Fentanyl is an extremely dangerous drug. In 2023, 72,776 people died from fentanyl overdoses in the United States alone. The synthetic opioid is up to 50 times stronger than heroin and 100 times stronger than morphine.
One symptom common to fentanyl use is the fentanyl fold. Also called the fentanyl lean, this occurs when users are bent at the waist, slumped forward in a rigid position with their heads bowed and knees relaxed. They are often unable to move or respond.
People on fentanyl may stay in this position for minutes or even hours, increasing the risk of decreased breath rate, poor circulation, falls, and injuries. Researchers are still struggling to determine why this condition occurs, although it is clearly a neuromuscular side effect of the drug. Learn more about what it means and what you can do when you see someone stuck in the fentanyl fold.
What is Fentanyl?
Fentanyl is a synthetic opioid used for medical purposes and for illegal drug use. The two main types include:
- Pharmaceutical Fentanyl: This drug is often prescribed by doctors to treat severe pain after surgeries or related to advanced-stage cancer. It is typically limited to patients who are already opioid-tolerant. It may be administered via patch, lozenge, or injection.
- Illicitly Manufactured Fentanyl: The fentanyl found on the street is often illegally produced in labs and distributed on the black market. To reduce costs, it is usually mixed with heroin, cocaine, or methamphetamines without the user’s knowledge, making it highly dangerous. It may be pressed into counterfeit pills to look like legitimate drugs, such as Xanax or oxycodone.
How Does Fentanyl Work?
Fentanyl binds with opioid receptors in the brain to block pain signals and produce relaxation, sedation, and euphoria. It depresses respiration and the nervous system. However, these effects are also what make it dangerous.
If you take too much, the respiratory and nervous systems can shut down, leading to an overdose.
What is the Fentanyl Fold and Why Does it Happen?
Fentanyl’s side effects appear when fentanyl crosses into the blood-brain barrier (BBB), a lipid composition that helps protect the brain from toxic substances. Although the BBB is powerful, it can be no match for fentanyl’s highly lipophilic effects. The drug dissolves easily, allowing it to cross the BBB and causing harmful effects.
Slumped posture is the main fentanyl fold symptom. It signifies that fentanyl has penetrated the BBB, causing muscle rigidity, particularly in the trunk muscles. As a result, the person may be unable to move or breathe properly. Researchers also believe the drug can make users feel lightheaded, further contributing to the need to slump over.
What Does Fentanyl Fold Look Like?
People on fentanyl may assume an opioid induced posture characterized by:
- Bent Over Position: The individual will be slumped forward, often at a near right angle, and will struggle to remain upright.
- Rigidity: The person may appear to be frozen in this position for hours.
- Unresponsiveness: They may not respond when they are nudged or spoken to.
- Head Drooping: Neck muscles become limp, leading to the head dropping forward.
- Other Symptoms: These may include slowed breathing, glassy or half-closed eyes, and pinpoint pupils.
The Dangers of the Fentanyl Fold
The fentanyl fold is a sign of a pending overdose. It produces the following risks:
- Respiratory Failure: A person in this position can easily stop breathing, as their chest muscles are restricted.
- Risk of Falls: The person may fall and sustain injuries.
- Less Awareness of Surroundings: An individual in the fentanyl fold has reduced awareness of their surroundings. They may move into oncoming traffic or incur other environmental risks.
What To Do If You Encounter Someone in the Fentanyl Fold?
Considering the dangers of the fentanyl fold, acting quickly can help you save a life. Here are some recommended life-saving activities.
- Ensure You are Not in Danger: Fentanyl use often occurs in dangerous areas. You should only offer help if you feel safe doing so. Consider environmental risks such as traffic, exposed needles, and crime risk before proceeding.
- Call for Help: This may include asking people around you for help or calling emergency services.
- Check Responsiveness: You may be able to get someone out of the fentanyl fold by speaking to them in a raised voice or by exerting a small amount of pressure, such as squeezing their shoulder.
- Check Breathing and Circulation: Slowed breathing, blue lips and fingertips, and reduced consciousness indicate respiratory issues. If you detect these fentanyl fold symptoms, call for help right away.
- Stay with the individual until emergency services arrive.
Consider Carrying Naloxone
If you live in an area where fentanyl use is prevalent, or are close to someone who uses fentanyl, consider carrying naloxone (Narcan). It is available without a prescription, lightweight, and easy to carry. Available as a nasal spray and injectable, it can restore breathing in 2 to 3 minutes.
CDC research reveals 80% of overdose deaths happen in the home, and 40% of the time, someone else is present. If the other person has Narcan, it can be the difference between life and death.
Other Signs of Overdose
The fentanyl fold is just one sign that a user could be in danger. Here are some other signs of a potential overdose:
- Constricted pupils
- Falling asleep or losing consciousness, aka “nodding out”
- Slow, weak, or no breathing
- Choking and gurgling sounds
- Limp body
- Clammy skin
- Blue lips and fingertips
How is a Fentanyl Addiction Treated?
Providers typically take a multi-pronged approach to fentanyl addiction, as follows.
Detox
The first stage of recovery is detox. The goal is to reduce the physical aspects of addiction.
Patients typically experience severe withdrawal symptoms as the body has gotten used to having fentanyl in its system. Typical symptoms include mood changes, fatigue, insomnia, body aches, digestive issues, and drug cravings.
These issues contribute to relapse risk as patients know that going back to using will relieve their symptoms. That’s why a professional approach is recommended.
A professional will oversee the detox process, ensuring relapse doesn’t occur. They will also administer medications to reduce cravings and minimize withdrawal symptoms.
Intensive Therapy
Addiction is often related to an underlying mental health condition. For example, some people use opioids to reduce anxiety and depression. Although they can temporarily relieve symptoms, they often lead people on a downward spiral, contributing to issues that exacerbate mental health disorders.
Providers will attempt to break the cycle by providing therapy that helps patients cope with their feelings in healthy ways. Popular approaches include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and motivational enhancement therapy (MET). These techniques have been proven to support long-term sobriety.
Ongoing Care
Maintaining sobriety often requires long-term management. Providers usually recommend that patients continue therapy on a once-a-week or as-needed basis in an individual or group setting. They may also recommend lifestyle changes, such as a nutritious diet, exercise, and mindfulness practices, to boost self-esteem, strengthen healthy habits, and reduce stress.
BlueCrest Counseling Aids with Fentanyl Recovery
BlueCrest Counseling plays a significant role in fentanyl recovery. We oversee the counseling stage and develop a tailored approach that considers the patient’s emotional and environmental needs. Our team addresses a wide range of drug addictions, ensuring high success rates.
Contact us to learn how we can help you or a loved one achieve a higher quality of life.
FAQs
Is the fentanyl fold a sign of an overdose?
Yes, the fentanyl fold can be an early warning sign of an overdose. It indicates high levels of the drug in the body and can lead to respiratory depression and unconsciousness.
How is the fentanyl fold different from ‘nodding off”?
Nodding off is a semi-conscious stage common to opioid users. The fentanyl fold involves muscle rigidity and a forward-bending posture that can last for hours. It generally indicates a higher risk of overdose.
Does the fentanyl fold only happen with fentanyl?
Although the fentanyl fold is most commonly associated with fentanyl use, it can occur with other opioids and drug combinations, especially those that cause nervous system depression.
Can someone recover from the fentanyl fold without assistance?
Yes, it is possible for someone in the fentanyl fold to regain consciousness on their own. However, due to the risk of potentially fatal airway obstruction, it is best to try to revive them or call for help.
Are there long-term health risks associated with repeated fentanyl fold episodes?
Yes, people who experience repeated fentanyl fold episodes increase their risk of brain injury, organ damage, and prolonged immobility.
Next Steps
If you are ready to take the first critical step in your recovery journey, contact our team for a consultation and to learn more today.
