2023-08-10 11:18:00
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In the last decade, there has been an alarming increase in the recreational use of fentanyl, with devastating effects particularly in the United States.
Between 2018 and 2021, deaths attributed to overdoses of this potent opioid skyrocketed by more than 90%, with approximately 70,000 deaths registered in the last mentioned year. The situation has reached epidemic proportions in some sectors of society.
This trend has been driven, in part, by the combination of fentanyl with other drugs, such as alcohol, heroin or methadone. These types of combinations magnify the effects of fentanyl, raising both the risk of addiction and of overdose and death.
X-RAY OF THE ‘ZOMBIE DRUG’
First synthesized in the 1960s, fentanyl was originally used as an intravenous pain reliever. However, in the 1970s and 1980s, its use expanded to other purposes, especially recreational.
The action of fentanyl in the human organism is complex and multifaceted. in our body, there are more than 20 endogenous opioid peptides, such as endorphins, which make it easier for substances such as fentanyl to act on specific locations in the brain. Stimulation of these substances in the central nervous system can affect what is known as the brain’s reward system, which regulates various aspects of human behavior, such as pleasure, memory, and learning.
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The powerful stimulation that fentanyl induces in this system can lead to brain changes known as neuroadaptations. These changes promote greater tolerance (meaning higher and higher doses are required to achieve the desired effects), dependence, addiction, and withdrawal symptoms.
The reinforcing effect of fentanyl is related to the mesolimbic dopaminergic system, the pathways used by the neurotransmitter dopamine to distribute itself in the brain. After continued consumption, the first neuroadaptations begin to affect the dorsal striatum, a region involved in habit formation.
Fentanyl belongs to the category of opioids, some of which are of natural origin, such as opium extracted from the Papaver somniferum plant, or synthetic, such as fentanyl itself. Historically, opioids have been valuable in medicine, but recently the black market for synthetic opioids has experienced rapid growth, emerging as a dangerous new fad in the realm of psychoactive substances.
The toxicity and addictive potential of these narcotic compounds exceed those of morphine and heroin. Added to their relatively low cost of manufacturing, this contributes to the increased risk of overdose. Fentanyl, for example, is 50 times more potent than heroin, a potency that has made it one of the most prominent and feared synthetic opioids..
WHY IS IT SO SERIOUS IN THE US?
lethal medicine (Painkiller) is the promising new Netflix series that will address the opioid crisis in the United States, an alarming and very current topic, given the fentanyl problem. This new fiction is the result of a collaboration between the streaming platform and Eric Newman, known for his fundamental role in Narcos: Mexicoadding a touch of authenticity and expertise in drug-related storytelling.
The reasons for this spike in drug use in the United States are diverse, but one of the main ones, in the opinion of experts, is the focus on drug control: The private health system in the United States grants great autonomy to private centers regarding the prescription of these substances. This can lead to a lack of coordination and regulation across the system, which in turn can result in easier access to these drugs and increased potential for abuse and addiction.
Drugs and alcohol in European prehistory
Contrasting with the situation in the United States, the approach of the Spanish public health system actively controls the supply of these substances and coordinates the different administrations in the fight against the addiction problem. Thus, in Spain, the measures include strict regulation, the need for special prescriptions for certain drugs and close monitoring of the patients who receive them.
THE SITUATION IN SPAIN
Although the fentanyl epidemic may seem primarily a US problem, Spain ranks fourth in the OECD in terms of fentanyl use, behind the US, Germany and the UK. According to the Edades 2022 Report, opioid use in Spain increased by 0.6% last year, and fentanyl, which was previously a marginal opioid, it is now the third most widely used opioid (14%) after codeine and tramadol.
Fentanyl is used in Spain as an analgesic to treat chronic and severe pain, and is marketed in the form of transdermal patches. Although it is useful for the treatment of pain, it has drawbacks such as dependence and the tolerance it generates.
Although the increase in fentanyl use in Spain is not particularly worrying, its increasing prevalence and potential for addiction and tolerance raise questions about the need for increased surveillance and control. The controlled dispensing methodology and continuing education on its proper use may be key in preventing a possible fentanyl “epidemic” in the country.
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