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Few medications carry as much public concern as fentanyl-based products. And this is for a good reason. Fentanyl is leading the way in terms of fatal overdoses in the opioid epidemic. Even small amounts can be life-threatening.
However, fentanyl comes in many forms. It’s historically been used medically as a sedative and for pain relief1. Fentanyl lozenges are one form of this highly potent drug. Originally developed for patients with severe chronic pain, this fast-acting version absorbs quickly through the mouth and can deliver intense effects within minutes.
While medically intended for very specific cases, the misuse of these lozenges has led to devastating consequences. Below, we take a closer look at why this is the case and what these fentanyl lozenges are exactly.
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What Are Fentanyl Lozenges?
Fentanyl lozenges2, often known by the brand name Actiq, are a unique form of pain medication designed to look and function a bit like a medicated lollipop. The fentanyl is mixed into a sweetened lozenge attached to a plastic stick, and it's meant to dissolve slowly in the mouth.
As it melts, the medication is absorbed directly through the lining of the mouth, allowing it to work much faster than pills that have to go through the digestive system.
These lozenges come in a range of strengths—from 200 to 1600 micrograms—and each one is individually wrapped in child-resistant packaging.
What Are Fentanyl Lozenges Used For?
Fentanyl lozenges are specifically approved for the management of breakthrough pain in cancer patients who are already receiving and have developed tolerance to around-the-clock opioid therapy for their persistent cancer pain3. Breakthrough pain refers to temporary flare-ups of severe pain that “break through” regular pain medication regimens.
These specialized medications are not intended for:
- Patients who are not already opioid-tolerant
- Treatment of acute or postoperative pain
- Management of mild or intermittent pain
- Use on an as-needed basis for non-cancer pain
Due to their high potency (fentanyl is approximately 50-100 times more potent than morphine), fentanyl lozenges are classified as Schedule II controlled substances by the Drug Enforcement Administration4. They are prescribed only when other pain management options have proven inadequate, and their use requires enrollment in the FDA’s Risk Evaluation and Mitigation Strategy (REMS)5 program to ensure appropriate prescribing, proper patient education, and patient monitoring.
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Why Are Fentanyl Lozenges So Dangerous?
While fentanyl lozenges may look harmless, they carry significant risks, even when used as prescribed. For instance, fentanyl is up to 100 times stronger than morphine6. This means that even a small mistake in dosing can have deadly consequences.
Because the medication is absorbed directly through the mouth, it enters the bloodstream quickly. In some cases, this can cause breathing to slow down or even stop before help has a chance to arrive.
Additionally, these lozenges are often compared to lollipops, which can be especially dangerous around children. If accidentally ingested, even a single lozenge can be fatal.
Due to its highly potent nature, there’s also a strong possibility of addiction, which we explore below.
Signs of Addiction
In particular, when used outside medical supervision, fentanyl lozenges can quickly lead to physical dependence and addiction. Signs you might have an addiction include:
- You’re using a higher dose than prescribed.
- You’re now doctor shopping to obtain more.
- You’ve tried to stop using it, but you can’t.
- You’ve begun to neglect personal hygiene, appearance, and other aspects of life.
- You’ve withdrawn from family and friends.
- You’re experiencing sleep issues.
- You need higher doses to achieve the same effects.
- You experience withdrawal symptoms when halting use.
If you notice any of the above, this is a sign that you need to discuss things with your doctor. They can help you wean off the medication or refer you to addiction specialists who can help you do so safely and effectively.
Withdrawal Symptoms
Withdrawal symptoms arise when stopping the use of fentanyl. This often drives the person to continue using. These symptoms may include:
- Anxiety
- Insomnia
- Nausea and vomiting
- Intense cravings
- Excessive sweating
- Flu-like symptoms
Due to the intensity of these symptoms, medically supervised detoxification is often strongly recommended.
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Treatment for Fentanyl Addiction
Suffering from Fentanyl Addiction? The good news is that recovery is possible. Your best days are still ahead of you!
Medication-assisted treatment (MAT) often forms the cornerstone of effective recovery, combining FDA-approved medications like buprenorphine, methadone, or naltrexone with counseling and behavioral therapies. These medications help stabilize brain chemistry while reducing cravings and preventing relapse.
Treatment programs, such as those with Freedom Recovery Centers, usually incorporate evidence-based therapeutic approaches, including:
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Motivational Interviewing
- And more!
Whether you’re in an inpatient program or outpatient care, toward the end of your rehab, you’ll be provided with relapse-preventative strategies and aftercare resources. This may include referrals for counselors, therapists, support groups, and more.
Ready to take that first step today? We’re here to help. Call us at 804-635-3746 or fill out our online form. At FRC, we’ll be with you every step of the way.
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