- Generic Name or Active Ingridient: Fentanyl
- Using or participating in addictive behaviors excessively, often at higher frequency or intensity than intended. This use is often couple with an expressed intent to control one's behavior.
- Excessive time lost looking for Duragesic, using the drug or recovering from the effects this opioid.
- Continuing to use Duragesic despite understanding the consequences of abuse.
- Losing interest in every except Duragesic.
- An apparent lack of interest or ability to quit using Duragesic.
- A preoccupation with Duragesic.
- Altered perception of the benefits and risks of using Duragesic.
- Inaccurate belief that the individual's problems are due to other causes rather than as a predicable consequence of abusing Duragesic.
- Increased anxiety, dysphoria and emotional pain
- Increased sensitivity to stressors. The individual suffering an addiction to Duragesic might say, "Things seem more stressful."
- Difficulty identifying feelings or expressing emotions to others
The U.S. Drug Enforcement Agency classifies Duragesic, or fentanyl, as a schedule II controlled substance, which means that this drug has a high potential for abuse, which may lead to severe physical dependence and addictive behavior. An individual may become addicted to Duragesic after using high doses of this opioid pain killer or using it for recreational purposes. Fentanyl is a favorite among recreational users; it is frequently diverted from prescription use and is sometimes manufactured in clandestine laboratories. Used Duragesic patches contain enough medicine to get high, and therefore recreational users seek out these used patches. A person who becomes addicted to Duragesic after taking it for pain control may find it more difficult to recover from addiction if they are still experiencing debilitating pain from acute and chronic conditions, such as cancer.
The definition of addiction
Addiction to Duragesic is a primary, chronic disease affected by genetic, psychosocial, and environmental factors influencing its development and manifestations. Addiction to Duragesic is characterized by behaviors including impaired control over drug use, compulsive use, continued use despite harm, and craving for fentanyl.
Addiction versus Dependency
Addiction is different from physical dependency. Both addiction and dependence cause real physical and neurological changes but addiction and dependence manifest themselves in different ways. Being physically dependent means your body has adapted to having a certain level of Duragesic. If the level of Duragesic were to drop, the body would struggle to regain chemical balance. This struggle manifests itself through withdrawal symptoms.
Addiction is a behavioral manifestation of a person's reliance on Duragesic. An individual who is addicted to fentanyl begins to act in a way that increasingly excludes everything but fentanyl. Addiction and dependence on drugs are separate and independent from one another: one can be addicted to something without being physically dependent on it and vice versa. Duragesic causes both physical dependence and addiction.
Addiction: What Family Members Should Know
Scientists have not yet established the underlying cause of addiction but research indicates that genetics may play a role. Other environmental factors thought to influence a predisposition to addictive behavior include peer pressure, emotional distress, anxiety, depression and environmental stress. People who use Duragesic to relieve acute or chronic pain resulting from a serious or terminal condition may develop an emotional dependence on Duragesic, as they fear how much pain they will be in once they stop using fentanyl. Family members of terminally ill or seriously ill patients should remain vigilant for signs of addiction.
The active ingredient in Duragesic, fentanyl, is about 100 time stronger than morphine. It is fast acting, rapidly crossing the blood-brain barrier to produce an intense high of short duration. Family members should know this is a potent and dangerous drug.
Duragesic addiction can have profound effects on a family. Drug addiction can cause violence, separation of parents and children, divorce, loss of income and legal issues. Families that struggle with Duragesic addiction frequently face financial trouble, single parenthood, child care issues and feelings of anxiety and hopelessness.
The home environment seems to influence the risk for addictive behaviors, such as addiction to Duragesic. Children who grow up in an environment where adults engage in illicit drug use are more likely to develop addictions later on in life. Scientists at the American Society of Addiction Medicine state that genetic factors account for about half the likelihood that an individual will develop an addiction.
Friends and family members can learn to recognize symptoms of addiction to Duragesic. These symptoms incorporate all aspects of the individual's being, including his physical state, psychological status and his behavior. Family members and friends may seek independent counseling to improve their interpersonal skills with the individual suffering the addiction.
Addiction Symptoms: Physical and Psychological
Addiction to Duragesic manifests itself in a variety of physical and psychological symptoms. Addiction causes physical changes to the structure and function of the brain, especially in those areas of the brain associated with reward. Addiction to Duragesic and other opioids changes the way the brain remembers reward, so that the individual builds a strong positive association with Duragesic. The brain and the body begin to crave Duragesic.
The individual with the addiction may suddenly gain or lose weight, alter his sleeping patterns, or have a deteriorating physical appearance and diminished hygiene care. His body or clothing may smell unusual; he might have bloodshot eyes with unusually large or small pupils. He may have tremors, slurred speech or seem clumsy or uncoordinated.
Psychological symptoms of Duragesic addiction include an inability to abstain from drug use consistently, despite an expressed intent to control or quit drug use. Addiction may also impair an individual's ability to control his behavior in other respects. She may participate in criminal behavior or act inappropriately in public. She may crave drugs or other intense reward experiences, like driving at dangerous speeds or participate in unsafe sex with strangers. She is unable to associate her addiction to Duragesic with significant personal and relationship problems, often saying her addiction is due to her problems and not the other way around. She may also display a dysfunctional emotional response to events by laughing inappropriately to bad news, for example, or bursting into a tirade for no reason.
Addiction and gender: how women and men are affected differently
Several studies have examined how gender effects addiction. These studies show significant difference in the ways men and women start drug abuse, the drugs they use and the way they use them.
Some statistics suggest women may be more likely to abuse prescription drugs and are more likely to abuse multiple substances than are men.
Women who abuse drugs frequently come from homes where parents allowed or engaged in illegal drug use. Women addicted to drugs are likely to have a partner or spouse with an addiction, whereas men with addictions do not necessarily cohabitate with another individual with an addiction.
Men are more likely to exhibit social disorders, such as engaging in criminal activity, whereas addicted women are more likely to experience mood disorders while addicted to drugs such as Duragesic. Women with addictions are more likely to have a poor body image than are addicted men and women are therefore at higher risk for developing concurrent eating disorders. Addicted men are more likely to engage in drugs at social gatherings, as compared with women with addictions who tend to to abuse drugs in private.
Men are more likely to admit to current drug abuse than are women, according to the 2002 National Survey on Drug Use and Health. Historically, women have a lower rate for entry into rehabilitation, staying in treatment and completing treatment than men. Rehabilitation specialists attribute this reluctance to seek and stay in treatment to social stigmas, economic barriers and family responsibilities.
Signs of addiction: For those around
Signs of addiction include changes in a person's behavior, his thinking patterns, emotions and interactions with others. Addiction alters an individual's executive functioning; these changes manifest themselves in problems with perception, learning, impulse control compulsivity and judgment.
Behavioral manifestation and complications of addition include:
Cognitive changes include:
Emotional signs of addiction include:
Addiction can cause disability or even premature death, especially when it is left untreated or poorly treated. Recovery from addiction is best achieved through a combination of self-treatment, support from family members and professional care provided by trained and certified professionals. There are two phases of treatment for addiction to Duragesic. The first phase includes detoxification and easing the subsequent withdrawal symptoms. The second phase addresses behavioral aspects of addiction through counseling and other social services.
Some people attempt to quit Duragesic alone, without the help of trained professionals. This is known as self-detox or quitting "cold turkey." The individual suffers through days of debilitating symptoms, such as diarrhea, stomach pains, tremors, cold and clammy skin, body aches and insomnia. Overpowering withdrawal symptoms often drive people back to Duragesic use. People attempting self-detox without medical supervision can suffer dangerous complications, such as vomiting and aspirating stomach contents into the lungs, or becoming dehydrated from excessive sweating, vomiting and diarrhea.
Other people use a regimen of drugs intended to reduce withdrawal symptoms. One such course of self-detoxification is called the Thomas Recipe. This treatment calls for Valium, Xanax, Klonopin, Ativan or Librium to reduce symptoms and cause sleep. The individual then takes consecutively smaller doses of these drugs each day to wean from that medication. Symptoms are usually worst around the fourth day. Withdrawal symptoms should subside enough after five or more days to discontinue valium or other drugs. Imodium helps control diarrhea and L-Tyrosine eases anxiety. Other supplements ease fatigue and depression while hot baths soothe body aches. The Thomas Recipe does not reduce the risk for complications, nor does it address the behavioral aspects of Duragesic addiction.
Withdrawal symptoms make self-detoxification difficult, if not impossible. Individuals often relapse to Duragesic use. People who have recently detoxified their systems now have a lower tolerance to Duragesic. After detoxification, it is possible for these individuals to overdose on lower doses of Duragesic than they used to take.
Overdose or toxic doses of Duragesic require emergency medical treatment. Emergency room physicians administer medications to lower the level of Duragesic in the system rapidly. Nurses and doctors monitor vital signs, administer fluids intravenously and administer life saving treatment whenever necessary. Once the patient is stabilized, she may be discharged to a drug treatment center.
People who do not wish to participate in inpatient treatment programs may choose drug replacement therapy, available in outpatient settings. Physicians prescribe replacement drugs, like methadone, Suboxone or buprenorphine to prevent withdrawal symptoms while the patient quits Duragesic. After treatment, the patient reduces his dose of the replacement drug until he no longer needs it. Opponents of this treatment style say it is trading one addiction for another.
Inpatient treatment programs use medicine to reduce the level of Duragesic in the system and drugs to reduce subsequent withdrawal symptoms. This therapy is preferable because a physician monitors treatment and the patient does not have to struggle with withdrawal from the replacement drug.
Rapid detox is the new standard in detoxification, providing humane care with faster detox time. During rapid detox, physicians administer the standard detoxification and anti-withdrawal drugs along with anesthesia and sedatives. Patients doze comfortably in a "twilight sleep" during detoxification and awaken refreshed and unaware of the unpleasant symptoms of withdrawal. Skipping the demoralizing effect of withdrawal improves the chances for success in treating addiction to Duragesic.
After completion of detoxification, individuals need to participate in behavior modification to address the issues that led to or resulted from their addiction to Duragesic. Rehabilitation includes individual and group therapy, family counseling and other social services. Long-term recovery depends on a patient's ability to change those behaviors that contributed to his addiction to Duragesic.
The largest complication to recovery for individuals who used Duragesic for recreational purposes is returning to drug abuse. Patients who became addicted to Duragesic as the result of using it to control pain, and who continue to rely on medication to relieve this pain, may relapse to addiction. Physicians should monitor all patients closely for signs of relapse.