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Fentanyl and other opioids have exposed the fractures of the US health system. This substance, 50 times more powerful than heroin and 100 times more powerful than morphine, killed 70,600 people from overdoses in 2021. The health system itself Health allowed the conditions for many people to become addicted to opioids and drug cartels aggravated the situation with the introduction of illegal fentanyl on the black market. The calls to reverse this problem involve more regulation of the system, putting limits on the pharmaceutical lobby and leaving prohibitionism behind in exchange for addressing consumption as a reality and promoting respect for the human rights of addicted people.
Fentanyl was created in the 1960s for medical purposes as an analgesic to be used in surgeries, to treat acute pain, such as injuries, or in palliative care… And it continues to be used for these purposes, both in the United States and in many countries. countries around the world.
However, in the last two decades the illicit consumption of this substance has skyrocketed and The deaths by synthetic opioids and mainly by fentanyl increased from 3,100 in 2013 to 70,601 in 2021, according to data collected by the Centers for Disease Control and Prevention. “The leading cause of death among Americans between the ages of 18 and 45 is drug poisoning,” says Frank Tarentino, a special agent with the Drug Enforcement Administration in New York.
One of the main causes of its rise is that Since the 1990s, American doctors have increased the prescription of opioids, very addictive, to alleviate pain. Among these, OxyContin, from the pharmaceutical company Purdue Pharma, which minimized the addictive risks of the drug and paid doctors to promote its product. Over time, many patients became addicted. Purdue Pharma is currently in the middle of a multimillion-dollar legal process with the US Justice over this case.
Another determining factor is that fentanyl is very cheap to produce because it is created synthetically in laboratories and drug traffickers have seen great profits from it. In 2022, the US Drug Enforcement Administration seized 379 million lethal doses of fentanyl, enough to kill the entire population of the country.
Many people who became addicted to opioids for medical use have ended up turning to illegal markets and becoming addicted to fentanyl without even knowing they are using this drug. This is highly dangerous because fentanyl is lethal in small doses. For most people, 2 milligrams are enough to cause cardiac arrest.
The problem is worsening because clandestine laboratories that are part of drug trafficking networks have begun to mix fentanyl with other substances, such as heroin or cocaine, which multiplies the possibilities of an overdose.
Besides, It is a highly addictive substance. Apart from alleviating pain, it produces various effects on people, such as sedation, a feeling of well-being or extreme happiness. At once, his withdrawal is deeply painfulso people tend to become addicted in the vicious circle that produces pleasure when they consume it, and pain when they stop doing so.
What options are there to reverse the epidemic?
The ways to fight this problem involve greater regulation of access to addictive medications and how The pharmaceutical industry influences the health system. “After approval (of drugs by the national regulatory agency, the FDA), it is generally up to the industry (not regulators) to educate and advise prescribers on how to evaluate and mitigate risk,” he noted in a recent interview Howard Koh, a professor of public health at Harvard University, as an example of the influence given to manufacturers.
But also to implement harm reduction programs, such as safe consumption rooms in which substances can be examined before they are consumed or provided Naloxone to reverse possible overdoses, according to Julián Quintero, founder of the Acción Técnica Legal corporation, a non-profit organization that promotes the human rights of those who consume psychoactive substances.
Quintero points out thatthe opioid crisis that countries like the United States and Canada are currently experiencing has little chance of reproducing in other countries in the region because historically health systems have limited medication with these drugs to spaces controlled by the medical community. “In Latin America we do not have these preconditions nor do we have a culture of opioid consumption like North Americans do, so it is very difficult for there to be an epidemic like the one they are experiencing.”
The United States has already begun to promote some of these measures, such as the free sale of Naloxone and safe consumption rooms. In addition, the Joe Biden Administration recently announced that it will allocate $450 million to combat overdoses with several of these programs. It is expected that in the coming years the lethal curve of deaths from opioids can be controlled, hand in hand with comprehensive addiction prevention and treatment programs.
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