Title : Fentanyl, mental health and society
Abstract:
The text reviews a health issue through its epidemiological scope; Points out: chemical structure, synthesis, and mechanisms of action; It discusses its potency and speed of action, forms of administration and interaction with other drugs; Instructs on medical use; It recommends the application of a specialized clinical history, and consequently indicates the clinical measures to follow. The characteristics of this psychotropic make it ideal for consumption via self-medication, omitting the high risk of intoxication and fatal overdose that frequently occurs alone or when combined with other drugs. Fentanyl, a powerful synthetic agonist opioid used as an analgesic and pre-anesthetic in surgical settings, under indication and control for decades, has enormous potency over morphine and heroin (50 and 100 times more potent, respectively), which facilitates its wide distribution among drug users. street drugs, favoring the illegal trade that disdains its secondary effects: The mild ones occur at controlled doses by prescription in the medical field, when symptomatic treatment is required. The serious ones result from the indiscriminate use to achieve altered mental states, as in the consumption of psychotropic drugs (CDPT), mixed due to abuse/dependence with other synthetic opioids and illegal drugs (cocaine, methamphetamines). In such patients, the clinical complexity -which should always consider the co-occurrence of mental and physical disorders- (dual pathology) makes diagnosis, management, prolonged maintenance of psychological and psychiatric clinical supervision and general health surveillance aimed at rehabilitation and social reintegration. Highly dangerous, fentanyl is usually aggravated by the CDPT of psychostimulants, anxiolytics, alcohol, tobacco, etc. that must be detected in all cases to provide the approach indicated by the condition, suggested by a specific and complete clinical history (Souza y M. et al. Coded Clinical History for Addictions. In: Souza y Machorro M. Alcohol and personality. Pathology Dual. Editorial Alfil. Mexico, 2018) or some equivalent. The self-medication of the CDPT added to the high-risk behaviors for health, CARS, that accompany it, becomes undesirable, due to the dangers and simultaneous damages to the individual, family, and society. The management of clinical pictures is carried out under international recommendations, shown in guidelines technics psychopharmacological and psychotherapeutic that require adequate instruction of health personnel in emergency rooms and hospital units to contain and, where appropriate, prevent morbidity and mortality of consumers (some of which, when acquiring it, are unaware of the frequent mixture of this opioid with other drugs). In addition, as far as possible, it aims to control the damage caused by the global black market for this substance. The current concern of the WHO and the Departments and Secretaries of Health of the different countries act in both directions: a) Reduce the CDPT and its consequences, as well as b) Prevent society from being affected by it, in any of its modalities, facilitated by unscrupulous traffickers who, by pursuing the acquisition of large sums of money, cause serious damage to the community. Therefore, such an emerging and imperative condition requires the participation of all members of society.
Audience take Away notes:
- The text reviews a health issue through its epidemiological scope; Points out: chemical structure, synthesis, and mechanisms of action; It discusses its potency and speed of action, forms of administration and interaction with other drugs; Instructs on medical use; It recommends the application of a specialized clinical history and consequently indicates the clinical measures to follow
- Recognize and use the proper recommendations mentioned
- It is a revision of the current situation
- It is a broad explanation of action mechanisms.
