Exploración de los mecanismos neurobiológicos de la adicción al Fentanilo

Abstract

In recent decades, the consumption of illegal substances has posed a significant health challenge affecting millions of people around the world. Particularly, in 2021, the World Health Organization (WHO) reported that out of 600,000 deaths caused by the abuse of illicit substances, 25% of these fatalities were attributed to opioid use, including fentanyl. The consumption of fentanyl is driven not only by its availability through illegal trafficking but also by its rewarding properties, which prevent users from stopping their intake. Numerous studies have focused on elucidating the neurobiology of fentanyl addiction. However, to date, compilations on this topic are scarce. Therefore, the present project describes, through a literature review, the neurobiological mechanisms underlying fentanyl addiction. The results show that the use of fentanyl alters the release of dopamine and serotonin, promoting maladaptive neuroplastic changes that lead to tolerance, dependence, and withdrawal symptoms. It also affects the serotonergic and opioid systems in the brain, affecting mood. The Ventral Tegmental Area (VTA), the Nucleus Accumbens (NAc), and the Prefrontal Cortex (PFC) are modulated by the action of fentanyl, promoting its consumption and diminishing the inhibitory controls aimed at regulating decision-making. Genetic and epigenetic factors, along with early exposure to this substance, affect the development of the pregnancy product by altering the number of dopamine receptors and the activity of certain histones. Understanding the neurobiological mechanisms of fentanyl use enables the development of more effective preventive and therapeutic strategies.