The Effects of Smoking Fentanyl

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Fentanyl is a potent synthetic opioid used medically for anesthesia and its painkilling properties, but it is most often found in illicit form. Although it is sometimes sought specifically for the intense euphoric feelings it produces, it is also frequently used as an adulterant in other drugs, such as heroin. Due to its incredible potency—up to 100 times that of morphine—it’s responsible for tens of thousands of deaths each year. In fact, it accounted for 67,325 preventable deaths in 2021, a 26% increase over 53,480 in 2020. (1)

If you or a loved one are struggling to overcome an addiction to fentanyl, heroin, other drugs, or alcohol, you are urged to seek professional help today. Guardian Recovery provides comprehensive treatment for those motivated to break free from substance misuse, including evidence-based services such as medical detox, individualized therapy, relapse prevention, and more. Contact us today to learn more about our integrated programs and complete continuum of care.

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How Does Fentanyl Interact With the Body When Smoked?

When smoked, fentanyl is absorbed rapidly through the lungs and into the bloodstream, where it then crosses the blood-brain barrier and binds to opioid receptors in the central nervous system.

Fentanyl works by blocking pain signals sent from the body to the brain, and when smoked, its effects are felt almost immediately and typically last for several hours.

All fentanyl use can be extremely dangerous, and smoking it can easily lead to an overdose. The amount of fentanyl in a single dose can vary significantly, and it can be difficult, if not impossible, to control the amount ingested. And due to fentanyl’s high potency, users face a high risk of severe respiratory depression and death.

Fentanyl Use Risks & Common Side Effects

Fentanyl’s potency places users in danger of experiencing severe side effects and complications, regardless of its administration method.

Common Effects & Risks of Fentanyl Include:

  • Confusion.
  • Decreased breathing rate.
  • Sedation and drowsiness.
  • Nausea and vomiting.
  • Constipation.
  • Tolerance, dependence, and addiction.

When a person is dependent on fentanyl, withdrawal symptoms will emerge when they attempt to quit. These range from uncomfortable to severe and include anxiety, agitation, insomnia, muscle aches, sweating, and diarrhea.

Overdose is the most severe result of fentanyl use and can result in death or lifelong impairments. In addition to the above effects, there are several signs to look for if you believe someone you know is overdosing on fentanyl.

Signs of Fentanyl Overdose Include:

  • Slow, shallow, or stopped breathing.
  • Blue or purple lips and fingernails.
  • Cold, clammy skin.
  • Constricted pupils.
  • Disorientation or confusion.
  • Extreme drowsiness or unconsciousness.
  • Slow, weak pulse.
  • Low blood pressure.
  • Muscle spasms or seizures.

If you suspect someone is experiencing a heroin overdose, this is a life-threatening emergency. Call 911 or visit the nearest hospital immediately. Administer naloxone, an opioid overdose reversal drug, if you have it available. (2)

How Does Fentanyl Affect the Lungs?

When fentanyl is smoked, it is inhaled into the lungs, where it can cause damage and irritation to the delicate tissues. The heat from smoking fentanyl can cause inflammation in the lining of the respiratory tract, leading to coughing, wheezing, and shortness of breath. These symptoms can be especially severe for those who already suffer from respiratory conditions such as asthma, chronic bronchitis, or emphysema.

Additionally, the smoke from fentanyl can contain other toxics, such as tar and carbon monoxide. (3)(4) As with cigarette smoke, smoke from these substances can damage the lungs and increase the risk of lung cancer, chronic obstructive pulmonary disease (COPD), and other respiratory problems.

Smoking fentanyl can also increase the risk of respiratory infections such as pneumonia and bronchitis, as the smoke can compromise the immune system.

Can Smoking Fentanyl Cause Permanent Damage?

Along with harming the lungs, smoking fentanyl can cause permanent damage to the brain and other parts of the body. It can result in long-term cognitive impairment, memory loss, and changes in the brain’s structure and function. Fentanyl can cause a range of cardiovascular issues, including an irregular heart rate, collapsed veins, and heart infections. Also, organs such as the liver and kidneys can be damaged to the point of failure, especially with long-term use. (5) Finally, smoking fentanyl can lead to an increased risk of overdose and death, which can have permanent consequences.

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Does the Method of Use Influence Fentanyl’s Effects?

The method of administration can greatly influence fentanyl’s effects. Smoking fentanyl can lead to a more rapid onset of effects but also a shorter duration compared to some other methods. For example, when fentanyl is taken orally as a tablet or capsule, the onset of action is slower, and the effects are typically more prolonged. Oral administration of fentanyl, as directed by a doctor, can be used to manage chronic pain conditions, but it carries a risk of addiction, dependence, and other side effects.

Transdermal patches, which are applied to the skin, provide a slow and gradual release of fentanyl into the bloodstream over a prolonged period. This method should only be used medically for the management of chronic pain, and it also comes with the risk of side effects, including skin irritation and respiratory depression.

Which Method of Fentanyl Use Causes the Quickest Effects?

Opinions are mixed on whether smoking or intravenous use of fentanyl induces the most rapid effects, and the answer can depend on the speed of injections. (6) While smoking fentanyl is solely an illicit method of use, IV administration is used both legally and illegally but should only be delivered by medical professionals due to the high risk of overdose. Furthermore, IV drug use can cause sores and scars to form at injection sites and increase the risk of infection, possibly leading to abscesses and sepsis. It can also result in damaged or collapsed veins and other complications.

Is Smoking Fentanyl More Deadly Than Injection?

Injection may be considered the riskier method of use, but smoking also has many short- and long-term effects. Like IV drug use, it can still cause respiratory depression and overdose. In some ways, however, smoking fentanyl can be more dangerous than injecting it because it may be more difficult to control the dosage, thereby increasing the risk of adverse reactions.

Can Fentanyl Be Accidentally Inhaled?

Fentanyl can be accidentally inhaled when handled or processed, especially when it’s in powder form. It can also be absorbed through the skin if touched. Being exposed to even a small amount of fentanyl in this way can lead to a rapid overdose and death, and the risk may be higher for those who haven’t developed a tolerance. For this reason, law enforcement and first responders who may come into contact with fentanyl often wear protective gear such as masks and gloves. (7)

Recovering From Fentanyl Smoking & Use

Recovering from fentanyl smoking and use can be a difficult process, but it is possible with the right support and resources. Seeking professional help is the first step, typically followed by several evidence-based methods commonly used in the process of recovery.

Treatment for Fentanyl Addiction Includes:

  • Medical detox is the process of removing fentanyl from the body, and it can be done in a medical setting with supervision and support from healthcare providers.
  • Medication-assisted treatment (MAT), in which medications such as buprenorphine, methadone, or naltrexone are used to help reduce cravings and withdrawal symptoms.
  • Counseling and therapy, which can be used to address the psychological aspects of addiction and provide strategies for managing triggers and preventing relapse.
  • Support groups, such as Narcotics Anonymous, can provide a sense of community, accountability, and support during the recovery process. (8)

Overall, people struggling to recover from fentanyl addiction are encouraged to seek professional treatment that uses a multi-faceted approach to address the many aspects of addiction.

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Reach Out to Guardian Recovery Today for Help

Fentanyl and heroin addiction can take over your entire life and leave you and your family devastated as a result. Although drug addiction is considered an incurable and chronic brain disease, it can be overcome using a holistic approach to treatment. At Guardian Recovery, we provide potential clients with a free, no-obligation assessment and health insurance benefits check. Reach out to us today to speak with a compassionate, experienced Treatment Advisor who can explain more about our various levels of care, including inpatient, partial hospitalization, and outpatient programs. Learn more about our commitment to providing clients with all the tools and support they need to conquer addiction and cultivate a more fulfilling, healthier life.


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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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