In addition, the DEA found in 2022 that six out of ten of the known fentanyl-laced counterfeit prescription pills contain a potentially lethal dose of fentanyl. The number of counterfeit pills laced with a lethal dose of fentanyl further reflects the significance of the fentanyl crisis as the DEA only found four out of ten pills contained a lethal dose in 2021. Moreover, the rapid rise of the fentanyl crisis and staggering increases in fentanyl-related deaths every year showcases the importance of recognizing the signs of an overdose.

Recognizing a Fentanyl Overdose

Another Medline Plus article notes that knowing how to recognize an overdose and use resuscitation medications like naloxone can be the difference between life and death in the fentanyl crisis. Listed below are some of the symptoms of a fentanyl overdose:

• Confusion
• Dizziness
• Drowsiness or sleepiness
• Difficulty breathing
• Choking or gurgling sounds
• Slow, shallow breaths
• Stops breathing
• Unresponsive
• Unable to wake up
• Small pinpoint pupils
• Cold and or clammy skin
• Limp body
• Cyanosis
  • A bluish discoloration of the skin around the nails and lips
    • Result of poor circulation or inadequate oxygenation of the blood
• Eventual hypoxia
  • Not enough oxygen is able to reach the tissues in the body
    • This can lead to a coma, brain damage, and eventually death

Looking at the symptoms and thinking about the possibility of a loved one overdosing is scary. However, without information and knowledge comes inaction. Without action, the fentanyl crisis is left to fester and take more lives. Therefore, your commitment to self-education can give you the tools you need to prevent an overdose and support your loved one in getting the help they need for recovery.

Addressing the Fentanyl Crisis

The fentanyl crisis has swept across the United States, taking countless lives and leaving loved ones to attempt to pick up the pieces of their lives. Many organizations all across the country recognize National Fentanyl Awareness Day in an effort to amplify the public’s awareness and understanding of the fentanyl crisis. Notably, the DEA points out that more Americans under fifty have died from fentanyl than from any other cause of death like heart disease, cancer, suicide, homicide, and other accidents. Not only are overdoses like the fentanyl crisis the leading cause of death for Americans between the ages of eighteen and forty-five years old, drug traffickers have expanded their target audience to children and young adults with rainbow fentanyl.

According to the DEA, rainbow fentanyl as the media calls it has been seized in twenty-six states since August of 2022. The brightly-colored pills, powders, and chalk-like blocks among other forms of fentanyl and opioids have been marketed to young people in a variety of accessible settings like social media and through friends. Therefore, the fentanyl crisis has put a large segment of the population at an increased risk for addiction and death in an extremely unregulated market of IMF. Without laboratory testing or as the CDC notes, fentanyl test strips, there is no way for people to determine if the substances they consume contain any fentanyl or not.

In addition, the fentanyl crisis has become so prominent that prescribing the rescue medication, naloxone with legally prescribed fentanyl is not uncommon. Medline Plus states that a physician may prescribe naloxone along with fentanyl for a few different reasons:

• If you live in a household with small children
• You live in a household with someone who has misused prescription and illegal drugs
• Public and private work settings

Considering the circumstances in which fentanyl could fall into the hands of multiple at-risk groups, naloxone could save lives in desperate situations. Naloxone is fast acting as it blocks the effects of opioids to provide relief from its deadly overdose symptoms. The DEA notes that sixty-six percent of deaths in the United States from drug poisoning in 2021 came from synthetic opioids like fentanyl. However, certain areas of the United States like Florida and Ohio, in particular, have seen a great deal of devastation from the fentanyl crisis.

Impact of the Fentanyl Crisis in Florida

The CDC along with the DEA issued nationwide alerts in 2015 noting the increase in fentanyl-related deaths in multiple states. In particular, reports found that between 2013-2015, Florida and Ohio had sharp increases in fentanyl deaths in connection to the increase in IMF supplies in both states. Moreover, the rapid increase in fentanyl overdoses and deaths in Florida and Ohio, had a large impact on heroin users as increasing amounts of fentanyl were being knowingly and unknowingly mixed into other illicit drugs like cocaine. Between 2013 and 2014, fentanyl submissions increased by 494% in Florida, which is concurrent with a 115% increase in fentanyl deaths.

There has also been a rapid increase in use and fentanyl-related deaths for specific age groups and genders. In Florida, during the initial IMF alerts, deaths among people between the ages of 14 and 34 increased by 250% between 2010-2012 and 2013-2014. Regarding gender, fentanyl deaths for men in Florida increased almost 2.5 times faster than for women. Today as the Florida Department of  Health (DOH) states, the fentanyl crisis is still a problem fueling the overall opioid epidemic both in Florida and nationwide. In 2022, first responders responded to over 105,400 overdose calls across the state of Florida. Of those 105,400 overdose calls, Florida reported 5,900 deaths.

Seeing the continued expansion of the fentanyl crisis can be distressing, but change does not happen overnight. The difficult task of addressing an epidemic like the fentanyl crisis and supporting your loved ones is not a problem tackled alone, but rather something done in collaboration. Thus, the collaborative process of understanding addiction and recovery is an important tool for giving your loved one and many others an opportunity for long-term healing.

Finding Fentanyl Crisis Support at the Guest House

At The Guest House, we believe discovering and understanding the root of your addiction can play a significant role in your recovery journey. When people are able to understand the why behind their self-defeating and self-destructive behaviors, they can address the core of the problem and truly start to heal. For many people, the root of their addiction and other co-occurring disorders like mental health disorders is unaddressed trauma. Thus, understanding how trauma has impeded a person’s well-being, means utilizing approaches to care that consider the whole person.

Holistic care can be an impactful tool for long-term recovery. A holistic approach to care focuses on supporting the healing of the whole person in mind, body, and spirit. With holistic healing, people are given the space to work in collaboration with their clinicians to meet the individual’s specific needs. Therefore, we are committed to providing a wide range of therapeutic modalities to help you and your loved ones build meaningful lives in long-term recovery.

Whether prescribed or not, opioids have led to countless deaths. Moreover, the increasing numbers of illegally manufactured fentanyl (IMF) have propelled the U.S. into a fentanyl crisis. With thousands of fentanyl-related deaths increasing in Florida and across the country, understanding addiction is more important than ever. Recognizing the signs and symptoms of opioid use and a fentanyl overdose can be the difference between life and death for many people. Further, increase awareness and access to information can provide the knowledge to understand the roots of addiction to support long-term recovery. Thus, at The Guest House, we are committed to providing holistic care to meet each individual’s specific needs on their recovery journey. Call us at (855) 483-7800 to learn more.