Fentanyl Rehabilitation and Treatment

This guide was written to provide an overview of the fentanyl rehabilitation process, as well as to offer helpful resources for persons recovering from fentanyl addiction.

When a fentanyl user is ready to receive treatment, the treatment process usually begins with an orientation session. During this session, the individual meets members of the treatment staff and learns about what services are available to aid in the rehabilitation process. The individual also undergoes an assessment to uncover co-occurring disorders, specific addiction triggers, and medical issues that could affect the course of treatment.

The orientation and assessment are followed by a supervised detoxification period, in which fentanyl is eliminated from the individual’s body. Supervision by treatment professionals makes this process safer and may make fentanyl withdrawal symptoms more tolerable for the user. Once this process is complete, the individual participates in programs aimed at developing better coping skills, avoiding certain triggers for substance use, and managing any co-occurring disorders.

Fentanyl is a Schedule II substance, which indicates that it has a high potential for abuse. According to the 2019 World Drug Report, there has been a “rapid expansion” of fentanyl throughout the world, as evidenced by an increase in the amount of fentanyl seized by global law-enforcement officials. In the Northeast and Midwest regions of the United States, fentanyl made up the highest percentage of opioid samples submitted to federal officials for analysis. Fentanyl accounted for 55% of the samples submitted in the Northeast, and 34% of the samples submitted in the Midwest.

It can be difficult to recover from fentanyl addiction due to the way this substance affects the brain. When an individual takes fentanyl, it quickly binds with opioid receptors in the brain, producing an overall sense of well-being that can be characterized by a sense of euphoria, a state of calmness, or a high level of happiness. Fentanyl acts on the reward center of the brain, making the individual want to feel these pleasurable effects again and again. Chronic users may build up a tolerance to the effects of fentanyl, making it even more difficult to stop using the substance.

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates in 2015:

• 12,462,000 individuals aged 12 and older were past-year misusers of prescription pain relievers, such as fentanyl.
• 3,775,000 individuals aged 12 and older were past-month users of prescription pain relievers, such as fentanyl.
• 124,943 individuals aged 12 and older in need of treatment enrolled in a rehabilitation program for misuse of opioids other than heroin, including fentanyl.

Recovery from fentanyl addiction begins with a short-term detoxification process in which fentanyl is eliminated from the user’s body. This is known as the initial detoxification process. Fentanyl has a half-life of eight to 10 hours, which means about half of it is removed from the individual’s system within this time frame. Therefore, the initial detoxification period usually lasts for two to three days, although it can take up to a week in chronic users and users who do not metabolize fentanyl as quickly as others.

Post-acute withdrawal symptoms are withdrawal symptoms that persist more than two weeks after the individual stops taking fentanyl. These symptoms may last up to a year, but the exact length of time depends on the user’s medical history and past use of fentanyl. For example, if a user took large doses of fentanyl or used fentanyl for several years, post-acute withdrawal symptoms may last for several months.

Several medications can be used to reduce the severity of fentanyl withdrawal symptoms. Loperamide and other anti-diarrheal medications are used to reduce cramping and frequency of bowel movements. Over-the-counter pain relievers, such as aspirin and acetaminophen, may be effective for relieving headaches caused by fentanyl withdrawal. Metoclopramide may be given to individuals experiencing nausea. Supportive medications are also used to control abdominal pain and muscle cramps.

For more information about withdrawal, read our guide on fentanyl addiction.

Within either an inpatient or outpatient setting, treatments, such as detoxification services, behavioral therapies, and medication-assisted treatments are offered for varying lengths of time.

Inpatient treatment involves living full-time (including overnight) at a treatment facility for a set period of time. Outpatient treatment involves scheduled appointments at a facility in which you are free to come and go. Within each category, there are several distinctions.

Behavioral therapy for substance addiction seeks to identify and manage addictive behaviors that lead to use and prevent relapse. Behavioral therapy is based on the concept that all behavior is learned, and, thus, unhealthy behavior can be changed through learning coping skills and increasing awareness of negative thoughts and beliefs that contribute to substance abuse.

Medication-assisted therapies aim to reduce cravings and prevent users from relapsing while they’re receiving treatment for fentanyl addiction. Individuals who are addicted to fentanyl may be treated with buprenorphine, methadone, or naltrexone, as these medications have been approved by the U.S. Food & Drug Administration for the treatment of opioid use disorder.

Buprenorphine is available as a tablet, an implant that is placed under the skin, and a film that can be placed on the inside of the cheek. It eases the symptoms of fentanyl withdrawal and can prevent cravings. Methadone prevents cravings and blocks the effects of fentanyl and other opioids, making it impossible for the user to experience the euphoria and sense of calm associated with fentanyl use. Individuals using methadone to withdraw from fentanyl must visit an FDA-approved clinic or pharmacy to receive the medication. Naltrexone pills can be taken daily, while the injectable form is given once a month. This medication also blocks the pleasurable effects of opioids.

For individuals who want to recover from fentanyl addiction, it’s helpful to look for a rehabilitation facility that offers supervised detoxification, as medical management of the detoxification process can help preserve the physical and psychological well-being of individuals withdrawing from fentanyl.

It’s also helpful to look for a facility that offers a combination of behavioral therapies and medication-assisted therapies. Medications can reduce cravings and help users avoid relapse, while behavioral therapies help individuals develop the skills they need to succeed in the recovery process.

Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, price, and location.