Fentanyl is considered one of the most lethal drugs, not just in the United States but the world. Not only is the drug incredibly potent, but it also comes with a range of side effects and symptoms that can become deadly.
One of the more distinctive side effects of fentanyl use is something called the “Fentanyl fold.” Fentanyl fold is a term used to describe what happens to a person’s posture when they have ingested fentanyl. Not only is it usually considered a sign of fentanyl abuse, but it can also be a sign of a possible overdose.
What is Fentanyl Fold?
The fentanyl fold is basically a gesture people do as a result of fentanyl use or addiction. It can have a few potential (direct) causes, such as loss of muscle control, extreme sedation, or a semi-conscious nodding posture. Most commonly, it refers to a distinctive posture where a person’s head droops forward, sometimes nearly touching their chest, while their body remains upright or sways slightly. In some cases, this folded posture is accompanied by glassy eyes, shallow breathing, and minimal responsiveness.
As fentanyl continues to wreak havoc far and wide, scenes of people slouched in doorways, bus stops, or standing in place while doubled over have become hauntingly familiar. While to an outsider, it may just look like the person is falling asleep, the fentanyl fold is the result of a large amount of fentanyl being ingested. It can even be an early warning sign of a potential fatal overdose.
Potential Causes of the Fentanyl Fold
Fentanyl fold can be caused by a number of reactions the body has to the ingestion of fentanyl, both in the brain and throughout the body. Some of the reasons the fentanyl fold happens include:
“Nodding off” is a term used to describe the semi-conscious state that many opioid users experience after taking the drug. Fentanyl, being a particularly potent synthetic type of opioid, can cause extreme drowsiness and sedation. Slipping in and out of consciousness as a result of the fentanyl intake can cause the body to collapse forward, creating that folded posture most associated with the fentanyl fold.
For chronic users of fentanyl, this state can become almost routine. However, this trance-like sedation is inherently dangerous, especially when combined with respiratory depression.
It’s important to note that drug-induced nodding off is not the same as falling asleep or acting sleepy because you are tired. Nodding off from fentanyl use is a form of semi-consciousness and can be dangerous.
Fentanyl disrupts the normal functioning of the brain, particularly areas responsible for equilibrium and coordination. This can cause lightheadedness or dizziness even before the drug fully takes effect. As the drug overwhelms the central nervous system, it can cause the person to slump forward uncontrollably as they try to compensate for the sudden physical disorientation.
When administered medically, one of the intended effects of opioids is muscle relaxation. However, when used and abused in ways other than directed (with no helpful medical guidance in case of emergencies), this muscle relaxation can be so extreme that the muscles “turn off.” This can lead the body to slouch or even fold over.
This muscle weakness can persist for hours after the initial high. In many cases, the person remains in this “folded” position until they are either helped or gradually awakened. Prolonged slouching like this can lead to physical injuries, blood flow issues, and further complications if not addressed.
Why is Fentanyl so Dangerous?
Fentanyl is used in medical settings, such as for treating pain from cancer treatment or blocking out pain experienced by giving birth. But fentanyl can be found and obtained on the street, frequently combined with other substances or used as a cutting agent. Instead of providing relief to people who need it, it can cause an addiction that wreaks havoc on the person’s life.
Some of the others include:
Fentanyl is roughly 50 times stronger than heroin and 100 times more potent than morphine. A dose as small as just two milligrams (about as much as a few grains of salt) can be fatal. Because of this, even experienced drug users or someone who has taken fentanyl in the past can overdose without even realizing that they consumed too much.
As we touched on, fentanyl is often mixed with or used to “cut” other popular drugs )such as heroin, powdered cocaine, methamphetamine, or counterfeit prescription pills) in order to produce and sell those drugs for a lower cost. Drug dealers can stretch out their supply of drugs and sell to more people, promising a potent high.
Often, the user is unaware that what they are taking is laced with fentanyl. They may take what they deem to be a “standard dose” of the drug they think they are taking. This often leads to fentanyl-related overdoses, since the inclusion of fentanyl can cause the dose to actually be lethal. The person taking the drugs has no idea fentanyl is present, and thus cannot accurately calculate how much to consume and remain safe.
As a synthetic opioid, fentanyl acts directly on the central nervous system (CNS) of the body. This controls the body’s systems of breathing, heart rate, and consciousness. High doses of fentanyl can slow or stop these functions. When someone enters the fentanyl fold, they may look like they’re “just out of it. But they may actually be slipping into respiratory arrest, a state where the body maintains a pulse but is not breathing.
Once a person becomes addicted to fentanyl, quitting can become a physical and psychological ordeal. Withdrawal symptoms are often severe and can include nausea, vomiting, muscle pain, anxiety, insomnia, and intense cravings. These effects can begin within hours of the last dose, which can push individuals to use fentanyl just to feel “normal.”
Signs of Fentanyl Addiction
Recognizing the signs of fentanyl addiction can save lives. Whether in yourself, a friend, or a loved one, early detection of fentanyl addiction is critical for seeking help before it’s too late.
- Constricted pupils
- Drowsiness or frequent nodding off
- Shallow or slowed breathing
- Weight loss or poor personal hygiene
- Injection scars or “track marks” on arms or spaces between toes (if injecting)
- Sudden “fentanyl fold” posture
- Secretive or erratic behavior
- Neglecting work, school, or family responsibilities
- Doctor shopping or frequent ER visits for pain relief
- Withdrawal from social activities or previously enjoyed hobbies
- Financial trouble or desperate actions (such as stealing) to support drug use
- Mood swings, anxiety, or depression
- Paranoia or confusion
- Cravings or obsessive thoughts about using or obtaining drugs
- Inability to control or reduce usage despite knowing the risks
Getting Help For Fentanyl Addiction
In the case of fentanyl addiction, early detection and treatment can quite literally be the difference between life and death.
If you or a loved one are looking to stop taking fentanyl, it is crucial that the process be done under the care and supervision of trained medical professionals by undergoing medically supervised detox. This can be done at a local medical facility, a dedicated detox center, or a treatment center that also offers detox services like Eagle Creek Ranch Recovery.
When it comes to fentanyl, withdrawal symptoms can be intense, uncomfortable, and in some cases, even potentially deadly. Medical detox provides access to medical care and monitoring, including the administering of medications to help alleviate and the more extreme withdrawal symptoms. The person detoxing will also be able to receive medical treatment as soon as possible if there are adverse effects, which can help them to prevent long-term physical damage.
After detox is complete, treatment can begin. Whether it is inpatient or outpatient, fentanyl addiction treatment often involves a combination of therapy, counseling, support groups, and holistic practices. Medication-assisted treatment (MAT) may be recommended. MAT incorporates FDA-approved medications to reduce cravings and rebalance brain chemistry. It is often combined with other forms of treatment (such as individual therapy) to help those with a history of relapse or overdose.
Receive Support For Fentanyl Fold and Addiction at Eagle Creek Ranch Recovery
If you or someone you care about is showing signs of fentanyl addiction, don’t wait to seek help. At Eagle Creek Ranch Recovery, we understand how overwhelming and dangerous opioid addiction can be. That’s why we provide specialized care for individuals struggling with fentanyl dependence and its physical and psychological effects.
Our compassionate, experienced team offers:
- Medically supervised detox to safely manage withdrawal
- Evidence-based therapy, including Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), and trauma-informed care
- Holistic care that treats the mind, body, and spirit
- Aftercare planning to prevent relapse and promote sustained healing
For more information on our recovery and treatment programs, contact us today.
Clinical Director
Kendall Maloof is the clinical director at Eagle Creek Ranch Recovery. She is a licensed marriage and family therapist and has held multiple leadership roles before settling here at Eagle Creek Ranch Recovery. Kendall received her master’s degree in marriage and family therapy from the Chicago School of Professional Psychology in 2016. Her career in mental and behavioral health began in 2014 when she took up internships in both the nonprofit and for profit sectors. She interned at multiple reputable companies, such as The Living Success Center and 449 Recovery in California.
In 2019, Kendall became the clinical director of Sunsets Recovery for Woman, a dual diagnosis program in southern California. Kendall is a natural leader. She has an incredible ability to problem solve and stay calm in any situation. Kendall never fails to show up when she is needed, and her calm demeanor makes her team and clients feel at ease. Eagle Creek Ranch Recovery is proud to have Kendall as our clinical director.
