The Relationship Between Synthetic Opioids (Fentanyl) and Depression
The Relationship Between Synthetic Opioids (Fentanyl) and Depression
Table of Contents
What are Synthetic Opioids?
Recent studies have revealed a relationship between synthetic opioids and depression. Natural opioids have been around for thousands of years, with just one example being the Papaver somniferum which comes from poppy flowers. Synthetic opioids, however, are human-made in a lab. Similar to natural opioids, synthetic opioids are made to lessen pain and dull the senses.
Some examples of synthetic opioids that were fully made by man include:
Other opioids may be semi-synthetic, meaning they are derived from natural sources but are still altered in a lab to enhance their properties.
Common examples of these include:
- Morphine
- Heroin
- Oxycodone
- Hydrocodone
When a medical doctor prescribes opioids, they relieve chronic pain or ease severe illness. When opioids are used illegally, however, then they can have deadly consequences.
What is Depression?
Depression is a mood disorder that impacts a person’s ability to perform daily activities such as working, eating, sleeping, hygiene, and more. Those diagnosed with depression may feel irritable, hopeless, or worthless.
Depression doesn’t have one specific cause, but someone can be more at risk due to their environment, genetics, biology, and psychological makeup. However, age is not a factor because depression can impact anyone at any point in their lives.
There is no one cure for depression, but a combination of therapy, drug treatments, and group supports have been shown to help manage this mood disorder. Often, substance use disorder (SUD) and depression are comorbid, meaning they occur simultaneously. Treatment centers must often treat these disorders together.
The common side effects of depression include, but are not limited to:
- Fatigue and lack of energy
- Feelings of restlessness
- Trouble concentrating or decision making
- Changes in sleep patterns, weight, and appetite
- Loss of interest in activities and favorite hobbies
- Thoughts of death or suicide
Additionally, some people who have been diagnosed with depression may feel aches, pain, and headaches that have no physical cause and that are not affected by treatments.1
What is Fentanyl?
Fentanyl is a strong synthetic opioid that works similarly to morphine, but it is 50 to 100 times more potent. Because of its potency, fentanyl is commonly used for:
- Severe cases of cancer
- A sedative for intubated patients
- Treatment for epilepsy
- Severe cases of renal failure
- Patients with a tolerance for less potent opioids
Fentanyl works by targeting the opioid receptors in the body, particularly the ones that are centralized in the brain and control emotions and pain. When fentanyl has entered the body, it creates a physiological response that acts on various opioid receptors. Additionally, fentanyl releases dopamine, causing the body to relax and feel good.
This reaction makes the body want to repeat the pleasurable behavior and contributes to fentanyl’s addictive qualities.
What is a Fentanyl Patch?
A fentanyl patch is a transdermal patch worn on the skin. While the exact use depends on how the doctor’s prescription, the patch is typically worn for around 72 hours before it’s replaced.2
What is a Fentanyl Lollipop?
While the fentanyl lollipop can come in the sugary variety, it’s more commonly a type of lozenge and consumed orally. For this form of fentanyl, the lozenge dissolves when sucked on.
Carfentanil vs. Fentanyl
Carfentanil and fentanyl are both synthetic opioids, but they serve two different purposes. While fentanyl is used as pain relief for chronic pain, carfentanil is used as an elephant tranquilizer. Fentanyl is a potent opioid, but carfentanil is up to 100 times more potent than fentanyl.3
Can Synthetic Opioids Cause Depression?
It’s difficult to say if synthetic opioids cause depression, but research shows a link between opioid usage and depression symptoms. The longer a patient uses synthetic opioids, the more at risk they are for developing a recurring physical dependence that is resistant to treatment.4 In fact, studies have found that patients with no history of substance use have reported feeling depressive symptoms.5
When patients take synthetic opioids for chronic pain, they are generally given a low dose to start. As they continue to take the prescribed medication, their body needs more of the drug to experience the same effects. Eventually, the body requires higher amounts of the substance, and the patient is at risk of developing physical dependence.
Does Fentanyl Cause Depression?
While there is little research supporting the claim that fentanyl causes depression, it does fall under the category of being an opioid, meaning there is a higher risk of developing symptoms of depression from using this drug.
Can Synthetic Opioids Help Depression?
Even though research on this topic has shown that synthetic opioids likely influence the onset of depression, these drugs can also play a role in aiding patients with depressive disorder. In some cases, synthetic opioids are used for the treatment of depression. Research for certain cases has shown that prescription opioids can help depressed patients regulate their sleep schedules and cope with the stress of everyday life.
Additionally, targeting opioid receptors has shown promising results in the treatment of depression. Unlike traditional depression treatments that take anywhere from 4 to 6 weeks to show results, the use of opioid treatments can show quicker results.6
Does Fentanyl Help Depression?
Fentanyl is not currently a popular treatment for depression. Like other opioids, fentanyl has been used in sleep deprivation studies for individuals with depression. Fentanyl is not often the typical treatment used for most cases of depression, however.7
Synthetic Opioids Effects
The most common side effect of using synthetic opioids is constipation, but several other side effects vary in severity.
Some common side effects of synthetic opioids include:
- Nausea
- Vomiting
- Dry mouth
- Bloating
- Headaches
- Decreased hormones (such as testosterone and estrogen)
- Low blood pressure
- Low heart-rate (brachycardia)
- Difficulty breathing
- Difficulty sleeping
- Pain sensitivity
While there may be more side effects, the ones listed above are the most common. The use of synthetic opioids can become deadly if too much is taken unintentionally and an overdose occurs. If that person begins to show the symptoms listed in the section below, contact 911 immediately.8
Those who use synthetic opioids, and all opioids for that matter, are at risk of developing a physical dependence on the drug. Physical dependence is when tolerance for the drug develops and higher dosages must be used to achieve the same effects.
Fentanyl Side Effects
Fentanyl’s side effects are like heroin, which makes it a potentially dangerous drug if used outside of a prescription by a medical doctor.
The common side effects of fentanyl include:
- Euphoria
- Confusion
- Difficulty breathing (respiratory depression)
- Drowsiness
- Nausea and vomiting
- Visual disturbances and hallucinations
- Constipation
- Loss of consciousness
- Low blood pressure
- Coma
- Death
Because fentanyl is an opioid, those who use it are at risk of developing physical dependence. Even though fentanyl is a more potent opioid, it’s still possible to develop a tolerance and need a higher dose to achieve the same desired effects.9
Synthetic Opioids Overdose Signs
If opioids are taken at a high dosage, the drug may inhibit the brain’s ability to regulate breathing. If the individual is not taken to a hospital and given naloxone treatment early on, the overdose may result in death.
If someone who uses opioids per a prescription or has an opioid use disorder displays any of the following signs, call an ambulance immediately.
- Pinpoint pupils (very small pupils)
- Becomes unconscious
- Difficulty breathing10
Fentanyl Overdose Signs
A fentanyl overdose has similar symptoms to other synthetic opioids. However, according to a bystander study done by the Center for Disease Control (2017), the overdose symptoms for opioids can progress at astonishing speeds—often within minutes or even seconds of taking the drug—and even though the bystanders for this study were trained to administer naloxone, not all had it available in time for treatment.11
Alongside the symptoms mentioned above, other symptoms of opioid overdose include:
- Blue lips
- Gurgling sounds (subject still breathing)
- Body stiffening or seizures
- Foaming at the mouth
- Strange behavior or confusion followed by unresponsiveness
Treating Depression as a Co-Occurring Disorder in Rehab
Because depression and substance abuse disorders can be co-occurring disorders, many rehabilitation programs opt to treat these disorders together. There are four main aspects of rehabilitation for these disorders.
Counseling
Individual and group counseling are important aspects of a rehabilitation program. For depressive disorders, cognitive-behavioral therapy has proven to be very successful. Generally, rehabilitation participants will work one-on-one with a therapist or counselor and will have the option to participate in group therapy.
Detox
The drug withdrawal period, also known as detox, is the period when substances are removed from a person’s system. This process is not pleasant, and many individuals experience negative side effects. With the right program, though, everyone will have the resources necessary to undergo this process.
Relapse Prevention
Preventing relapse is the key to success with rehabilitation. Many individuals can go through a rehab program, but the ones who successfully follow their treatment plan are the ones who avoid relapse. A good relapse prevention program teaches the skills necessary for coping in everyday life.12
Support Groups
Research shows that Narcotics Anonymous or other support groups can benefit those who struggle with addiction. Not only do individuals in support groups make lasting connections with their fellow group members, but they have a sense of accountability to stay on course with a treatment plan. 13
Resources
- https://www.nimh.nih.gov/health/topics/depression/index.shtml
- https://www.uofmhealth.org/health-library/d00233a1
- https://www.pbm.va.gov/AcademicDetailingService/Documents/Pain_Patient_FentanylCarfentanil_IB101137.pdf
- https://pubmed.ncbi.nlm.nih.gov/29505419/
- https://doi.org/10.1370/afm.1371
- https://doi.org/10.1016/j.pharmthera.2019.04.009
- https://pubmed.ncbi.nlm.nih.gov/12798980/
- https://www.ams.ac.ir/AIM/NEWPUB/16/19/12/0010.pdf
- https://www.ncbi.nlm.nih.gov/books/NBK459275/
- https://www.who.int/news-room/fact-sheets/detail/opioid-overdose
- https://dx.doi.org/10.15585/mmwr.mm6614a2
- https://www.sciencedirect.com/science/article/abs/pii/S0006322304007425?casa_token=b_4LU1QT200AAAAA:V0jwW9BhvmJljPCfX4ZgDfYFNoSqGKf6o4kL-SZ_a_BPQpDMPqqZUX9Vvd5IKNWzZ6Q2UXUnbAs
- https://dx.doi.org/10.15585/mmwr.mm6614a2
