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The History of the Opioid Crisis

In the United States, there is an opioid crisis that has the health system and the government in check. However, it is worth asking how this crisis originated. Here we tell you.

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LatinAmerican Post | Brandon Martínez Salazar

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Leer en español: La historia de la crisis de los opioides

The opioid crisis that the United States is experiencing has left countless deaths in recent years that have put the country's health system on alert. Although this situation has been occurring for decades, in the last five years the number of overdoses from controlled drugs has drawn the attention of the authorities.

According to the American Academy of Pediatrics, there were 68,630 overdose deaths in the United States in 2020 alone, with fentanyl being one of the leading substances for users. This year, the total deaths represented 75% since the origin of the problem.

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How did the opioid crisis originate?

To address this topic, one must first understand what opioids are. It is a diverse group of substances that includes pain-relieving drugs and narcotic drugs. "Opioids are a class of drugs that include heroin, synthetic opioids (such as fentanyl), and certain pain relievers that are legally available with a prescription," according to the National Institute on Drug Abuse. Its natural origin is opium, which is found in minute amounts in the poppy plant.

Now, the opioid crisis has its roots in the last century, but 1996 was a significant year for this social concern, where the pharmaceutical industry plays an important role. Large corporations launched aggressive marketing campaigns to promote the use of opioids as first-line pain relievers for chronic pain.

Likewise, the Food and Drug Administration (FDA) approved that same year the drug Oxycontin, a long-acting pain reliever manufactured by Purdue Pharma. This led to an incredible increase in prescribing and its use in patients, who over time became addicted and had disastrous effects on their health. Years later, this company was convicted for its irresponsibility in marketing a dangerous product and had to pay a fine of 634.5 million dollars.

However, the use of opioids did not stop there, but has evolved into other types of substances in the same category, which have caused more than 500,000 deaths since 1999. In 2017, Donald Trump, during his presidency of the United States, declared the opioid crisis a national public health emergency and vowed to address the issue to eradicate its use, including illegal substances.

Major Opioids Used in the United States

According to the Healthy Children web portal, the most widely used opioids for non-medical purposes are:

oxycodone
Fentanyl
Hydrocodone or dihydrocodeinone
Codeine
Morphine

At the same time, it warns that "these substances produce short-term positive feelings because they mimic the body's natural endorphins, or feel-good hormones." opioids, which implies higher doses in the medium and long term to continue having the same effects. This can lead to an overdose where breathing levels are reduced to extreme levels and, finally, leads to death.

How are you currently tackling the problem?

For President Joe Biden, the opioid situation is worrisome, which is why he has announced a strengthened approach to addressing the difficulty among American youth. In addition, he has been emphatic that the collaboration of the Mexican government is required to counteract the responsibility that the cartels of that country have in fentanyl trafficking.

On the other hand, two weeks ago, the FDA approved a drug called "Narcan", which is used as a nasal spray and would be the first drug to reverse the effects of opioid overdoses. It is available free of charge and seeks to mitigate the number of people who die from addiction to these substances, which is an average of 115 every day.

Panorama in Latin America

In Latin America, opioid misuse or addiction is not common. However, countries like Colombia and Mexico are producing and trafficking fentanyl. According to the 2021 World Drug Report of the United Nations Office on Drugs and Crime, in recent years an increase in the manufacture and distribution of fentanyl has been detected in Latin America and the Caribbean, which has been evidenced through seizures of this substance in Mexico and Colombia.

Similarly, in an article published by the Brazilian Journal of Anesthesiology, it is explained how the use of fentanyl has increased in Brazil due to its lower cost and greater availability compared to opioids such as morphine, which has resulted in an increased consumption and a higher probability of overdose. For the moment, the situation in Latin America is not worrisome, but it is important to observe the long-term behavior of these substances in the region and activate prevention plans.

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