Snorting Fentanyl: Long-Term Effects & Dangers

Fentanyl is a pain-relieving substance with two main uses ¹:

• Treating significant acute, post-operative pain following surgery.
• Treating chronic or breakthrough pain in people that no longer respond to other narcotic medications.

Like morphine, fentanyl is an opioid substance that reduces the user’s perception of pain by acting on opioid receptors in the brain and body ². Fentanyl is one of the most potent opioid medications, which is why it frequently reserved only for use in opioid-tolerant patients ^3,4. Fentanyl is up to 100 times more powerful than morphine, an opiate that is addictive in its own right ^1,3. In recent years, fentanyl has become a major health concern, as its popularity has increased due to its powerful high and the numbers of overdoses related to fentanyl-laced heroin have reached alarming heights. On the street, fentanyl is increasingly sought-after and is referred to by a number of names such as “apache,” “china girl,” and” china white” ¹.

A substantial amount of fentanyl abused will be illicitly produced in clandestine labs ³. Using illegally-produced, non-pharmaceutical fentanyl is very dangerous due to lack of regulation, but misusing any fentanyl product (legally or illegally produced) by changing the dose, frequency, or route of administration can also be hazardous due to the potency and possible side effects ^1,2. For example, snorting fentanyl will produce effects that are unpredictably dangerous and potentially deadly, especially compared to using the drug as directed.

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Is Snorting Fentanyl Dangerous?

Snorting fentanyl is indeed very dangerous and poses numerous risks to the user. Non-pharmaceutical fentanyl is commonly found in powdered form, which makes snorting it a common option ¹.

Even with a prescription, fentanyl use must be carefully monitored ⁴. Anytime a substance is consumed in ways other than prescribed, the danger rises.

Some dangers of snorting fentanyl include:

• Speed of onset. Snorting fentanyl allows the opioid to be absorbed into the bloodstream through the mucus membranes in the nasal passage before reaching the brain a few minutes later. This will be much quicker than oral ingestion ⁵.
• Intensity. Snorting fentanyl also contributes to an intensified high compared to oral ingestion. A quicker route allows for the concentration of fentanyl in the brain to rise more quickly, leading to intense and dangerous effects that can overwhelm the body and cause many unwanted consequences like respiratory depression. The dangers rise if the person has a low tolerance to opioids ⁶. Additionally, snorting allows more fentanyl to reach the brain compared to oral consumption. Unlike snorting, when fentanyl is consumed orally, the stomach, intestines, and liver begin to break down some of the drug before it can reach the brain ⁵.
• Duration. When a substance reaches the brain quickly, it may produce effects that are more intense but shorter in duration than when the substance reaches the brain in a slower, more controlled manner ⁵.

Can I Become Addicted to Fentanyl?

Another danger that comes with snorting fentanyl is the risk of addiction. Addiction is a major concern for all opioid users, even when the drug is taken as prescribed. However, the likelihood of an addiction developing is significantly increased anytime the drug is abused. Misusing any drug (for example, snorting non-pharmaceutical fentanyl) will further increase the risk of addiction ⁶. This is partly due to the changes that altering the method of administration produces; remember that snorting creates a rapid and intense high with a shorter duration. This leaves the user:

1) Feeling immediately euphoric.

2) Quickly coming down from the high and craving to use again.

This pattern of use is strongly linked to the development of addiction.

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Side Effects of Snorting Fentanyl

Fentanyl carries a risk of side effects no matter how it is consumed. While using the medication as prescribed presents certain side effects, the user’s risk of experiencing these effects rises significantly with abuse of the drug. Someone snorting fentanyl may experience side effects like ⁴:

• Sleepiness.
• Weakness.
• Diarrhea.
• Nausea.
• Vomiting.
• Decreased appetite/weight loss.
• Headache.
• Impaired vision.
• Dry mouth.
• Sweating.
• Pain in the chest or back.
• Trouble with sleep.

Snorting fentanyl may also cause certain mental health side effects to arise, such as ⁴:

• Anxiety.
• Depression.
• Hallucinations.
• Unusual dreams.
• Odd thoughts.

Can Snorting Fentanyl Cause an Overdose?

Yes. Fentanyl is extremely powerful, and misusing it even once can cause a potentially fatal overdose.

According to the National Institute on Drug Abuse (NIDA), 19,000 people died in 2014 from opioid pain reliever overdose ². The signs of fentanyl overdose may include ^2,4:

• Cyanosis (blue tint to lips and nails).
• Extreme drowsiness.
• Profound disorientation and confusion.
• Small pupils.
• Cold, clammy skin.
• Violent shakiness.
• Uncontrollable vomiting.
• Slowed, labored, or stopped breathing.

Fentanyl overdose is especially likely when someone who has not used fentanyl before uses it recreationally or unknowingly (e.g., in a laced or counterfeit drug). It is also likely to occur if someone who has become tolerant to the drug takes a larger amount to produce the kind of high that used to come with lower doses ⁶. Any dose increase outside the careful monitoring of a medical professional can be extremely dangerous ⁶. Overdose is also a risk for someone who has returned to fentanyl use after a period of abstinence during which their tolerance decreased ⁶.

Combining fentanyl use with alcohol or other drugs can increase the overdose risk. First, using fentanyl with other substances that affect breathing—including other central nervous system (CNS) depressants (e.g., benzodiazepines or another opioid like heroin)—poses extreme danger of respiratory depression and death ^2,6. Second, non-pharmaceutical fentanyl is frequently laced with other drugs, such as cocaine or heroin. In these situations, the user is unprepared for the effects which may occur and may experience an overdose when taking what they thought was their “normal” fentanyl dose ¹.

Opioid overdose can sometimes be reversed when the individual is given a medication called naloxone. This opioid antagonist (blocker) reduces the negative impact of fentanyl on breathing, and can save lives if administered early. Due to the potency of fentanyl, repeated doses might be needed to improve symptoms ¹.

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Signs That Someone is Addicted to Fentanyl

Addiction is marked by the continued, compulsive desire to acquire and use a substance even when negative repercussions are likely to occur. Someone addicted to fentanyl may show signs like ⁸:

• Taking more fentanyl than expected and for longer periods than intended.
• Failed attempts to stop or reduce use.
• New or worsening problems meeting demands at work, home, school, or in the community.
• Shifting interests and activities.
• Changing relationships or increased conflict with established relationships.

Someone abusing fentanyl by snorting it may:

• Have powder on their face, hands, or clothes.
• Possess tools to tamper with and snort the substance.
• Sniff, sneeze, and wipe their nose frequently.

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Getting Help for Fentanyl Addiction

Someone seeking help for fentanyl addiction should begin by seeking professional treatment because when use ends, very uncomfortable and potentially dangerous withdrawal symptoms can emerge that lead to relapse. Examples of fentanyl withdrawal symptoms include ^6,9:

• Widespread body aches and pains.
• Diarrhea.
• Nausea and vomiting.
• Higher blood pressure and irregular heart rate.
• Fever, chills, and sweating.
• Runny nose and watery eyes.
• Strong cravings to restart use.

A period of medically-assisted detoxification to manage withdrawal symptoms and help the recovering individual maintain abstinence can be extremely helpful for those attempting to end fentanyl use. Painkiller detox often occurs in an inpatient or residential setting so the patient can be continuously monitored and the symptoms can be managed on the spot to increase comfort and mitigate any risks ^6,9.

Ongoing treatment may include a combination of medications and behavioral therapies to reduce cravings and promote recovery. Pharmacotherapies include ^6,9:

• Opioid agonists like methadone that trigger a response in the brain similar to fentanyl but in a more controlled way to reduce addictive behaviors.
• Opioid partial agonists like buprenorphine (or the combination product, Suboxone—buprenorphine + naloxone) that work like an agonist but create a less intense response, thus minimizing the potential for abuse.
• Opioid antagonists like naltrexone that diminish the impetus for continued opioid abuse by blocking the opioid high.

Behavioral therapies include ⁹:

• Cognitive-behavioral therapy (CBT) – focuses on identifying and changing negative coping mechanisms into positive skills that support recovery. Also helps to develop strategies to limit cravings.
• Contingency management (CM) – works to provide desirable rewards to the individual when drug-free behaviors are completed. Helps to counteract the reinforcing sensations of fentanyl use by rewarding behaviors that promote abstinence.

Making the choice to end fentanyl use and beginning recovery is a challenging time. To improve your recovery experience and potentially increase treatment outcomes, seek professional rehabilitation services. To find effective options for you or a loved one, call today.

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