I. The Basics of Fentanyl Rehabilitation

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.

the four steps of rehab process

II. What Makes Fentanyl Rehabilitation Difficult?

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 Unique Struggle of Fentanyl Addicts
Fentanyl…
  • binds quickly with opioid receptors in the brain, creating a reinforcing effect that can cause intense cravings.
  • has a high potential for abuse, making it more likely that an individual will become dependent on it.
  • is difficult to stop using because it produces undesirable withdrawal effects.
  • is sometimes mixed with other drugs, causing users to experience severe withdrawal effects when they try to stop using.

Fentanyl Rehabilitation Statistics

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

Opioid Treatment Admissions by Gender

52.7 Male
47.3% Female

Demographics of Individuals Seeking Treatment for Opioid Addiction

According to a 2017 SAMHSA report that charts admissions to and discharges from publicly-funded substance use treatment facilities, men are more likely to seek treatment for abuse of opioids, such as fentanyl. The gender breakdown of treatment admissions for opioids other than heroin was 52.7% male and 47.3% female. While opioid addiction occurs in all age groups, the most common age group admitted to a treatment facility for addiction to opioids other than heroin was individuals aged 25 to 34, with 35 being the average age of all individuals from all age groups who are seeking rehabilitation.

Opioid Treatment Admissions Percentages by Age Group, 2017
Age at the Time of Treatment Admission Percentage of Opioid Treatment Admissions
12-17 0.7%%
18-24 15.1%
25 – 34 46.2%
35 – 44 21.8%
45-54 11.0%
55-64 4.6%
65+ 0.5%

III. Fentanyl Detoxification and Withdrawal Process

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.

Withdrawal Symptoms

Body Mind
Short-Term Symptoms Muscle aches
Insomnia
Yawning
Sweating
Runny nose
Increased tearing
Involuntary muscle jerking
Tremors
Heart palpitations
General malaise
Anguish
Anxiety
Agitation
Long-Term Symptoms Nausea
Vomiting
Diarrhea
Abdominal pain
Goose bumps
Changes in pupil size
Anxiety

The risk of fentanyl overdose increases during withdrawal

Fentanyl is usually eliminated from the body within two to three days after the last dose. Users who relapse after fentanyl has been cleared from the body do not have the same tolerance for fentanyl they did before completing the initial detoxification period. Thus, users who take large doses of fentanyl may overdose unexpectedly.

Withdrawing from fentanyl may be especially dangerous for people with heart conditions

Maathuis and Dijkstra reported the case of an 80-year-old woman who experienced several withdrawal effects after stopping the use of fentanyl skin patches. Rapid heartbeat and increased respiratory rate were two of her most serious withdrawal symptoms. In people who already have heart problems, this increase in heart rate could lead to a heart attack or other complications.

Fentanyl Detoxification Medications

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.

IV. Treatment for 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.

Rehabilitation Settings

Fentanyl Treatment Programs
Setting Type of Treatment Description Duration Time Commitment
Inpatient Short-Term Residential Intensive treatment, sometimes in a hospital setting. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:

24

Days Per Week:

7

Long-Term Residential Intensive treatment in a non-hospital setting, most often a therapeutic community with other patients. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-12 months Hours Per Day:

24

Days Per Week:

7

Partial Hospitalization Intensive treatment in a hospital setting. Patients do not stay overnight. Considered inpatient due to the hospital setting. Extensive services are provided and require a near full-time commitment every week. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:

6-8

Days Per Week:

5

Outpatient Intensive Day Treatment Extensive services of an inpatient program but patients return home each day following treatment. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-4 months Hours Per Day:

2-4

Days Per Week:

3

Counseling Both individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medication-assisted treatment is not available. As long as desired Hours Per Day:

1-2

Days Per Week:

1-3

Support Groups Self-help groups center on maintaining abstinence after another form of treatment. Typically meet one day a week for 1-2 hours. As long as desired Hours Per Day:

1-2

Days Per Week:

1

Behavioral and Medication-Assisted Therapies

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.

Behavioral Therapies for Fentanyl Addiction
Type of Therapy Definition
The Matrix Model

Further reading:

The Matrix Model was originally developed to help individuals addicted to methamphetamine and other stimulants, but it has shown promise in treating addiction to opioids, such as fentanyl.

Working directly with a therapist, the individual learns about addiction, has access to a variety of recovery resources, and learns how to avoid relapse.

Cognitive-Behavioral Therapy (CBT)

Further reading:

Cognitive-behavioral therapy (CBT) is one of the mainstays of opioid addiction treatment. This behavioral therapy is based on the principle that it’s possible for people to improve their coping skills, making them better equipped to handle stressors that have led to substance use in the past.

CBT helps participants learn strategies, such as recognizing distorted thinking patterns, understanding the behavior of others, and developing the self-confidence necessary to manage stressful situations in a healthy way.

V. How to Find Help

Finding a Rehabilitation Center for Fentanyl Addiction

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

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.