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14 Long-term effects Regular, long-term use of fentanyl may cause: dependence less effective pain relief (tolerance) increased risk of getting sick from viruses and infections sleep problems reduced bone density and higher risk of breaking bones heightened sensitivity to pain (opioid-induced hyperalgesia) impacts on hormone levels leading to reduced sex drive, infertility, erectile dysfunction, or menstrual cycle changes

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In general, non-toxic papers do not have any of these harmful compounds