When many people hear about fentanyl, their thoughts likely shift to the illicit street drug that’s devastating communities across the globe. While they’re correct to think that way, many seem to forget that fentanyl is a highly potent prescription opioid medication used to treat severe pain when providers have exhausted all other resources. Fentanyl is occasionally prescribed for chronic pain, and paramedics also administer it after an acute injury occurs.

Fentanyl is a Schedule II controlled substance that’s 100 times more potent than morphine. The drug is reserved for individuals who have become tolerant to other opioids, such as oxycodone or hydromorphone, and endure severe pain that is untreatable by other means. If you are considering fentanyl treatment, the doctor must first determine if it’s right for you. If so, they will likely send you to a pain management clinic, where you’ll sign a contract and be subject to random drug tests to ensure you’re using the medication only as prescribed.

What to Consider Before Using Fentanyl for Pain Management

When you’re trusted to take a drug with a notorious reputation like fentanyl, you must consider the potential reactions that can occur from use. Even someone tolerant to opioids will experience side effects when they start using fentanyl. The doctor will prescribe you the lowest dose possible and adjust as needed to treat your pain. If this isn’t enough, your doctor will increase the amount in small increments to find one that works. Over the next week or two, the euphoric side effects will subside as you develop a fentanyl tolerance. Becoming tolerant of a drug isn’t always bad, but you must bring it up to your prescribing physician.

Developing a fentanyl tolerance is typically an early sign that you are on the verge of developing a substance use disorder (SUD). At this point, how you approach it will determine the outcome. For example, if you increase your dose to combat tolerance without your doctor’s approval, you’re at risk of becoming addicted. If your doctor tells you it’s fine to increase the dose, there won’t be an issue. It’s important to learn more about fentanyl tolerance, how fast it occurs, and how to manage pain.

Learning to manage your pain and using opioids responsibly can be the difference between life and death. The U.S. Centers for Disease Control and Prevention (CDC) estimates that 75,673 people lost their lives in 2021 from opioid use, primarily driven by illicit fentanyl and prescription drug abuse. Below, we’ll explain how fentanyl affects the brain and how tolerance happens.

How Fentanyl Affects the Human Brain

Fentanyl is the most potent pain medication available and has profound effects on the brain and body. Despite its potency, it still acts similarly to other opioids like heroin or morphine. It binds to opioid receptors throughout the body and brain. The receptors are in areas that regulate how a person experiences pain and where emotions are regulated.

When you ingest a drug like fentanyl, it binds to opioid receptors that flood the brain with dopamine. Dopamine is a naturally occurring neurotransmitter responsible for various functions in the brain, including happiness. Although it occurs naturally, it’s not nearly as much as when taking fentanyl. The flood of dopamine leads to extreme relaxation and euphoria.

The effects fentanyl has on the brain are similar to heroin but significantly more powerful. While opioids produce relaxation and euphoria, you can also expect drowsiness, nausea, confusion, sedation, respiratory distress, coma, and death. How fentanyl affects the brain is extremely dangerous and can easily lead to the development of an opioid use disorder (OUD).

Fentanyl Tolerance Development

When taking medication like fentanyl, it’s possible to develop a tolerance in as little as two weeks. Drug tolerance results from regular exposure to the medication. When you become tolerant of the medicine, you’ll notice that your current dose isn’t delivering its desired effect. This could also indicate your body is adjusting to fentanyl’s presence in your system. You have several options to combat this, including changing your regimen, increasing the dose, or stopping your use altogether. Since there isn’t a more potent option when it comes to fentanyl, your choice is limited in that sense.

Fentanyl tolerance stems from behavioral and genetic elements. Although it often occurs within the first two weeks of use, some people become tolerant to fentanyl in as little as a few uses. It’s crucial to remember that tolerance and dependence are not the same. Despite the number of studies on the subject, researchers still misunderstand tolerance. One benefit of tolerance is that fewer side effects will occur as your body adjusts to the medication in your system.

What Are the Effects of Fentanyl Tolerance?

If you’ve become tolerant to fentanyl, you’re likely at a crossroads as it’s the first sign you’re developing an OUD. You’ll have to decide whether you can lower your dose or stop altogether. If you’re in severe chronic pain, other opioids aren’t an option, so choosing the best course of action with your doctor is your final hope. If you’re not experiencing relief from fentanyl, it might be in your best interest to stop. It’s not worth becoming addicted to something that isn’t working.

Fentanyl tolerance indicates your current dose isn’t working anymore. Your first thought might be to take more. However, this will solidify your odds of becoming dependent on fentanyl, leading to withdrawal symptoms if you lower your dose or stop altogether. Speak with your doctor about what to do next.

Can You Reverse Fentanyl Tolerance?

Fortunately, you can reverse fentanyl tolerance. While it may sound easier than it is, it’ll help you tremendously in the long term. The most common treatment options to lower fentanyl tolerance include slowly tapering the dose, using longer-acting opioids, or managing your opioid withdrawal symptoms. Your doctor will likely suggest tapering the dose to reduce tolerance, which consists of gradually decreasing the amount of fentanyl you’re using. The process helps your body adjust to a lower dose and reduce the severity of your cravings. It should help with pain since less fentanyl will be more effective.

Do Fentanyl Patches Cause Tolerance?

Although fentanyl patches are believed to be safe and effective when used as directed by a prescribing physician, fentanyl patches can cause tolerance. The patches are given to those who have exhausted all other resources for pain management. A person using a fentanyl patch has high-sensitivity pain and could also be experiencing emotional problems, which is likely why other opioids weren’t working. These problems often lead to opioid misuse.

When someone receives a fentanyl patch, the drug is released slowly for maximum pain relief. For example, a 10.5-centimeter square patch releases around 25 micrograms of the drug per hour. The patch’s size indicates how much it will release each hour. While slow-release patches sound safer, extended-release formulations cause more problems, such as an overdose. Since emotional problems enhance the experience of pain, it can lead to someone using patches more often than they should, leading to an overdose.

Another issue with fentanyl patches is they become less effective at the end of each dose. Patches are typically supposed to be worn for 72 hours. However, in the end, doses are milder than when the patch was applied, which can lead to someone putting a new patch on earlier than they should. The longer a person uses fentanyl patches, the more likely they will develop a tolerance to them.

Fentanyl patch tolerance is expected in those who use the medication for prolonged periods, even when under their doctor’s guidance. As noted earlier, tolerance is a sign the person isn’t experiencing pain relief as they once did. Since fentanyl patches are thought of as a safer alternative to opioids, people might think to increase the dose without medical supervision. You must always contact your doctor before making medical decisions that can significantly impact your well-being.

If you’re concerned about fentanyl tolerance, the only choice you have is to speak with a licensed physician who can guide you in the right direction. Although it’s safe when used as prescribed, fentanyl is a potentially deadly drug. A fentanyl overdose can cause long-term damage or death. Be careful when using this medication.

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