New Jersey has its share of health problems. One of them is cancer. According to data gathered by State Cancer Profiles, New Jersey records a rising number of cancer patients, with rates increasing by as much as 2.7% yearly. Rising cases of prostate and liver cancer between 2015 and 2019 are also highlighted in the data.
For cancer patients in the state, treatments range from chemotherapy to more palliative forms of care. When it comes to medicinal management, fentanyl lollipops have become one of the go-to medication options for health providers.
The fentanyl lollipop — commercially known as Actiq — has consistently proven its effectiveness as an opioid medication that brings quick pain relief. Unfortunately, its effectiveness also increases its demand among both cancer and non-cancer patients.
As an opioid, fentanyl lends itself to abuse and misuse, and the numbers prove this. As of 2019, deaths from fentanyl overdose rose to an all-time high in New Jersey.
Actiq addiction — or addiction to any opioid medication — is no joke. If you or someone you know has an opioid use disorder, seek help immediately.
In the meantime, you can learn everything about fentanyl lollipops, how they work, and fentanyl use disorder. Also, read to the end to find out what you can do if you or someone you know is struggling with opioid use disorder.
What Is a Fentanyl Lollipop?
Fentanyl is one of many types of opioid medications. Like many opioid analgesics, fentanyl is a prescription medication for pain management. It’s a rapid-onset medication, meaning that it takes effect quickly upon administration.
Fentanyl comes in many forms. It’s available in the form of transdermal fentanyl, fentanyl lozenges, and fentanyl lollipops. A fentanyl lollipop — or oral transmucosal fentanyl citrate — is a dosage form of fentanyl that allows patients to ingest the medication without swallowing it.
A fentanyl lollipop consists of many ingredients aside from the active one, fentanyl. One of the ingredients incorporated in the lollipop is confectioner’s sugar. The incorporation of confectioner’s sugar allows patients to passively dissolve the medication in the mouth. As a result, the fentanyl enters the bloodstream without requiring the patient to swallow.
Other inactive ingredients include citric acid and edible glue or modified food starch. The edible glue acts as a binder for the fentanyl lollipop.
The fentanyl lollipop is by far one of the most popular dosage forms of fentanyl. We can attribute this to its ease of administration.
Oral transmucosal fentanyl citrate comes in 200 to 400 mcg doses and is much more potent than morphine. For this reason, healthcare providers must closely monitor patients on fentanyl lollipops, especially because these patients will also be on other drugs for pain relief.
How Do Fentanyl Lollipops Work?
A fentanyl lollipop is a dosage form of fentanyl. Patients take this medication for acute pain relief and other drugs. Fentanyl lollipops work by dissolving quickly in the mouth, introducing the active ingredient (fentanyl) into the bloodstream.
Patients use fentanyl lollipops like candy or lozenges. Once in the mouth, the fentanyl-incorporated stick enters the oral mucosa by passive dissolution. Most of the drug enters through the mouth instead of the gastrointestinal tract.
After the fentanyl enters the bloodstream, it makes its way to the opioid receptors. The synthetic opioid then activates opioid receptors — particularly the delta and kappa opioid receptors.
When these opioid receptors are active, nerve cells and pain receptors become less sensitive. As a result, patients will experience pain relief after a few minutes of taking the medication, among fentanyl’s other effects.
Because of its mechanism of action, fentanyl is one of the go-to drugs for a variety of conditions and indications. For the most part, it’s the medication of choice to manage chronic pain and treat breakthrough cancer pain.
Fentanyl Lollipops for Breakthrough Cancer Pain Relief
Physicians typically prescribe fentanyl for cancer patients struggling with breakthrough pain. Often, they prescribe fentanyl lollipops as an adjunct to other pain medications.
The fentanyl lollipop is an essential and effective component of breakthrough pain management for two reasons. First, fentanyl lollipops elicit quick pain relief. As mentioned earlier, the drug dissolves in the mouth where much of the fentanyl’s absorption takes place.
As the drug dissolves quickly in the oral tissues, fentanyl enters the bloodstream much more quickly compared to morphine. For this reason, patients often report lower pain scores minutes after taking their fentanyl lollipops.
Another reason why fentanyl lollipops outshine other opioids is their other effects on the central nervous system. In particular, fentanyl has been shown to affect the dopamine receptors of the brain. As a result, patients on fentanyl lollipop treatment report general feelings of well-being as the first subjective sensation.
In short, fentanyl lollipops treat breakthrough cancer pain relief and improve patients’ feelings of comfort, which is essential in cancer management.
What Are the Side Effects of Fentanyl Lollipop Use?
During fentanyl lollipop treatment, patients can experience a variety of adverse events and side effects. The magnitude or severity of these effects will differ from one individual to the next. For the most part, patients on fentanyl lollipop treatment commonly report these side effects.
One of the first side effects of fentanyl is constipation. Constipation happens because of the drug’s effects on the central nervous system — particularly the parts that regulate peristaltic movement, or the movement of the intestines.
Fentanyl binds with the intestinal nerve cells to reduce nerve activity in the intestines. As intestinal activity drops, so does the movement of food along the intestinal tract. As a result, patients will often express difficulties in elimination.
Drowsiness is also a common side effect of fentanyl lollipops. Drowsiness occurs because of fentanyl’s CNS depressing effects.
Once fentanyl activates opioid receptors, the central nervous system reduces its activity. The reduced activity causes the sedating effects seen in many other opioid medications. At higher doses, the sedative effects become severe, prompting immediate medical attention.
3. Low Blood Pressure (Even at Low Doses)
Low blood pressure or hypotension is also among the possible side effects of fentanyl lollipop treatment. The reductions in blood pressure often happen at high doses but can occur at low doses too.
Fentanyl’s effects on the cardio-respiratory system are depressive. The opioid drug reduces the heart rate along with the respiratory rate. With reductions in heart rate comes reduced blood flow and vascular resistance that manifest as low blood pressure.
Low blood pressure isn’t always life-threatening. However, physicians and other members of the healthcare team must monitor patients receiving fentanyl lollipops closely. Close monitoring is especially critical for cancer patients because these patients receive other drugs to treat breakthrough cancer pain.
If left unchecked, a patient’s blood pressure can drop further. Significant blood pressure drops are medical emergencies and can cause brain damage and death if left unaddressed.
Another common side effect of fentanyl lollipop treatment is dizziness. This side effect happens as a result of the drug’s effects on both the brain and blood vessels — specifically as a result of the previous side effect: low blood pressure.
Once a patient’s blood pressure drops, their brain may receive less oxygenated blood than usual. This can cause dizziness. Fortunately, this side effect dissipates quickly. If not, physicians must monitor the patient and address the dizziness accordingly.
Drug Interactions Involving Fentanyl Lollipops
Because fentanyl lollipops are potent pain medications, physicians must be cautious about combining fentanyl lollipops with other drugs. Patients must also be aware of such interactions to prevent mistakenly mixing fentanyl lollipops with other drugs and opioid medications.
Below are some of the drugs patients must not take fentanyl lollipops with.
St. John’s Wort
St. John’s Wort is a herbal medication taken to manage anxiety. It is also an alternative herbal medication used to manage mild depression and insomnia. Because of fentanyl’s CNS depressing effects, taking a fentanyl lollipop with St. John’s Wort may lead to more pronounced CNS depressive symptoms like excessive drowsiness and low heart rates.
HIV Protease Inhibitors
These medications are drugs meant to manage HIV. When taken with fentanyl lollipops, they can remain in the body much longer, causing liver or kidney damage.
While this is not a drug, grapefruit and its juice are also substances to avoid when on fentanyl lollipop treatment. It can affect plasma concentrations of fentanyl, causing fentanyl to remain in the body for a long time.
When left unchecked, high fentanyl levels in the blood can lead to serious adverse events. You can expect the effects to be worse with fentanyl lollipops since these have a more rapid onset than most opioids.
Antibiotics and Antifungal Agents
Antibiotic and antifungal drugs are hepatotoxic, meaning that they can damage the liver when taken for long periods. If they’re taken with fentanyl, these drugs can remain in the body for extended periods and wreak havoc on the liver.
Antibiotics and antifungal medications can keep fentanyl in the bloodstream. As a result, patients who take antibiotics and fentanyl together may be at risk for respiratory depression.
Opioid Substance Use Disorder: The Signs of Fentanyl Lollipop Addiction
Fentanyl lollipop treatment enables patients to experience relief from severe pain. Using fentanyl lozenges, a patient can also experience a pleasant feeling from the opioid — an effect that’s unseen in similar drugs for treating breakthrough cancer pain.
The benefits of fentanyl for managing cancer pain are clear. However, this is a reason why fentanyl lends itself to substance use disorder.
The first step to managing an opioid use disorder is by identifying the early signs of addiction to opioid pain medication. Below are the signs you should watch out for if you suspect opioid pain medication addiction.
Physical Signs of Dependence
Physical dependence on fentanyl is common because of the relief the drug provides. Over time, patients will develop an overreliance on the drug, craving it more even in the absence of pain. When this occurs, patients report physical symptoms even after missing doses for a short duration.
These symptoms of Actiq dependence are similar to those seen in anxiety and include:
- Elevated heart rate
- Rapid breathing
The presence of these symptoms signals the early stages of fentanyl lollipop addiction and dependence. Of course, healthcare providers and physicians must also establish the presence of other signs and symptoms to diagnose fentanyl use disorder.
Besides the physical signs of addiction and dependence, patients will also exhibit behavioral changes. These behavioral changes are the results of the patient’s attempt at procuring fentanyl lollipops.
The behavioral signs associated with fentanyl addiction include frequent attempts at getting fentanyl lollipops without a prescription. These can also include improper use of alternative fentanyl dosage forms like fentanyl patches.
What Are the Signs of a Fentanyl Overdose?
Patients who have been on fentanyl lollipop treatment for a long time tend to develop dependence. If this is left unaddressed, a patient’s abuse can lead to an opioid overdose that’s both debilitating and life-threatening.
Several symptoms point toward a fentanyl overdose. Below are the most commonly observed signs of overdose in patients who abuse fentanyl and other opioid medications.
Respiratory depression is a life-threatening sign of opioid overdose and is a medical emergency. It occurs because of fentanyl’s depressive effects on the central nervous system.
When fentanyl activates opioid receptors, the brain structures that are responsible for lung constriction and expansion will experience reduced stimulation. As a result, breathing slows down.
When respiratory depression happens, a patient can go into cardiorespiratory arrest. This is why physicians closely monitor patients who use fentanyl lollipops for chronic pain.
Fentanyl is a CNS depressant. It can result in significant muscle weakness in high doses. Muscle weakness from fentanyl overdose can lead to reduced activity tolerance. At its worst, it can place a patient at risk for falls and further injury.
Reduced or Absent Reactivity to Light or Sounds
Once patients overdose on fentanyl or other opioid medications, they can become unresponsive to light or sounds. When this happens, the fentanyl has depressed the central nervous system to the point where medical attention becomes necessary.
Fentanyl has a sedating effect. In high doses, it can lead to prolonged drowsiness that can escalate to a fentanyl-induced coma.
As an opioid pain medication, fentanyl can affect the motor nerve cells that control the muscles of the tongue. Fentanyl relaxes the tongue’s muscles, causing patients to develop slurred speech.
Fentanyl Lollipop Withdrawal Symptoms
It may seem advisable for a patient to quit fentanyl, morphine, or other opioids cold turkey. However, this will result in withdrawal symptoms.
Withdrawal symptoms from chronic fentanyl lollipop use can be uncomfortable for most patients. At their worst, these symptoms can be life-threatening. The excruciating discomfort patients experience from fentanyl lollipop withdrawal often becomes a stumbling block for them. In fear of withdrawal symptoms, most patients would relapse into fentanyl use and risk overdose and addiction.
Managing withdrawal is a critical part of managing fentanyl use disorder. Once patients enter our facility, our trained healthcare staff and physicians assess for the following symptoms:
- Chest tightness
- Severe pain
- Other adverse effects of long-term fentanyl lollipop use
What To Do When You or Someone You Know Has a Fentanyl Lollipop Addiction
If you or someone you know is developing a fentanyl use disorder, don’t try to manage the disorder alone. Immediately seek help. By reaching out to an CarePlus in New Jersey, you or your loved one can receive the proper medical care to manage withdrawal symptoms. With proper treatment and counseling, you or your loved one can recover, avoid relapses, and take the journey toward long-lasting recovery.
Do you need a place that provides opioid addiction recovery services? Reach out. We are here to help.
Why CarePlus New Jersey?
At CarePlus New Jersey, we commit to your full recovery. We offer recovery programs that treat substance use disorder in all age groups. Whether you or your loved one is an adult or adolescent, we have a recovery program just for you. We offer the following addiction treatment programs in New Jersey:
- Adult addiction treatment
- Adolescent addiction treatment
- Family support services
- Support groups for all ages
Also, we accept major health insurance providers this means we work with private and state funded plans. This way, when you reach out to us for our addiction treatment services, all you need to think of is your recovery.
Our physicians and healthcare staff specialize in various modes of addiction treatment. We can help you overcome whatever addiction you’re struggling with.
Addiction treatment at CarePlus can help with alcohol and drug addiction to any substance.
Support, Treatment, and Lasting Recovery From Fentanyl Addiction
Fentanyl lollipop addiction can be life-threatening, and recovery from it can be an uphill battle. The journey to recovery can be accomplished. Get help and support from people who know exactly what you’re going through.
If you need addiction services in New Jersey, CarePlus NJ can help. Let us walk with you as you learn to navigate living drug free.
CarePlus NJ, INC. is dedicated to excellence in mental healthcare and has a commitment to life-long support needed by individuals and their families to ensure that they achieve their full potential and improve the quality of their lives.