Fentanyl Addiction Treatment in Ohio

Fentanyl is a synthetic opioid, 50 to 100 times the potency of morphine. It turns up inside counterfeit pills sold as oxycodone or alprazolam and inside powder sold as heroin, mixed unevenly, so the gap between a dose that holds off withdrawal and one that stops breathing is small and unpredictable.

Naloxone reverses an opioid overdose, which kills by slowing breathing until it stops. Ohio pharmacies dispense it without an individual prescription and Project DAWN sites give it out free. Keep it where another person can reach it.

• Give naloxone whenever an overdose is suspected, even if you are unsure opioids are involved.
• If breathing has not come back in two or three minutes, give another dose. With fentanyl, one is often not enough.
• Call 911 either way. A person can go back down once the naloxone clears.
• Treat any break in use as a tolerance reset. A few days away can make a familiar amount fatal.

Fentanyl withdrawal is rarely dangerous by itself and hard to get through alone. It is less predictable than withdrawal from heroin. Fentanyl builds up in body fat and leaves the body slowly, so symptoms can start later than expected and last longer, and the prescriber plans any buprenorphine start around your last use.

Leora runs ambulatory detox at both facilities. A nurse practitioner and a registered nurse assess you and monitor you through the acute phase. Medication for symptoms is prescribed as needed. You sleep at home. It covers mild to moderate withdrawal that does not need 24/7 medical supervision, and not everyone is a candidate. Leora has no beds and does not provide inpatient or overnight care. If you need a level of care Leora does not run, the assessment says so.

Buprenorphine and naltrexone are approved by the FDA for opioid use disorder. Leora's medication assisted treatment uses FDA approved medications such as buprenorphine (Suboxone) and naltrexone (Vivitrol), alongside therapy. Buprenorphine also comes as an extended release injection given by the care team: Sublocade once a month, and Brixadi once a week or once a month. Medication is optional.

• Buprenorphine started too soon after a fentanyl dose can precipitate withdrawal instead of relieving it, so the prescriber sets the start point around that risk.
• Tell the assessing clinician if precipitated withdrawal has happened before. It changes the plan.
• Methadone is also approved for opioid use disorder. Leora does not prescribe methadone as part of its MAT program. Leora can provide addiction treatment to people established on methadone with an outside provider.

Both facilities welcome walk-ins. Bring:

• Photo ID and your insurance card
• A list of your medications
• A discharge plan if you are coming from another program
• Any chronic pain, depression or anxiety history. The same team treats them in one plan.