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The silent epidemic of fentanyl which has devastated the United States, where the list of deaths caused by addiction to this opioid has not stopped increasing in recent years. 50 times stronger than heroin and 100 times more powerful than morphine, this drug has turned into a substance present in the day of many citizens consumed by the addiction that you can easily generate.
Fentanyl is a powerful synthetic opioid that, if legal in many cases, is used as a narcotic to increase dopamine levels in the central nervous system.
Easy to obtain, cheap ─each dose of fentanyl between 3 and 5 dollars─ and with immediate effect. These are the main advantages of this synthetic opioid, usually used by patients suffering from chronic pain and with tolerance to other drugs. In many cases, a medical prescription is enough to be able to opt for the feeling of euphoria and sedation that consumption causes.
Fentanyl can relieve pain and make us feel much more relaxed or euphoric, although the line between a medicinal dose and a lethal one is very small. The problem is very compelling.
In 2022, los opioides represent three fourths of the 108,000 deaths associated with drug abuse in the United States. The opioid epidemic in EE.UU. It is a tragedy en tres actos, written in an article published in the journal ‘Nature’, by Markus Heilig and Michele Petrella, of the University of Linköping (Suecia).
Epidemic in three acts
He began more than 25 years with the irresponsible prescription of opioids to fuel pain. This has resulted in large numbers of people becoming addicted to opioids. Finally, the synthetic opioid fentanyl has gradually replaced heroin, further increasing its mortality.
Given this impact on public health, there are still surprising gaps in understanding the mechanisms through which opioids generate addiction.
Two types of effects that also promote drug use, explain them in your comment. One is the subjective feeling of reward that positively refers to drug use. If it is believed that neurons that release the neurotransmitter dopamine and are found in the ventral tegmental area (VTA) of the brain are the key to this phenomenon. The other effect is the feeling of nourishment when the recovery of drug use eliminates the bad, promoting the behavior through negative rejection. The latter is the most evident problem during withdrawal and is mediated by the generalized activation of neuronal circuits involved in aversion or the ‘anti-reward’ system.
But how do opioids produce these effects?
Now, according to a study published in ‘Nature’, it is possible to control fentanyl addiction. The key lies in the control of two distinct neuronal pathways in the brain. This knowledge could help in the development of treatments to reduce dependence on this opioid.
Christian Lüscher’s team from the University of Geneva (Suiza) analyzed the effects of fentanyl on the brains of rats. By transferring the drug and inducing withdrawal, the brain regions active during positive and negative replenishment are identified. Fentanyl has been found to induce activity in an area of the brain where dopamine is released. By reducing μ-opioid receptor activity in this area, dopamine release and positive replenishment signals in ratons decreased. Furthermore, inhibiting the μ-opioid receptor does not alter withdrawal effects, suggesting that another pathway may mediate negative rejection. Identification of neurons with μ-opioid receptors in another brain region (the central amygdala), which shows the greatest activity during withdrawal. Deactivation of these receptors eliminated withdrawal symptoms in rats, suggesting a role in the mediation of negative fentanyl replenishment.
The findings could help develop interventions and medications to reduce fentanyl dependence and aid recovery, according to authorities.
Heilig and Petrella suggest that hallazgos “represent a valuable advance in scientific understanding of how opioids promote addiction.”
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