Nirvana Recovery

Signs And Symptoms of Fentanyl Addiction In Loved Ones

Signs And Symptoms of Fentanyl Addiction In Loved Ones

Are you concerned that a loved one may be struggling with fentanyl abuse, dependence, or addiction? You are in the right place! At Nirvana Recovery, we understand the complexities of fentanyl addiction and its possible consequences on personal lives, interpersonal relationships, and overall mental health. In response to these, we offer tailored treatment, support, and resources to help families and individuals overcome the scourge of fentanyl addiction. 

In this blog, we help you recognize the signs and symptoms of fentanyl addiction in your loved ones to foster early intervention and prevent possible fatal consequences. We have also included effective solutions worth exploring.

Understanding Fentanyl Addiction

Fentanyl is a highly potent opioid used to relieve chronic or excessive pain. It is commonly prescribed for painful chronic conditions (such as cancer) and extremely painful medical procedures. If abused, misused, or used for prolonged durations without medical supervision, your body can become increasingly tolerant and dependent on it, leading to withdrawal symptoms if it is stopped. Owing to the extreme severity of some of these withdrawal symptoms, individuals may have a hard time quitting usage, keeping them locked in a cycle of repeated, compulsive usage. This usage builds dependence and addiction. 

Being 50-100 times stronger than other pain medications, including morphine, fentanyl addiction can lead to several life-threatening physical and psychological issues. You are also required to have a prescription before acquiring fentanyl, and a medical professional should closely monitor its use for medical purposes. Therefore, most chronic or compulsive users turn to street dealers for their daily supply, which has led to overdoses and deaths as most street-sold fentanyl has impurities and its use is not monitored safely.

General Indicators of Substance Abuse

Before delving into specific signs of fentanyl addiction, let’s first explore the general indicators of substance abuse to help you understand how drugs and substances affect individuals. In the course of our discussion, you will realize most of these signs are also common in fentanyl users.

Recognizing Substance Abuse

Here are the general indicators of substance abuse: 

  • Physical health issues include bloodshot eyes, dilated pupils, weight loss, and fatigue. 
  • Skin issues, such as changes in complexion, are also common. 
  • School or work problems include frequent absenteeism, sudden lack of interest in work or school activities, or a decline in academic or occupational performance. 
  • Neglect of appearance is signified by diminished interest in grooming, clothing, and looks. 
  • Significant behavioral changes, such as increased secretiveness, social withdrawal, and loss of interest in previously enjoyed activities. 
  • Sudden, unwarranted financial challenges.  
  • Changes in eating and sleeping patterns. 
  • Sudden change in friends or social circles. 
  • Unexplained mood, personality, and attitude changes. 
  • Being defensive when questioned on drug use.
  • Sudden neglect of responsibilities. 
  • Increased irritability.
  • Frequent anger outbursts.
  • Sudden or frequent involvement in criminal activity. 
  • Trouble getting along with others. This is commonly signified by frequent conflicts or unwarranted disagreements with family members, friends, and co-workers. 
  • Reduced motivation.

Commonalities Across Addictions

  • Despite their different characteristics, psychoactive substances share one thing in common: their addictions stem from increased tolerance and dependence. 
  • Individuals addicted to substances struggle with withdrawals. For example, any attempt to quit or suddenly minimize fentanyl use (after prolonged periods of dependence) is often met by withdrawal symptoms with differing severities.

Hallmarks of Fentanyl Addiction

Knowing the specific symptoms associated with regular or chronic fentanyl use and abuse can help you tell if a loved one is addicted to the opioid. Here are distinctive fentanyl behavioral patterns, physical manifestations, and withdrawal symptoms:

Behavioral Patterns Associated with Fentanyl

The following behavioral patterns can indicate a fentanyl addiction: 

  • An overwhelming urge to seek and use fentanyl. 
  • Obtaining fentanyl illegally or engaging in risky, impulsive behaviors to obtain it. 
  • Prioritizing fentanyl over personal responsibilities and interpersonal relationships. 
  • Frequent absenteeism from work or school.
  • Forging prescriptions to obtain fentanyl. 
  • Using fentanyl in risky situations, e.g., driving while under the influence of fentanyl. 
  • A sense of detachment from physical discomfort due to diminished pain perception.

Physical Manifestations of Fentanyl Use

Besides the above behaviors, fentanyl use can manifest physically in the following ways:  

  • Constricted or pinpointed pupils. 
  • Episodes of nodding off or loss of consciousness. 
  • Profound sedation. 
  • Respiratory depression, signified by shallow or slowed breathing. This can lead to respiratory failure. 
  • A decreased heart rate commonly known as bradycardia. This can lead to a significant drop in blood pressure, dizziness, and fainting. 
  • Unsteady movements resulting from impaired motor and coordination skills. 
  • Muscle stiffness or rigidity leads to impaired movement. 
  • Gastrointestinal distress due to fentanyl-induced nausea, vomiting, and constipation.

Distinctive Fentanyl Withdrawal Symptoms

Fentanyl has a rapid withdrawal onset, which makes it difficult to stop using once a tolerance has begun to build. Here is a close look at its withdrawal symptoms and their onset: 

  • Day 1 Users often experience headaches, significant loss in appetite, muscular pains, aggression, anger, irritability, and intense cravings within the first 24 hours of not using fentanyl or minimizing usage. 
  • Day 2 Day 1 symptoms persist during the second day. They are also commonly accompanied by panic attacks, runny nose, excessive sweating, insomnia, and stomach upsets. 
  • Day 3 More often than not, fentanyl withdrawal symptoms peak on the third day. Some of the most severe or challenging symptoms witnessed include nausea, diarrhea, and vomiting. 
  • Day 4 – Day 4 is usually characterized by shivering, cramps, enlarged pupils, fatigue, and gastrointestinal discomfort. 

Although most withdrawal symptoms vanish after the seventh day, some, like sleep disturbances, may persist, taking time to normalize. Many users also report intermittent depressive episodes and ongoing fatigue. Other post-acute withdrawal symptoms include irritability, sleep issues, and powerful fentanyl cravings. These withdrawal symptoms, particularly cravings, may last long-term.

Behavioral Shifts to Watch For Fentanyl Use

The following behavioral shifts may signify fentanyl addiction in loved ones, necessitating early intervention:

Social Isolation

Fentanyl addiction can lead to a compulsive drug-seeking and taking habit, inhibiting interpersonal connection and social engagement. Individuals may also withdraw from friends, family members, or the community at large to hide their fentanyl habit (fearing judgment, shame, ridicule, or repercussions), leading to social isolation.

Impaired Decision-Making

Fentanyl, like other psychoactive substances, can lead to impaired judgment, affecting an individual’s decision-making ability. Its sedative effects can also slow cognitive functions, responses, and processes, inhibiting sound decision-making. This can contribute to challenges in personal, social, and occupational life.

Unpredictable Mood Swings

Unpredictable mood swings accompanied by the unique symptoms we have mentioned above can signify fentanyl use. This is mostly because chronic fentanyl usage has profound impacts on the brain’s reward system and emotional regulation center. 

The euphoric effects witnessed shortly after fentanyl use are often followed by dysphoria or irritability owing to its rapid withdrawal onset. The challenges associated with maintaining a fentanyl addiction can also trigger mood fluctuations.

Physical Signs of Fentanyl Use

Regular or chronic fentanyl use can take a huge toll on an individual’s body, leading to the following physical effects:

Skin Changes

Although rare, fentanyl can cause noticeable changes in an individual’s skin after a while, such as a bluish color on the palms, skin, lips, fingernails, and nail beds or skin rash, swelling, redness, itchiness, burning, or soreness at the point of application (for transdermal patches). Additionally, fentanyl’s effects on blood vessels can cause skin temperature fluctuations, leading to abnormally cool or clammy skin.

Gastrointestinal Distress

Fentanyl can slow down digestive tract movement, leading to constipation or infrequent and difficult bowel movements. Additionally, the activation of opioid receptors in the stomach during withdrawal often causes nausea and vomiting. 

These and many other gastrointestinal symptoms associated with fentanyl usage can cause electrolyte imbalances, nutritional deficiencies, and dehydration, compromising users’ overall health.

Respiratory Effects of Fentanyl

Fentanyl can depress an individual’s respiratory centers or suppress breathing by binding to the mu-opioid receptors in the brain and spinal cord. These can lead to slowed and shallow breathing, insufficient tissue oxygenation (hypoxia), and, in some cases, respiratory arrest.

Mental and Emotional Warning Signs

Fentanyl addiction can also lead to psychological and emotional changes. Here are the most common mental and emotional warning signs of fentanyl addiction:

Cognitive Impairment

Like other opioids, fentanyl interacts with the central nervous system and suppresses certain neurotransmitters once it binds to the brain’s mu-opioid receptors. Prolonged usage can trigger structural and neuroadaptive changes in brain regions,  leading to learning and memory issues. Other cognitive impairments commonly associated with chronic fentanyl use include decision-making and information-processing inhibitions.

Emotional Detachment

Prolonged fentanyl misuse or abuse can interfere with the brain’s limbic system, leading to emotional issues. This potent pain reliever can alter the brain’s reward and mood pathways, reducing users’ capacity for pleasure or emotional connection. Its sedative effects can also affect one’s responsiveness to emotion-evoking stimuli, which may be seen as emotional detachment. 

Additionally, owing to fentanyl’s potent and compulsive nature, users may prioritize seeking the next high over social connections.


Anxiety disorders are common co-occurring disorders with fentanyl addiction. Fentanyl can affect parts of the brain responsible for processing fear and stress responses, such as the amygdala, leading to or exacerbating anxiety-related symptoms. The intense physical and psychological symptoms commonly experienced during fentanyl withdrawal can also heighten users’ anxiety levels.

Effects on Daily Living

Like other addictive substances, fentanyl can affect or impair daily functioning, leading to occupational challenges, financial consequences, and problems with interpersonal relationships. Here is an in-depth exploration:

Occupational Implications of Fentanyl Use

The occupational challenges associated with fentanyl use can be linked to the opioid’s potency and sedative nature. Fentanyl can cause slowed cognitive function, impaired concentration, and drowsiness, leading to poor performance in tasks that require high levels of alertness or attention to detail. 

Compulsive fentanyl use can also lead to frequent absenteeism, inconsistent work attendance, and damaged or strained relationships with workmates.  Additionally, fentanyl carries an increased overdose risk, which, when combined with its ability to impair judgment, can endanger work safety.

Impact on Interpersonal Relationships

Fentanyl addiction can lead to strained relationships with friends, family members, and partners owing to its compulsive nature. Individuals may prioritize acquiring the next dose over strengthening relationships with loved ones, leading to trust issues, emotional detachment, and communication breakdown. 

Other factors that may cause strained interpersonal relationships include heightened anxiety caused by fentanyl’s potency and unpredictability, negative behavioral changes, and fentanyl-induced financial challenges.

Financial Consequences of Fentanyl Use

Although fentanyl is relatively cheaper than other potent opioids, its addiction’s compulsivity can create a cycle of constant fentanyl seeking, leading to rapid depletion of finances. Chronic users may also find themselves prioritizing their fentanyl habit over necessities, basic needs, and utilities, leading to financial issues and, in severe cases, homelessness. The occupational challenges associated with fentanyl use can also lead to job loss, plunging users into financial hardship.

Recognizing Withdrawal Symptoms

You can tell that a loved one is addicted to fentanyl by looking out for certain withdrawal symptoms experienced in between doses, such as physical discomfort, psychological challenges, and intense cravings. Here is an in-depth exploration:

Physical Discomfort During Fentanyl Withdrawal

Chronic fentanyl users often experience intense physical discomfort on stopping or minimizing usage, resulting from joint pains, muscle aches, chills, excessive sweating, overall physical weakness, gastrointestinal disturbances, flu-like symptoms, and heightened pain sensitivity. This explains why medical supervision and supportive care are recommended during fentanyl withdrawal.

Psychological Challenges of Withdrawal

Besides causing physical discomfort, fentanyl withdrawal can impact an individual’s mental health, leading to a range of psychological challenges, including increased restlessness, nervousness, irritability, mood fluctuations, insomnia, dysphoria, and depressive feelings.

Cravings and Relapse Risks

Fentanyl is a potent opioid with profound effects on the brain’s reward system. Stopping or minimizing usage suddenly can lead to intense cravings, heightening relapse risks. These cravings can also pose a significant challenge during recovery by causing an overwhelming urge to seek and use the opioid, possibly interfering with individuals’ commitment to staying sober.

Denial and Secrecy in Fentanyl Addiction

Individuals addicted to fentanyl tend to be increasingly secretive, with others denying ever using the opioid. While denial and secrecy may hinder prompt intervention, they may not be intentional. Here are some of the reasons your loved one may deny or hide their fentanyl habit:


It’s common for individuals addicted to drugs and substances to use self-deception as a psychological defense mechanism against acknowledging the severity of their addiction. They may trivialize the problem, rationalize continued usage, or convince themselves that they have control over their addiction, perpetuating the cycle of addiction and preferring to keep their habit hidden. 

Family Dynamics

Individuals addicted to fentanyl may deny or keep their habit hidden to protect their loved ones from distress or maintain a sense of normalcy within the family. Others may also turn to denial and secrecy out of fear of judgment, shame, ridicule, and potential repercussions from family members.


Negative societal perceptions regarding substance use and addiction have contributed to the denial and increased secrecy associated with drug use. Loved ones may refrain from admitting usage or go to great lengths to hide a fentanyl habit out of fear of judgment or ridicule by society. This may hinder prompt intervention, leading to preventable long-term consequences.

Immediate Steps to Take for Fentanyl Addiction

Finding out that a loved one has a fentanyl addiction can be difficult and even overwhelming. However, like other addictions, fentanyl abuse is treatable and manageable. Here are the steps to take when you realize a loved one is dependent on fentanyl: 

  • Educate yourself about fentanyl addiction for a more knowledgeable and empathetic approach. 
  • Approach them with empathy and express concern for their well-being. Do not criticize or blame them for their actions; show that you genuinely want to help. 
  • Encourage them to seek help from addiction specialists, healthcare providers, or mental health specialists. Remind them that proper addiction treatment fosters enhanced treatment and recovery outcomes. 
  • Collaborate with them to research the most suitable treatment options for their addiction. At Nirvana Recovery, we offer supervised detox programs, therapy, counseling, and group support to help patients overcome a range of addictions. 

It’s also important to assure your loved one of your presence and support throughout their recovery journey. You should refrain from any enabling behaviors, such as giving them money to fund their fentanyl use or covering up for them. Additionally, consider professional intervention if a loved one is adamant about getting the right help and support for their fentanyl addiction. Feel free to contact us for further support and guidance.

Navigating Arizona's Opioid Crisis

The Arizona Department of Health Services estimates that more than five people lose their lives daily from opioid overdoses in Arizona. The same department also provides that there were 4,051 verified non-fatal opioid overdose deaths and 1,766 confirmed opioid deaths in 2023 alone. What’s the best way of dealing with this ongoing crisis? Here are a few measures that can help navigate Arizona’s opioid crisis: 

  • Increasing awareness about the risks and dangers of opioid abuse, addiction, and overdose. 
  • Educating Arizona communities on the proper usage of opioids and the dangers of opioid abuse and misuse. 
  • Tracking and analyzing prescription and dispensation of medicinal opioids through strengthened prescription drug monitoring programs. 
  • Encouraging safe prescribing practices among healthcare professionals. 
  • Making naloxone more accessible to the public to minimize opioid overdose deaths. Offering training on its safe usage is also important. 
  • Encouraging medical professionals to prescribe non-opioid medications and use alternative pain management strategies where possible. 
  • Supporting and participating in community opioid addiction education, counseling, and support initiatives. 
  • Partnering with local organizations, such as faith-based groups, to develop a network of resources for individuals affected by the opioid crisis. 
  • Strengthening law enforcement agencies to identify and prosecute unlawful distribution networks. 
  • Expanding mental health treatment access to address the underlying issues that may lead individuals to opioid abuse. 
  • Offering support and resources for individuals and families grappling with opioid addiction. 
  • Investing in research to promote a better understanding of the leading causes of the opioid crisis in Arizona. 
  • Supporting and advocating for policies aimed at addressing fentanyl addiction.

Local Support and Resources for Fentanyl Addiction

Besides seeking professional intervention for your loved one’s fentanyl addiction, you should encourage them to leverage local support and resources for enhanced understanding, connection, and support. Here are a few recommended options for individuals struggling with  fentanyl addiction in Arizona: 

  • Local support groups for fentanyl addiction 
  • SAMHSA’s national helpline (1-800-662-HELP)
  • Arizona Department of Health Services 
  • Community behavioral health agencies 
  • Narcotics Anonymous Arizona 
  • Community health centers 

Arizona substance abuse helplines, e.g., Arizona Addiction Hotline and Drug Addiction Hotline Arizona.


Learning that your loved one is struggling with fentanyl addiction can be frightening. However, with the right treatment and support, you can help them overcome the dreaded withdrawal symptoms and get on the path to recovery. We understand the challenges associated with fentanyl addiction at Nirvana Recovery. Therefore, we offer a range of services and programs for safe detoxification and fentanyl addiction treatment. 

We also allow you and your family members to participate in your loved one’s treatment through collaborative treatment planning, family therapy, and psychoeducation sessions. Feel free to contact us for tailored, individualized fentanyl addiction treatment, guidance, and support.

Frequently Asked Questions (FAQs)

Fentanyl’s exceptional potency differentiates it from other opioids, such as oxycodone and hydrocodone. It’s estimated to be 100 times stronger than morphine, a widely used pain reliever.

If left untreated, fentanyl abuse or addiction can cause significant changes in an individual’s brain chemistry, leading to or exacerbating mental health disorders such as depression and anxiety. It can also contribute to cognitive impairments and challenges with concentration, memory, or decision-making.

Yes. Fentanyl users face an increased overdose risk owing to the opioid’s potency. This is even more pronounced in illegally manufactured or obtained options, as more often than not, fentanyl bought from street dealers has impurities with potentially dangerous, unpredictable effects. Relatively small amounts can cause life-threatening consequences, including an overdose.

Although fentanyl addiction cuts across all age groups, teens and younger adults face an increased risk of addiction due to peer pressure, increased experimentation, and a false sense of invincibility.

Lower socioeconomic backgrounds are often associated with limited access to resources (and opportunities) and higher stress and unemployment levels, which may push individuals to use drugs as a maladaptive coping mechanism. But, since medicinal fentanyl is expensive and requires a medical prescription, such individuals may turn to illegally distributed options, which carry higher addiction and overdose risks.

Yes. Fentanyl addiction specialists commonly administer methadone and buprenorphine during treatment for a controlled, gradual tapering process. These medications are usually referred to as opioid replacement therapies as they bind to opioid receptors, reducing cravings and the intensity of withdrawal symptoms.

Mental health disorders and substance abuse have a complex, intertwined relationship. Individuals with severe mental health disorders such as major depression, social anxiety, and PTSD may resort to self-medication, triggering a fentanyl addiction. On the other hand, chronic fentanyl use can significantly affect brain chemistry and the central nervous system, leading to or exacerbating mental health disorders such as anxiety.

Fentanyl addiction during pregnancy puts the unborn children at risk. Besides causing significant challenges in accessing prenatal care, it increases the likelihood of preterm birth, neonatal abstinence syndrome, and low birth weight. Additionally, the developing fetus can experience respiratory depression, persistent neurobehavioral issues, and developmental challenges if fentanyl crosses the placental barrier.

The complexities and withdrawal symptoms associated with severe fentanyl abuse and addiction present heightened risks and potentially life-threatening complications, warranting round-the-clock supervision in a stable environment such as our inpatient treatment facility. However, individuals with mild to moderate addictions and a stable home environment can benefit from outpatient treatment.

Yes. Families of individuals struggling with a fentanyl addiction can benefit from family therapy, NAMI /Nar-Anon family support groups, education programs from organizations such as the Partnership to End Addiction and the Substance Abuse and Mental Health Services Administration’s (SAMSHA) resources, and family programs.

Owing to the ongoing opioid crisis and fentanyl’s high potency and overdose risks, being caught illegally possessing or distributing fentanyl can have severe legal repercussions, including hefty fines and lengthy prison sentences.

Here is how cultural factors contribute to fentanyl addiction within communities: 

  • Social pressure and the normalization and acceptance of drug use within certain cultural contexts can encourage individuals to experiment with fentanyl, leading to an addiction. 
  • Socioeconomic challenges within certain communities can push individuals to use fentanyl as a means of escape, possibly triggering an addiction. 
  • Limited awareness about the risks of fentanyl use within certain cultural communities can increase the risks of fentanyl addiction. 
  • The widespread availability of or easy access to fentanyl in certain cultural settings can contribute to fentanyl addiction.

Although we mostly use medication-assisted treatment (MAT) and behavioral therapies to treat fentanyl addiction at Nirvana Recovery, we may also include alternative therapies and holistic approaches such as mindfulness-based interventions, art, music therapy, and yoga.

Yes. Recovering from compulsive fentanyl use is possible. However, it requires addressing the physical, social, and psychological aspects of fentanyl addiction through a tailored treatment plan comprising evidence-based interventions, counseling, support groups, holistic approaches, and, in some cases, pharmacological interventions. Individuals recovering from fentanyl addiction also need social support and effective aftercare programs.

The stigma surrounding substance use and addiction has led to a widespread notion that addiction is a moral rather than a medical issue. Individuals struggling with fentanyl addiction may, therefore, shy away from seeking help out of fear of judgment, ridicule, or shame. Additionally, the notion mentioned above can lead to self-blame and feelings of worthlessness, deterring individuals from seeking assistance.

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Nirvana Recovery