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Actiq (Fentanyl) Lollipop Abuse

  1. Table of ContentsPrint
  2. ACTIQ Abuse
  3. Signs and Symptoms
  4. Effects of ACTIQ Abuse
  5. ACTIQ Statistics
  6. Teen ACTIQ Abuse
  7. Resources, Articles, and More Information

Man suffering from Actiq abuse

ACTIQ is the brand name of a prescription opioid medication that is only to be used for the treatment of breakthrough pain in cancer patients. ACTIQ is only recommended for those patients with cancer who 1) already take and have developed tolerance to another opioid painkiller but continue to have uncontrolled pain and 2) are at least 16 years old 1.

Fentanyl, the active ingredient in ACTIQ, is between 50 and 100 times stronger than morphine.

The active ingredient in ACTIQ is fentanyl citrate 1, a manmade opioid pain medication that is between 50 and 100 times stronger than morphine 2. Fentanyl is prescribed in a number of forms and brand names, including sublingual tablets (Abstral), patches placed on the skin (Duragesic), and injections 2,3,4:

ACTIQ, in particular, uses a novel method to deliver fentanyl to the individual. ACTIQ is an oral transmucosal lozenge on the end of a stick. The fentanyl is combined with inactive ingredients like citric acid or confectioner’s sugar to create a sweet, berry-flavored medication sometimes referred to as 3:

  • Fentanyl lollipop.
  • ACTIQ lollipop.

Special care must be taken when beginning treatment with ACTIQ. It is intended to be used only in cases of unmanaged cancer pain and should not be used within 4 hours of the previous dose 1. Use of this substance outside of these parameters is considered misuse/abuse and may cause an array of health risks and may even be fatal.


Prescription drug abuse and addiction is a growing epidemic, with 6.5 million people currently abusing prescription medications and approximately 66% of those abusing opioid pain relievers like fentanyl 5.

The potent narcotic, fentanyl, which used to be relatively unknown, is becoming one of the most talked-about and deadly drugs in this epidemic.

What Does It Mean to Abuse Fentanyl?

Any time an individual takes ACTIQ outside of the strict prescription guidelines, it is considered abuse. This includes 6:

  • Taking more of the substance than prescribed (more often or in higher doses).
  • Taking the substance for reasons other than prescribed.
  • Taking the substance without a valid prescription.

Now commonly referred to as “the drug that killed Prince,” fentanyl produces effects similar to that of heroin but is actually a much more potent drug. These effects include 2,3:

  • A euphoric “high.”
  • Pain relief.
  • Mental and physical relaxation.
  • Drowsiness.

Misusing ACTIQ is incredibly dangerous due to 3:

  • The strength of the substance.
  • The rapid onset of effects.
  • The short duration of effects.

Someone that is abusing ACTIQ may be unprepared for the strength of the substance and experience serious health consequences or overdose, which can cause serious respiratory depression and death 1.

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Signs and Symptoms

Aside from the ACTIQ “high” described above, someone abusing ACTIQ may also exhibit the following physical signs and symptoms 1,3,4:

  • Pain.
  • Fever.
  • Weakness.
  • Headache.
  • Indigestion.
  • Diarrhea.
  • Dehydration.
  • Constipation.
  • Sleep changes.
  • Rash.
  • Weight loss.
  • Changes in sexual functioning or desire.

While many of these are normal side effects of fentanyl, if these symptoms arise in someone without a valid prescription or increase in frequency and severity for someone with a prescription, ACTIQ abuse and/or addiction may be present or developing.

ACTIQ abuse may also produce numerous psychological symptoms such as 1,4:

  • Irritability.
  • Anxiety.
  • Depression.
  • Mood changes.
  • Disturbed thoughts and dreams.
  • Psychotic symptoms like seeing or hearing things that are not there.

Serious Symptoms

The most serious side effect of ACTIQ is respiratory depression, which can quickly be fatal; however, other potentially dangerous effects include 1,4:

  • Changes in heart rate.
  • Difficulty swallowing.
  • Confusion.
  • Extreme sedation.
  • Dizziness,
  • Fainting.
  • Seizures.

ACTIQ Overdose

ACTIQ overdose may occur in individuals taking the drug outside prescription guidelines or in those using it recreationally. The risk can be significantly heightened in individuals combining ACTIQ with other substances, especially other depressants such as alcohol or sedatives.

ACTIQ overdose symptoms include 4,7:

  • Slowed or stopped breathing.
  • Blue lips and fingers.
  • Cold, clammy skin.
  • Shakiness.
  • Vomiting.

ACTIQ overdose can be treated with naloxone, but due to the potent nature of the painkiller and the fact that ACTIQ is prescribed to individuals with a baseline opioid tolerance, greater doses of naloxone may be required 2.

Effects of ACTIQ Abuse

Once fentanyl is consumed, it attaches to opioid receptors in the brain 2,6. This triggers the release of a neurotransmitter called dopamine—a physiologic response that underpins many of the positive effects associated with opioids 2.

The artificially high rewards produced by the fentanyl in ACTIQ cannot be matched by natural rewards like food or sex.

A marked sense of reward becomes linked with this dopamine surge, which can lead to the desire, if not an eventual compulsion, to reproduce the sensation. The artificially high rewards produced by the fentanyl in ACTIQ cannot be matched by natural rewards like food or sex 2,6.

With time, ACTIQ use can lead to tolerance, dependence, and addiction.

ACTIQ Tolerance

Like many other drugs of abuse, continued use of ACTIQ can lead to tolerance. When tolerance has developed, the medication can no longer produce the same effects in the user at the same dose 1,6.

It is common for individuals to increase their doses and/or combine the drug with other substances like alcohol to augment the effects, both of which put them at continually increasing risks of drug toxicity, related injury, and death.

ACTIQ Dependence

Over time, an individual may also become dependent on ACTIQ, and their body will require the drug to feel or behave normally. Dependence can occur in those taking the drug as prescribed; however, it is closely intertwined with addiction, as well. Those dependent on fentanyl will need to keep using fentanyl in order to avoid extremely uncomfortable withdrawal symptoms. This pattern of use and avoidance of withdrawal is common to addiction.

Woman laying on couch experiencing Actiq abuse symptoms

ACTIQ withdrawal symptoms include 6,8:

  • Restlessness.
  • Anxiety.
  • Bone and muscle pain.
  • Insomnia.
  • Nausea.
  • Diarrhea.
  • Vomiting.
  • Cold flashes.
  • Higher body temperature.
  • Involuntary muscle twitches.
  • Faster pulse/ higher blood pressure.
  • Sweating.

ACTIQ Addiction

ACTIQ addiction may develop in a shorter amount of time when compared to other opioids due to the strength of the substance. Addiction is marked by the strong desire to consume the substance despite the mounting negative impact of use. Someone addicted to ACTIQ may:

  • Seek out multiple prescriptions from multiple doctors.
  • Not use or dispose of the product correctly.
  • Continue using the drug longer than directed.
  • Encourage others to sell, trade, or obtain the product for them.
  • Have increased conflict with others in their life.
  • Be unable to perform normal tasks and activities of daily living like household chores.
  • Fall behind on bills or report financial trouble.
  • Have noticeable deficits in self-care.

ACTIQ Statistics

According to the National Institute on Drug Abuse (NIDA) for Teens, 19,000 people died in 2014 from overdose of opioid pain medications like fentanyl 7.

The Drug Enforcement Administration (DEA) reports that:

  • More than 20,000 people presented to emergency departments for symptoms of fentanyl abuse in 2011.
  • In 2014, about 3,300 examples of illicitly distributed fentanyl were obtained by law enforcement, which was more than 3 times the amount from the previous year.

Teen ACTIQ Abuse

Teens that abuse prescription pain medications typically acquire the substance from a friend or relative 6. To prevent teen ACTIQ abuse:

  • Keep your prescriptions in a safe place.
  • Track your medication usage.
  • Dispose of all medications appropriately.
  • Educate yourself and your teen regarding the dangers of prescription opioid abuse.
  • Monitor your teen’s behavior and their access to ACTIQ and other medications.
  • Praise your teen for good decision-making.

Resources, Articles, and More Information

For more information, check out the following articles:

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  1. U.S. Food and Drug Administration. (2011). ACTIQ.
  2. National Institute on Drug Abuse. (2016). DrugFacts: Fentanyl.
  3. Drug Enforcement Administration. (2015). Fentanyl.
  4. U.S. National Library of Medicine: Medline Plus. (2016). Fentanyl.
  5. Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
  6. National Institute on Drug Abuse. (2014). Research Report Series: Prescription Drug Abuse.
  7. National Institute on Drug Abuse for Teens. (2016). Prescription Pain Medications: Opioids.
  8. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
Last updated on May 6, 2019
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