From fentanyl to xylazine, the opioid threat in the U.S. turns into a diplomatic crisis… and begins to show up in Spain
Fentanyl, one of the pharmacological treatments for treating pain, is a substance 80 to 100 times more potent than morphine.. It was originally intended to combat pain in people diagnosed with some type of cancer. However, in the United States it ended up being prescribed for almost any type of pain. As a result, fentanyl has killed more than 60,000 people in that country between April 2020 and April 2021.
And it continues to do so. This is because this pain reliever is not just any drug, but a synthetic opioid, i.e., a drug. And as such it is addictive. Initially it is addiction to the legal drug prescribed by the doctor. You start taking it to relieve a backache or a recurrent migraine, but without knowing the real risks. But in the end, it gets you hooked.
No fentanyl, xylazine, an animal sedative.
In the last 25 years, more than 500,000 Americans have died from opioid overdoses.including fentanyl (50 times more potent than heroin). Doctors all over the country have been prescribing legal drugs for decades that have ended up turning the patient into an addict, as is the case with the doctor played by Michael Keaton in the series Dopesick.
When the opioid is no longer available by prescription, it is bought on the black market; and when even then it cannot be acquired, the addict jumps directly to street drugs. This market has done as it does with everything it sells, mixing and adulterating it in order to get more profit out of every gram. For this reason, the U.S. government has already described it as a “emerging threat” fentanyl adulterated or mixed with xylazine.a potent animal sedative used as a drug.
They are seeing xylazine playing an increasing role in overdose deaths in all regions of the country. This drug Is (was) a tranquilizer intended for animals: it was used as a muscle relaxant and anesthetic for horses and dogs. In the absence of fentanyl, xylazine flooded the market for opioid addicts. Today it is the “tranq” epidemic.
Fentanyl with xylazine, emerging threat.
The mixture of fentanyl with xylazine has entered the emerging threat category because it is being sold “illicitly” and is linked “with significant and rapidly worsening negative health consequences,” including “fatal overdoses and serious morbidity,” asserts the White House Office of National Drug Control Policy (ONDCP).
According to data from the U.S. Drug Enforcement Administration (DEA), the xylazine overdose deaths increased by 1,127% in the southern part of the country. between 2020 and 2021, 750% in the West, more than 500% in the Midwest, and more than 100% in the Northeast.
Already last March, the U.S. authorities decided on a partial ban on the importation of this drug. Xylazine thus became subject to increased scrutiny by the Food and Drug Administration (FDA). This agency can now stop a shipment of the product if it is not properly credited. its legitimate veterinary use.
U.S. reproaches Mexico
A day before labeling xylazine an “emerging threat,” the White House decided to to reinforce its strategy against fentanyl consumption and trafficking from Mexico.. According to Washington, fentanyl seizures at the border increased by 31% in 2022. In addition, almost 4,000 people were brought to justice for trafficking in this substance.
Biden reinforces the fight at the border after weeks of criticism and crossed statements with the neighboring country on the fight against this synthetic drug. Voices from the Democratic Administration opine Mexico should do more in the fight against fentanyl and organized crime and the Republican opposition has called for military intervention.
If it is not produced in China, where is it produced?” questioned López Obrador this week.
On the other side of the border, Mexico’s foreign minister, Marcelo Ebrard, assures. that his country is the “main ally” of the U.S. in the fight against fentanyl. He said this hours before meeting with Biden administration officials.
Mexican President Andres Manuel Lopez Obrador has also denied that fentanyl is manufactured in his country. He says that this substance comes to North America from Asia. “If it is not produced in China, where is it produced?”, Lopez Obrador has questioned this week before the media.
And from Mexico to China
China was the leading manufacturer of fentanyl. Faced with the dimensions of the opioid crisis, Washington pressured Beijing to curb its production.. Thus, in 2019 the Chinese authorities finally did so. The result was that on the streets of the USA addicts had to scramble to discover a substitute. Thus they came upon xylazine which, however, might be arriving precisely. from Chinese laboratories.
Source of opioid overdoses” in U.S. is at home, Beijing says
Which the Chinese government denies. “The origin of the cause of overdoses” in the U.S. is in the country itself, says Beijing. A week ago, the Asian giant assured that there is no problem of illegal fentanyl trafficking. into Mexico.
It was a Chinese response after the letter that López Obrador sent to his Chinese counterpart.Xi Jinping, asking for help against fentanyl trafficking in the face of growing US criticism of Mexico.
And since anything goes for Donald Trump, the former president and a good part of the Republican representatives in the Senate and House of Representatives have gone so far as to propose militarily attacking Mexico’s drug cartels.which are the ones that handle the trafficking of fentanyl and xylazine. Some have suggested bombing the laboratories and warehouses that the DEA has located in Mexican territory.
Consumption increases in Spain
Fentanyl does not yet seem to be a problem in Spain, but its consumption has clearly increased in recent years. Its sporadic intake -sometimes in a lifetime- has risen from 1.9% in 2018 to 14% in 2022. Thus, fentanyl is already the third most commonly used opioid. in our country, behind codeine and tramadol, and ahead of morphine.
Fentanyl is already the third most widely used opioid in our country, behind codeine and tramadol, and ahead of morphine
These are data from the Survey on Alcohol and other Drugs in Spain, Ages 2022, a survey prepared every two years by the National Plan on Drugs of the Ministry of Health. According to this document, the prevalence of opioid analgesic consumption. among the Spanish population aged 15 to 64 years has increased from 15.2% to 15.8% among those who have taken them at some time in their lives, with or without prescription, and from 3.6% to 4% among those who have used them in the last 30 days.
In view of these numbers, the National Plan on Drugs claims to be. “very alert” about this worrying increase. In addition, the Interterritorial Council of the National Health System launched a plan in 2021 to improve the use of this type of drug.
Spanish healthcare warns of fentanyl.
The Spanish Agency of Medicines and Health Products (AEMPS) identified in December a new side effect for fentanyl. It was in their monthly human drug safety bulletin for the month of December 2022 (published, however, in February of this year).
In discussing tolerance and dependence to fentanyl transdermal patches, the agency cites “risks associated with accidental ingestion, misuse, and abuse , including death“.
Repeated use of fentanyl can lead to opioid use disorder.”
“Repeated use of fentanyl can lead to opioid use disorder. The Risk is greater with higher doses and longer duration. of treatment,” the report reads. It therefore recommends that during treatment there should be “frequent contacts between the physician and the patient to assess the need for continued treatment.”
Before starting treatment and during treatment, the goals and discontinuation plan should be agreed with the patient. Prior to and during treatment, the patient should also be informed of. “the risks and signs of opioid use disorder.” and the importance of seeking medical assistance in case of occurrence. Finally, it is noted that “tolerance may develop with repeated use”.