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Prescription Fentanyl

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Often when fentanyl is being discussed in today’s news cycles, it is in reference to the dangerous illicit uses happening worldwide. Fentanyl, as dangerous as it may be when used inappropriately, has many medical purposes when used as prescribed. The medical community has used this powerful pain relieving chemical formula for decades with its illicit use only coming to the forefront in recent years.

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What Are the Medical Uses of Fentanyl?

This powerful synthetic opioid is prescribed as a method of treating pain (1). Like other opioids, fentanyl binds with the brain’s opioid receptors to block pain signals from being communicated throughout the body. Due to its potency, fentanyl is only medically available by prescription from a doctor or while in a medical setting like a hospital or doctor’s office.

Who is Pharmaceutical Fentanyl Prescribed to?

Fentanyl is typically prescribed for those experiencing extremely high amounts of pain or those who do not have the appropriate effect when using other pain relieving measures. Many times a patient will develop a tolerance to other prescription opioids over time and need to transition to a more potent substance like fentanyl. The most common applications for prescription fentanyl are after a surgical procedure and for those experiencing the pain of the late stages of cancer.

Alternative Synthetic Opioids to Fentanyl for Pain Relief

Due to a variety of factors, many doctors and patients are pursuing other means of pain management that do not include a prescription for fentanyl. Tramadol is an often prescribed synthetic opioid (2) alternative to fentanyl for the treatment of moderate to severe pain. Methadone is also used for pain relief as well as its incorporation in the treatment of opioid use disorders.

Can Prescribed Fentanyl Be Addictive or Dangerous?

Though no substance is completely free from the potential for unwanted side effects, when used as prescribed by a physician, the likelihood of harmful reactions is greatly decreased. Fentanyl, when used as directed, is still considered to be highly addictive. Labeled by the Drug Enforcement Administration (DEA) as a Schedule II  controlled substance (3). This means that it carries medical benefits, but is still considered one of the most addictive substances available. Along with many other opioids, the possibility of using legally obtained prescription fentanyl in a manner other than intended exists as well and has proven to be a path that many have taken towards a lifestyle of addiction.

Side Effects of Fentanyl Prescribed by a Doctor

Common side effects of prescription fentanyl include:

  • Sedation,
  • Confusion
  • Drowsiness
  • Dizziness
  • Nausea
  • Vomiting,
  • Urinary Retention
  • Pupillary Constriction
  • Respiratory Depression

If these side effects increase in severity, it is possible that the person using fentanyl is experiencing an overdose and medical help should be sought out immediately.

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What Forms of Medical Fentanyl Administration Are Available?

Based on the specific needs of the patient and their unique situation, there are a multitude of routes of administration (4) for fentanyl and forms that it can take. One of the most common applications in a medical setting is intravenous injection of a solution containing the appropriate dosage of fentanyl for pain relief during a surgical procedure. Another prescription application is a transdermal patch. Placed on the surface of the skin, fentanyl is soaked into the skin and enters the bloodstream this way. A sublingual tablet is also a common form that fentanyl can be ingested. The tablet is placed under the tongue and dissolved into the bloodstream through the capillaries found under the tongue. Fentanyl can even be found in a lozenge to be sucked on by the patient.

Is Fentanyl Prescribed for Long-Term Use

Many times, providers will avoid the use of fentanyl for long term pain relief. Generally, doctors will prescribe the minimum effective dose of a substance for the desired effect. With the high potency of fentanyl, it is rarely the first choice for long term applications. Often it will be used only in long term instances if the patient is experiencing extremely high amounts of pain or the patient has developed a tolerance to other pain relief medications, and they are no longer effective in treating their pain.

Doses Used in Prescribed Fentanyl

Due to its extremely high potency, fentanyl is measured, for medical applications, in micrograms (mcg). There are 1 million micrograms in 1 gram. The typical application (5) for an adult undergoing a minor surgical procedure is 0.5-2 mcg per kilogram of body weight given intravenously. Similarly, if a patient is undergoing a major surgical procedure, the dosage increases to between 2-20 mcg per kilogram of body weight initially and 1-2 mcg per kilogram of body weight 1 hour prior to the end of the procedure. Patches given (6) for the treatment of end of life cancer pain can range anywhere from 150 mcg to 1000 mcg depending on the severity of the patient’s pain.

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Treatment for Fentanyl Addiction

With fentanyl use and overdose being more prevalent than ever, the need for substance use treatment is equally as high. The most effective methods of treatment involve a combination of medication and Cognitive Behavioral Therapy.

Guardian Recovery understands the toll that addiction can take on individuals and families and is committed to providing the highest level of care for those seeking treatment for their substance use. If you or a loved one are struggling, call Guardian Recovery today. One of our trained admissions professionals is available day or night to help guide you easily through your decision to enter treatment. Your journey to freedom could begin today with one simple phone call.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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