Treating Fentanyl and Anxiety

The Connection Between Drugs and Anxiety

fentanyl and anxiety  


Opioids and narcotic pain relievers are extremely addictive. If you or someone you love has developed a substance use disorder to one of these substances, it can be scary. Fentanyl is an extremely powerful painkiller that is known to be more potent than morphine and heroin. Although it is often abused, it can be prescribed by medical professionals as a pain reliever as well.


Over 18% of the adult population in the United States suffers from anxiety, and almost half of people struggling with drug addiction live with a co-occurring mental disorder.1  Although fentanyl is typically only prescribed when morphine no longer works, it is possible to be prescribed this drug. If you are someone struggling with opioid addiction or dependency, it is possible to have a co-occurring disorder of fentanyl and anxiety.

Is Anxiety Related to Drug Addiction?

Many people who are dealing with substance use disorders are diagnosed with mental health disorders as well. In fact, if you are struggling with drug addiction, you are twice as likely to suffer from a mood or anxiety disorder. Around 5% of all adults struggling with substance use disorders also struggle with mental health. It is not conclusive if anxiety can cause a substance use disorder, but there is evidence that they are related in many ways.

Does Fentanyl Cause Anxiety?

Using Fentanyl typically is known to cause the opposite of anxiety in the short term. Despite this, sometimes adverse effects can happen, and fentanyl will cause anxiety. There are many other side effects of fentanyl as well.2

Fentanyl Side Effects

Fentanyl side effects can also include:2
  • Feeling anxious
  • Panic attacks
  • Swelling of limbs
  • Burning, itching, numbness, or tingling
  • Feeling confused
  • Feeling disoriented
  • Difficulty breathing or shallow breathing
  • Fast heartbeat
  • High blood pressure
  • Weight loss or gain
  • Stomach pain
  • Nausea
  • Vomiting
There are also more rare and dangerous side effects of fentanyl that you must watch out for. If they occur, contact a medical professional immediately.
  • Discoloration in your lips, skin, fingernails, or palms
  • Severe skin problems that include burning, swelling, or rashes
  • Hallucinations
  • Extremely high level of euphoria
  • Fainting, or feeling light-headed for a long time
We can conclude that normally there isn’t a strong connection between fentanyl and anxiety. But there are a few exceptions where a person can suffer from using fentanyl and anxiety at the same time.

Forms of Fentanyl

  • Transdermal Patch: Like a patch typically used for nicotine addictions, this patch is placed on your skin and releases the medication over a period.
  • Buccal Tablet: An alternative to swallowing a tablet, this form of medication can be dissolved between your cheek and gums.
  • Sublingual Tablet: Dissolves under your tongue.
  • Sublingual Spray: Sprayed under the tongue.
  • Oral Lozenge: Similar to a lozenge that you would use for a sore throat. You suck on these until they dissolve.
  • Nasal Spray: If you have ever used a saline solution, this is very similar. It is a solution that contains fentanyl, that is sprayed into the nose.
  • Injectable: Injectable fentanyl should only be administered by a healthcare provider as it can be extremely fatal. Even doses of 400 micrograms can be deadly.

Fentanyl and Anxiety Medication

If you are taking fentanyl but also suffer from a co-existing anxiety condition, you need to be aware that you cannot take many anxiety medications. Not only can it be harmful, but some drugs can also prevent fentanyl from working properly. If you are taking anxiety medications combined with fentanyl illegally, it can create a horrible interaction that can result in death if not addressed.

Drug Interactions That Increase the Risk of Side Effects with Fentanyl


This group of medications is used to treat many different forms of anxiety disorders and can increase the risk of suppressed breathing, impaired cognitive functions, and even cause a fatal overdose.3

Baclofen, Cyclobenzaprine, and Methocarbamol

These are all muscle relaxants that can cause breathing problems in conjunction with fentanyl.4

Zolpidem, Temazepam, and Estazolam

Hypnotics such as these can increase breathing problems, create low blood pressure, extreme drowsiness, or even coma5

Atropine, Scopolamine, and Benztropine

Typically used as an anticholinergic, when taken with fentanyl you may have problems urinating or severe constipation, which could lead to serious bowel problems.5

Voriconazole and Ketoconazole

These drugs increase the levels of fentanyl in your body which can be very dangerous if not monitored by a doctor.5

Drugs you Should Not Take With Fentanyl

Do not take these drugs with fentanyl. Taking fentanyl with these drugs can cause dangerous effects in your body. Examples of drug interactions, including those with anxiety medications include:


This is a narcotic that can lower the effects of fentanyl, and even cause withdrawal symptoms.6

Monoamine Oxidase Inhibitors (MAOIs)

These are drugs that are typically taken to reduce depression. If you take these drugs with fentanyl it can actually cause anxiety, confusion, slowed breathing, or even coma. Avoid taking fentanyl if you have taken an MAOI in the last fourteen days.7

Fentanyl Withdrawal

Withdrawal from fentanyl can cause serious side effects. If you also suffer from anxiety this can cause increased levels of anxiety. During fentanyl withdrawal, you can expect to feel restless, have a runny nose or watery eyes, and yawn often. Although you might be tired you may also have trouble sleeping, and have pain in your joints, muscles, and back.

Because your anxiety is heightened during fentanyl withdrawal, you might feel irritable or have mood swings. You may also not feel hungry, and experience purging such as vomiting and diarrhea. Rapid heart rate is not uncommon and might increase feelings of anxiety during fentanyl withdrawal.


Although it is an extremely rare side effect of fentanyl use, hallucinations are possible. They can also occur during Fentanyl withdrawal as well. Typically this side effect is rarer when under the watchful eye of a doctor, but it is still possible. This can be especially alarming for people with anxiety, as hallucinations can be scary.

Anyone who abuses or uses fentanyl is at risk of experiencing auditory or visual hallucinations. These hallucinations can include hearing voices, music, clapping, or other sounds that do not exist.

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