An article published by the Oswaldo Cruz Foundation (Fiocruz) warns against the use of fentanyl in the country. Used as an analgesic and anesthetic for medical purposes, fentanyl began to be consumed improperly and indiscriminately in many countries, such as the United States, causing chemical dependence and addiction, as it is 100 times more potent than morphine and 50 times more than morphine. heroin.
In Brazil, the first seizure of illicit fentanyl took place in March, in Espírito Santo, and raised the alarm about the importance of adopting strategies to control and prevent the circulation and use of the drug in the country. In addition, a series of cases of opioid intoxication were reported in the metropolitan region of Campinas (SP), in the first months of this year.
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in the article published in the online version from the magazine The Lancet Regional Health – AmericasFrancisco Inácio Bastos, senior researcher at the Institute of Communication and Health Information at Fiocruz (Icict/Fiocruz) and Noa Krawczyk, assistant professor at the Center for Epidemiology and Opioid Policy at NYU Grossman School of Medicine, highlight measures that Brazil should adopt to avoid a serious crisis, such as the one currently faced in the United States, where more than 70,000 people die each year from the non-medical use of the drug.
They guarantee that the time is not for panic in Brazil. “Until now, the emerging threat of a potential public health crisis driven by the spread of fentanyl has basically been addressed by a proactive media, few research groups and ANVISA’s immediate responses. A commitment from civil society, the scientific community and the government at all levels is extremely necessary. Looking at the lessons learned in other countries is fundamental, but all the great problems that affect societies have global and local dimensions. , in the article.
What can be done
The researchers clarify that the fentanyl crisis in the United States brings important lessons to Brazil and also show differences in relation to consumption in the two countries.
According to Bastos and Krawczyk, the epidemic among North Americans has two factors: excessive prescription of opioids and diversion of the medical purpose and the growth of the use of heroin, and after fentanyl, due to the high rates of dependence and demand of population.
Another observation is that in the United States, fentanyl is offered mixed with other drugs, such as cocaine, which is not reflected in Brazil, including the opioid being considered an expensive substance compared to others. “Most likely it would be a mixture of a few seizures of pure fentanyl. I do not believe that what is happening in the United States will happen, other substances with different properties (mixed) with fentanyl”, said Bastos in an interview with Agência Brasil.
Last week, the subject was discussed during a seminar by the National Secretariat for Drug Policies (Senad), of the Ministry of Justice, in partnership with the United Nations (UN), in which representatives of the National Health Surveillance Agency also participated ( Anvisa). The ministry stressed that the seizures carried out in the country were episodic, and do not represent an epidemic.
In the article, the researchers suggest the following fronts for action: investment in continuous surveillance and research to understand changing patterns of substance use and abuse in the Brazilian population; integration of apprehensions with careful toxicological analysis; improve surveillance of medical fentanyl and other opioids, avoiding potential diversion and misuse, especially in hospital units; adoption of treatment protocols and awareness of health professionals who work at the front door (emergencies) in the public and private sectors.
“At the time I was practicing, I hospitalized several colleagues, some of them only used it and others ended up getting involved in diverting ampoules, because they were the people who had access”, revealed the researcher from Fiocruz.
The researcher also mentions the need to control the supply of the substance on the internet and social networks. “People are making fentanyl in the kitchen. Although it doesn’t have the purity of industrial fentanyl, traffic doesn’t care if it’s pure or dirty”.
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