What Are Fentanyl Lollipops?

Last Updated: November 27, 2023

Editorial Policy | Research Policy

Fentanyl lollipops are a fast-acting version of the opioid drug prescribed to treat breakthrough pain. As with all fentanyl, there’s high abuse potential.

Fentanyl is a synthetic opioid significantly more powerful than morphine. It was initially developed for pain management, particularly for cancer patients. For this purpose, they are available as lollipops to treat breakthrough pain. Because of fentanyl’s potency and the crisis the U.S. faces with the ongoing opioid epidemic, fentanyl is also abused and distributed illegally in America.

Fentanyl is mainly brought into the U.S. through the southern border and is a major culprit for the high number of opioid overdose deaths in America. Fatalities from opioids have increased from 70,029 in 2020 to 80,816 in 2021.

What Is Fentanyl (Actiq)?

Medically, fentanyl is available in different forms. One brand-name version of fentanyl is Actiq, an oral transmucosal lozenge on a handle similar to a lollipop. Actiq was originally approved for medical use in the U.S. in 1998.

Actiq is intended for breakthrough cancer pain. Since Actiq is an opioid, it works by attaching to opioid receptors. These receptor sites are located throughout the brain and body. When the opioid attaches to the receptors, it reduces pain by lowering the transmission of pain signals to the brain. Opioids like Actiq don’t treat the underlying cause of pain.

What Are Fentanyl Lollipops?

A fentanyl lollipop refers to the formulation of fentanyl citrate. Fentanyl citrate is prepared into a lozenge that is attached to a handle. The lollipops are prescribed for severe acute cancer pain and come in doses of:

  • 200 mcg
  • 400 mcg
  • 600 mcg
  • 800 mcg
  • 1,200 mcg
  • 1,600 mcg

Fentanyl Lollipops for Breakthrough Pain

Fentanyl citrate is a fast-acting form of this opioid pain reliever, and it is used to treat breakthrough pain. Breakthrough pain occurs quickly and intermittently. It can happen even if someone is regularly using long-acting pain medicines, so fentanyl citrate, in this instance, is an appropriate medication that acts quickly to combat that pain.

How Fentanyl Lollipops are Administered

Fentanyl lollipops should remain in the blister package until immediately before use. The lollipop should then be placed in the mouth between the cheek and lower gum, and the patient should occasionally move the lollipop from one side of the mouth to the other using the lollipop handle. 

The lollipop should be sucked. It is important to avoid chewing the lollipop as this can cause lower fentanyl levels in the body than if the lollipop is sucked as instructed. The lollipop should take about 15 minutes to consume, and the drug may not work as well if it takes longer or shorter than that time to finish. 

Actiq Misuse

Misusing Actiq can be the first step to developing an Actiq addiction. When a drug is misused, it is taken differently than your doctor prescribes. For example, if your Actiq is prescribed to be taken when you have severe pain, misuse would be taking it even when your pain is fully controlled. Drug misuse, tolerance and dependence are closely linked and can pave the way to addiction.

Actiq Tolerance

When you become tolerant to Actiq, you require progressively higher doses to achieve the same effects you initially did. It is important to remember that Actiq is FDA-approved to treat cancer pain: as such, dose increases may be necessary to control pain adequately. However, if you are misusing Actiq to get high and not to control pain, you may notice that the doses that got you high at first are no longer sufficient and that you need higher doses, indicating tolerance.

Actiq Dependence

When you take Actiq regularly, your brain becomes used to its presence and adapts accordingly, expecting the drug. This phenomenon is known as physical dependence and means that if you suddenly stop Actiq, you may experience withdrawal symptoms as your body struggles to adjust to being without the drug. While it is possible to become dependent on a drug despite using it as instructed, dependence can lead to addiction when it is misused.

Actiq Addiction

Addiction is a complicated phenomenon in which you are not only tolerant of and dependent on Actiq but also realize that the drug is harming you. Nonetheless, when you are addicted to the drug, you find it extremely difficult to cut back or quit. The prospect of withdrawal symptoms can lead you to keep taking the drug, and tolerance can force you to take higher and higher doses even though you know it is hurting your life. Help is needed to overcome an Actiq addiction.

Dangers of Fentanyl Lollipops

Whether someone is prescribed fentanyl lollipops or uses them illicitly, this medication has significant risks. As an opioid, fentanyl can interact with other central nervous system depressants such as benzodiazepines and other narcotics. Fentanyl is 50–100 times stronger than morphine. 

Side Effects of Fentanyl Lollipops

Common side effects of fentanyl lollipops (Actiq) include:

  • Drowsiness
  • Dizziness
  • Nausea
  • Vomiting
  • Constipation
  • Headache
  • Weakness
  • Anxiety
  • Depression

This drug may have more serious side effects, particularly if an individual abuses or misuses fentanyl lollipops. These dangerous side effects include:

  • Slowed heart rate
  • Shallow breathing
  • Extreme drowsiness
  • Upset stomach
  • Confusion
  • Strange thoughts or behavior
  • Extreme weakness or tiredness
  • Dependence and addiction
  • Overdose
  • Death

Risk of Overdose

Due to its powerful potency, fentanyl lollipops have a high risk of overdose. Overdose deaths from fentanyl have risen dramatically. In 2011, a reported 2,666 Americans died from fentanyl overdose. In 2018 that number skyrocketed to 31,335 people in the U.S. This number continues to rise as the supply, distribution and abuse of fentanyl increases. It is important to be able to recognize the signs and symptoms of a fentanyl overdose. They include:

  • Sleepiness
  • Dizziness
  • Difficulty breathing
  • Hypoxia (decreased oxygen to the brain)
  • Cyanosis (bluish discoloration of the skin as a result of hypoxia)
  • Cold and clammy skin
  • Constricted pupils (pinpoint pupils)
  • Person is unresponsive
  • Slow breathing or breathing that has stopped
  • Coma
  • Brain damage
  • Death

Help for Fentanyl Addiction

Whether using fentanyl as prescribed, like fentanyl lollipops for legitimate pain, or using fentanyl illicitly, this drug is highly dangerous and addictive. Opioid addiction and opioid use disorders are at epidemic levels in the U.S. and worldwide. If you are struggling with fentanyl or opioid addiction, you aren’t alone and treatment is available. At The Recovery Village Cherry Hill at Cooper, we work to help people medically detox from fentanyl and overcome addiction.

Treatment programs include:

If you’d like to learn about our full program options and how they could help you or someone you love overcome addiction to opioids or other substances, we’re here and ready. Contact us today.

Sources

Department of Justice, Drug Enforcement Administration. “Drug Fact Sheet: Fentanyl.” April 2020. Accessed July 30, 2023.

Scarpino, Madison. “Fentanyl deaths overwhelm US morgues.” Fox News, August 24, 2022. Accessed July 30, 2023.

Centers for Disease Control and Prevention. “U.S. Overdose Deaths In 2021 Increased Half as Much as in 2020 – But Are Still Up 15%.” May 11, 2022. Accessed July 30, 2023.

Food and Drug Administration. “Actiq Approval Letter.” 1998. Accessed July 30, 2023.

Centers for Disease Control and Prevention. “Fentanyl.” June 1, 2022. Accessed July 30, 2023.

Drugs.com. “Actiq.” October 25, 2021. Accessed July 30, 2023.

U.S. National Library of Medicine. “Fentanyl.” May 15, 2023. Accessed July 30, 2023.

National Institute on Drug Abuse. “Fentanyl DrugFacts.” June 2021. Accessed July 30, 2023.

Centers for Disease Control and Prevention. “Understanding Drug Overdoses and Deaths.” May 8, 2023. Accessed July 30, 2023.

National Library of Medicine. “Actiq.” November 30, 2022. Accessed July 30, 2023.

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