Fentanyl Addiction in Veterans: Effects & Treatment

Fentanyl is a powerfully addictive opioid drug involved with many overdose deaths.¹ Many Veterans face unique issues that could place them at increased risk for developing an addiction to opioids like fentanyl.²

This page will discuss the dangers of fentanyl use, fentanyl withdrawal, and explore treatment options for Veterans addicted to fentanyl.

What is Fentanyl?

Fentanyl is a potent synthetic opioid that may be prescribed to treat severe pain or misused for its euphoric effects. Despite legitimate prescription uses in pharmaceutical form, the drug is sometimes diverted for non-medical misuse and also manufactured illicitly to be sold on the black market.^1,3

Fentanyl is more powerful than most other opioids. It is up to 50 times more potent than heroin and is linked to dangerous side effects and overdose risks.³

Fentanyl is available in many different forms. Prescription fentanyl is available as an injectable solution, transdermal patch, oral lozenges, or sublingual and buccal dissolving tablets. Illegally manufactured fentanyl can be encountered on the illicit market as:¹

• A powder.
• Pills.
• Liquid form put in eye droppers, sprays, or on blotter paper.

Fentanyl powder may be mixed with other drugs or taken on its own and either snorted, smoked, or dissolved into liquid and injected.¹

Dealers often mix fentanyl in with other drugs because fentanyl is relatively cheap to manufacture and elicits a strong high. Lacing other drugs with fentanyl can be especially dangerous for people who are not expecting it and may not have developed an opioid tolerance.¹

Fentanyl is a Schedule II narcotic by the Drug Enforcement Administration (DEA). This means that fentanyl has a high risk of misuse and addiction.³

In 2021, there were more than 70,000 overdose deaths due to synthetic opioids like fentanyl.⁴

Is Fentanyl Addictive?

Yes, fentanyl is highly addictive for several reasons. For example:

• Fentanyl can cause users to develop a physiological dependence on the drug.¹ Dependence is a condition that develops as the body adapts to the presence of a drug. When that drug is not available, the body attempts to restore balance, which can cause withdrawal symptoms to emerge. A person who has developed a dependence on fentanyl may feel like they need the drug to function and feel normal, which can drive compulsive use and addiction.⁵
• Using opioids like fentanyl is associated with increased dopamine activity in key regions of the brain. Dopamine is a neurotransmitter associated with motivation and reward. The increase in dopamine activity that occurs after using fentanyl is believed to reinforce its continued use, despite the harm caused by such use.⁶

Certain people may be at a relatively greater risk of developing an addiction to drugs like fentanyl. The following risk factors are associated with addiction:⁶

• Genetics: Having a family history of addiction increases the likelihood of a person also developing an addiction. Genetics are believed to account for 40 to 60% of a person’s risk.
• Environment: Factors related to a person’s home, school, and community environment play a role in risk of developing addiction, such as being around family and friends who use drugs or growing up in poverty.
• Trauma: Exposure to traumatic events is also associated with a higher risk of addiction. These experiences can occur during childhood, adolescence, and adulthood. Vets who have experienced deployment and/or combat are at high risk for developing both post-traumatic stress disorder (PTSD) and addiction.

Many people develop an addiction to opioids after first being prescribed pain medication. This may be of particular concern for Vets, who are more likely than the general population to suffer from chronic pain. Mental health struggles—also commonly experienced by service men and women—is another strong contributing factor in developing an addiction.²

Adverse Effects of Fentanyl Use

Fentanyl can cause a range of negative effects. Some of these effects may not only be uncomfortable, but even dangerous. Potential adverse effects of fentanyl include:¹

• Sedation.
• Drowsiness.
• Confusion.
• Nausea.
• Constipation.
• Difficulty breathing.
• Loss of consciousness.

Fentanyl Overdose

Overdose is another possible risk of using Fentanyl. A fentanyl overdose is potentially fatal and requires immediate medical attention.^1,7

Signs of an opioid overdose include:⁷

• Loss of consciousness.
• Slow or shallow breathing.
• Choking or gurgling sounds.
• Blue or purplish lips and fingernails.

If you suspect a fentanyl overdose, try to wake the person up by rubbing your knuckles on their sternum or upper lip. If the person does not wake up and remain responsive, call 911 right away and administer naloxone if it is available. Remain with them until emergency medical attention arrives.⁷

What Are the Effects of Long-Term Fentanyl Misuse?

Chronic fentanyl use can lead to a number of health risks. Some of the potential health effects of chronic fentanyl use may include:⁸

• Chronic constipation and increased risk of bowel obstruction.
• Increased risk of a heart attack.
• Chronic dry mouth and related tooth decay.
• Suppressed immune system response.
• Osteoporosis.
• Fractures and other injuries from falling.
• Depression.
• Hypogonadism and infertility.
• Decreased libido and erectile dysfunction.
• Cumulatively increased risk of overdose.

Addiction is also a serious risk of long-term fentanyl use.⁸ Fentanyl addiction—known clinically as opioid use disorder (OUD)—can lead to serious negative consequences in all aspects of someone’s life.^1,9

What Are the Signs of Fentanyl Addiction?

Fentanyl addiction is characterized by continued fentanyl use despite significant negative consequences.¹ The diagnostic criteria for an opioid use disorder involving fentanyl use include:⁹

• Taking more fentanyl over time or for a longer period of time than planned.
• A persistent desire to quit or failed efforts to cut down on fentanyl use.
• Spending long amounts of time getting, using, or recovering from fentanyl.
• Experiencing cravings for fentanyl.
• Inability to keep up with obligations at home, work, or school because of fentanyl use.
• Continuing to use fentanyl even though it has caused recurrent social or interpersonal problems.
• Giving up previously important social, occupational, or recreational activities because of fentanyl.
• Using fentanyl in dangerous situations (e.g., while driving).
• Continuing to use fentanyl even though it has caused or worsened physical or psychological problems.
• Developing tolerance: A need for more fentanyl to feel the same effects or experiencing less of an effect from the same amount of fentanyl over time. (This criterion does not apply to people that are prescribed fentanyl and taking it as directed.)
• Experiencing withdrawal when ceasing or reducing fentanyl use. (This criterion does not apply to people that are prescribed fentanyl and taking it as directed.)

To be diagnosed with OUD by a medical or mental health professional, someone must exhibit 2 or more of the above criteria within a 12-month period.⁹

Withdrawal & Detoxing from Fentanyl

Fentanyl misuse can increase the risk of significant physical dependence.¹ Fentanyl withdrawal can be very uncomfortable, but it is not usually life-threatening. However, in some cases, severe dehydration and electrolyte imbalances can occur, which can be dangerous without medical support.¹⁰

The discomfort of acute fentanyl withdrawal can also lead to relapse during early recovery. Medical detox can make the fentanyl withdrawal process much safer and more comfortable.¹⁰

Fentanyl Withdrawal Symptoms

People dependent on fentanyl may develop withdrawal symptoms if they stop taking the drug. Withdrawal symptoms typically begin within a few hours of taking the drug. Fentanyl withdrawal symptoms can include:¹

• Sleep disturbances.
• Strong fentanyl cravings.
• Bone and muscle pains.
• Chills and goosebumps.
• Uncontrollable leg movements.
• Gastrointestinal distress, including diarrhea and vomiting.

Fentanyl Addiction Treatment for Veterans

Treatment for fentanyl addiction often begins with medical detox. The primary goal of detox is to stabilize a person during withdrawal. During detox, medical staff closely monitor withdrawal symptoms and administer medications as needed to reduce discomfort.^5,10

While detox is crucial for many people that are addicted to fentanyl, most need continued treatment—often in inpatient rehab or outpatient treatment—to achieve long-term recovery.⁶ Rehab in either setting usually involves behavioral therapy, psychoeducation on addiction and recovery, peer support, and medication, if appropriate.⁵

Many people in fentanyl addiction treatment and early recovery benefit from the use of medications for opioid use disorder (MOUD). These medications can help people maintain their recovery momentum by minimizing withdrawal symptoms, decreasing cravings, and reducing the risk of relapse.^1,5

Medications used to treat OUD include opioid receptor agonist methadone and partial opioid receptor agonist buprenorphine, both of which reduce opioid cravings and withdrawal symptoms with less risk of eliciting a rewarding euphoria like misused opioids once did. Another MOUD—naltrexone—is an opioid receptor antagonist that blocks the effects of opioids, discouraging relapse and easing cravings.¹

Treatment for co-occurring mental health disorders is another vital part of addiction treatment for many people. Research shows that treatment that addresses both addiction and other mental health problems simultaneously is more effective than treating them separately.⁶ This is especially important for Veterans with OUD, who commonly meet the criteria for other mental health issues.²

If you or someone you know is a Veteran in need of treatment, call us at to learn more or to start the admission process today. We can also help you navigate coverage for Veteran’s addiction treatment and explore payment options.