The fentanyl epidemic has emerged as the most pressing public health crisis in the United States. According to the CDC, more than 100,000 Americans lose their lives each year to drug overdoses, and fentanyl is involved in the vast majority of these deaths. It is now the leading cause of death for Americans ages 18–45. Behind every number is a person and a family profoundly impacted by this crisis.
As a Registered Nurse, I have worked directly with patients struggling to break free from fentanyl addiction. What makes my perspective unique is that I also hold a Master’s degree in Bioengineering and a Master’s degree in Psychology. These fields allow me to approach addiction care in a truly multidisciplinary way: with the clinical precision of nursing, the biochemical insight of bioengineering, and the psychological understanding necessary to address trauma, depression, and anxiety that often accompany substance use.
At Elevate Wellness Center in Los Angeles, I work with some of the most complex clients, many of whom arrive in acute withdrawal after long-term fentanyl use. Treating these patients is challenging because fentanyl changes the clinical picture of detoxification. Traditional induction onto buprenorphine often triggers precipitated withdrawal, a frightening and destabilizing experience for patients.
To address this, our team uses micro-induction protocols for Suboxone, combined with COWS and CIWA-AR monitoring and adjunctive medications such as clonidine and gabapentin. The results are encouraging: in a recent group of 25 patients, 84% completed detox successfully, cravings decreased from an average of 7.8 to 3.1 in the first week, and precipitated withdrawal rates dropped to just 8% compared to 20% or more in traditional protocols.
Beyond immediate patient care, I am working with colleagues on what we call the Fentanyl Care Optimization Initiative (FCOI). This project combines three elements:
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Adaptive Suboxone micro-induction protocols designed specifically for fentanyl-exposed patients.
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Biochemical monitoring, including semi-quantitative fentanyl assays to guide induction decisions.
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Wearable technology to track physiological changes and predict complications during detox.
The vision is to develop an evidence-based model that can be replicated and scaled nationwide. Addiction treatment in the era of fentanyl requires new solutions, and nurses are uniquely positioned to lead this transformation.
As a member of APNA, I believe that sharing our experiences and innovations is critical. By combining nursing expertise with scientific and psychological insight, we can build new protocols that improve patient safety, reduce relapse risk, and save lives. The fentanyl crisis demands that we work together, across disciplines, to create care models that meet the scale of the problem.