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Aftercare & RecoveryFentanyl Treatment and Rehab
Written by Jonathan Strum
& Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS, CACP
Medically Reviewed
Last updated: 12/28/2022
Key Takeaways
- Fentanyl is a potent opioid that has become popular in the last few years
- Less fentanyl is required to achieve the same effect as other opioids because fentanyl is more potent
- Addiction to fentanyl is called opioid use disorder (OUD)
- OUD can be treated with inpatient rehab, outpatient rehab or partial hospitalization
- Medication-assisted treatment is the primary treatment for OUD and has very good evidence to support it
- People should know the right questions to ask before choosing a rehab center
- Most insurance carriers pay for rehab, and cash patients may have free and low-cost options available
Fentanyl, America’s deadliest drug, has made recovery from substance addiction more urgent than ever before. Here are the facts about withdrawal and detox from fentanyl.
Fentanyl has recently gained attention as a synthetic opioid that is much more potent than other opioids, including heroin. These drugs have contributed directly to the nationwide opioid crisis, which has devastated both small and large communities across America.
Here is how intravenous (IV) fentanyl stacks up compared to similar opioids:
- Codeine, oral: 4,000 times more potent
- Morphine, oral: 1,200 times more potent
- Hydrocodone, oral: 400 times more potent
- Oxycodone, oral: 200 times more potent
In medicine, potency is a comparison of how much of each substance is needed to accomplish the same thing. For example, 1 mg of fentanyl will have the same pain-killing effects as 4000 mg of codeine.
This property can be incredibly useful in certain circumstances. If someone is going into surgery, it is easier and safer to inject 0.1 mg of fentanyl than make someone drink 400 mg of codeine. Fentanyl’s potency also means it tends to work faster.
Like all opioid drugs, fentanyl is very addictive. Fortunately, fentanyl treatment and rehab programs are already in place, as pre-existing opioid treatment programs are capable of performing fentanyl addiction treatment.
Fentanyl Addiction Treatment and Rehab Options
The property that makes fentanyl so useful in a hospital setting is unfortunately what makes it ideal for misuse. Higher potency means less product to store and transport for drug dealers. Compared to similar opioids like oxycodone and hydrocodone, dealers can charge the same amount for much less of the substance. A small bag of fentanyl can replace a whole bottle of pills.
For people who need fentanyl addiction treatment, any opioid treatment program (OTP) is already equipped to handle the complex nature of fentanyl rehab.
Fentanyl Addiction Treatment Options
Partial Hospitalization
What is partial hospitalization? Partial hospitalization is a relatively new treatment option for psychiatric care. A partial hospitalization program (PHP) is a hybrid between inpatient hospitalization and outpatient treatment. A PHP requires patients to attend several days per week (sometimes Monday through Friday) for most of the day. In exchange for regular attendance, the person does not need to enter inpatient treatment, which is a 24-hour on-site treatment situation. Simply put, PHP can be thought of as partial inpatient treatment. PHPs are suitable for psychiatric illness that does not present immediate harm to self or others. Most insurance plans pay for this type of treatment.
Inpatient Rehab
Inpatient rehab is carried out in a 24-hour hospital setting. Inpatient is most appropriate for people who are an immediate danger to themselves or others. It is also useful for people who need a more structured rehab environment. Inpatient drug rehab consists of a treatment team with a primary care provider, a psychiatrist, a social worker and counselors with different types of therapy training.
Outpatient Rehab
Outpatient rehab occurs outside of a hospitalized environment. Someone in outpatient treatment can function in their regular life and job roles, but they need treatment for opioid misuse. Outpatient drug rehab typically consists of weekly counseling sessions and classes. Counseling can be individual or group therapy, depending on the needs of the patient.
Medication-Assisted Treatment
Medication-assisted treatment (MAT), or medication-assisted therapy, is the use of medications to treat opioid addiction. MAT is considered first-line treatment for opioid use disorder and should be considered for every patient with the condition. Not everyone benefits from MAT, but evidence strongly supports that MAT has better outcomes than drug-free treatment. The three primary goals of MAT are to conduct daily living activities without intoxication, experiencing withdrawal symptoms and cravings for opiates. There are several types of medications that are used: Methadone is an opioid medication that works to block opioid receptors in the body. Methadone is thought to work similarly to a nicotine patch: It prevents cravings and withdrawal but does not cause pleasurable feelings that encourage addiction. Methadone is obtained daily at methadone clinics. Buprenorphine is another opioid medication that helps to prevent cravings and withdrawal without causing pleasure in people with addiction. An advantage of buprenorphine is that it can be obtained at any pharmacy. Suboxone is the brand name for combination buprenorphine and naloxone. This formulation prevents diversion, which is when someone attempts to misuse or sell their buprenorphine. A common method of diversion is to crush and inject buprenorphine, which can be prevented by formulating it with naloxone. Naloxone binds to opioid receptors more strongly than buprenorphine, preventing misuse. Naltrexone works differently from methadone or buprenorphine because it is not an opioid. Naltrexone blocks opioid receptors completely, so if a person tries to take fentanyl while taking naltrexone, the fentanyl will not work. A disadvantage of naltrexone is that the person must go through withdrawal before they begin taking it. Clonidine is not a MAT, but some evidence has shown it to be useful in managing cravings for opioids and other addictive substances.
Teletherapy
Teletherapy is a treatment program available to those requiring partial hospitalization, intensive outpatient and outpatient levels of care. Online substance abuse counseling involves video conferencing for individual and group therapy sessions. This is ideal for those with are not experiencing major addiction symptoms, cannot travel for treatment and who need a flexible schedule.
Dual Diagnosis and Co-Occurring Disorders
Co-occurring disorders, or dual diagnosis, is when someone has both a drug addiction and a psychiatric condition like schizophrenia or bipolar disorder. Dual diagnosis rehab requires a treatment team that can address both the addiction and underlying psychiatric condition. Most rehab centers provide this, but not all do. Some are only equipped to treat addiction.
Choosing a Rehab Center for Fentanyl Addiction
If you or someone you know is considering inpatient treatment, consider several factors when making a choice. Many people try to dive into rehab headfirst without asking the right questions and without knowing how to choose a rehab center. Here are some factors to consider:
- Location: People who want family and friends involved may consider inpatient drug rehab nearby. However, some people prefer a more private experience, and inpatient rehab near friends and family could make treatment more difficult.
- Cost: How much does rehab cost? Insured patients should call the number on the back of their insurance to determine if rehab treatment is covered. Cash patients should call the desired clinic to inquire about the cost of inpatient rehab and other types of treatment.
- Treatment options provided: Each rehab center offers different programs and options. Some are outpatient only, some only have inpatient and some have both.
- Staff-to-patient ratio: This ratio is an important consideration that many people do not ask about before entering treatment. A typical nurse-to-patient ratio is one to five. Doctors each tend to care for between 25 to 30 patients.
Paying for Fentanyl Addiction Treatment
Many people wonder about how to pay for drug rehab. Paying for drug rehab depends on each person’s unique situation. Many insurance programs cover rehab treatment, so people should always call their insurance carrier to ask about treatment centers in their network and out-of-pocket costs.
Cash patients may be more limited in their treatment locations. However, many states have free and low-income rehab treatment options available.
Will Insurance Cover Rehab?
Does health insurance pay for rehab? Coverage depends entirely on insurance. An insurance company should provide a phone number on the back of the insurance card to call a benefits line. Calling this number will usually put a person in touch with an insurance specialist who can answer this question.
Some people will need to know how to pay for drug rehab without insurance. Before a person gets to this stage, they have usually already met with an addiction specialist or social worker who can help them answer this question. Free and reduced-cost rehab options are available in most states.
View Sources
DEA Diversion Control Division. “Fentanyl.” 2016. Accessed July 17, 2019.
eMedicineHealth. “Opioid Potency Comparison.” 2019. Accessed July 17, 2019.
MedlinePlus. “Fentanyl: MedlinePlus Drug Information.” 2018. Accessed July 17, 2019.
SAMHSA. “Medication-Assisted Treatment (MAT).” 2015. Accessed July 17, 2019.
Stuart, Gregory; et al. “Empirical Studies Addressing the Opioid Epidemic: An Urgent Call for Research.” Substance Abuse: Research and Treatment, 2018. Accessed July 17, 2019.
Authorship
Editor - Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read More
Medical Reviewer - Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read More