Expert warns about the increase in the use of opium-based anxieties in Brazil and the world
Feeling pain and, above all, ‘living’ with pain has always been a problem for part of the world’s population. In this context, pain management represents a major challenge for health professionals around the globe. Danilo Avelar, biomedical doctor and master of Science (Physiology and Pharmacology) and professor of Nursing at the University Center of Brasília (CEUB), comments on the worrying issue of opioid dependence, a public health problem on the rise in Brazil.
Danilo Avelar explains that there are different classes of drugs that relieve pain, such as anti-inflammatories and analgesics, including dipyrone and aspirin, in addition to anesthetics with their various subtypes. Morphine, on the other hand, has molecular characteristics similar to or derived from opium, a substance known for its notable effect on the nervous system, almost completely inhibiting pain – which came to prominence in the historic ‘Opium War’.
According to the CEUB specialist, opioids are a class of drugs that are effective in the treatment of pain, but their inappropriate use can lead to dependence. An example is fentanyl, a substance much more potent than morphine itself and which has become a worrying public health problem, both in the United States and in Brazil.
According to data from the US National Institute on Drug Abuse, overdose deaths related to opioid use increased from 21 million in 2010 to 80.4 million in 2021, a nearly four-fold increase in just over a decade. In 2021 alone, more than 100,000 deaths were reported in the US related to overdose of fentanyl and similar substances, representing an increase of almost 280% compared to 2016.
“In the United States, more than two decades ago, there was an unacceptable promotion of the consumption of opioid drugs as a more viable and easier option for the treatment of pain. Some pharmaceutical companies claimed that substances such as oxycodone were safe and did not cause addiction. approach addressed in an alarming increase in the number of prescriptions for these drugs”, details Avelar.
In the case of Brazil, the popularity of opioids continues to grow. Between 2012 and 2018, the prescribed sale of pathologies based on opiates or synthetic opioids increased significantly, according to data from the National Health Surveillance Agency (Anvisa), with a growth of 465%. According to research carried out by Fiocruz in 2019, 2.9% of the population has already made illegal use of substances, without a medical prescription, a significantly higher number than that of people who use crack or cocaine.
Investigations carried out recently by the Federal Police in Brazilian states resulted in the seizure of irregular batches of fentanyl. The CEUB biomedical doctor considers that these events serve as an alert to the possible trend towards an increase in the demand for synthetic opioids, both legally and illegally, in the national territory. “It is crucial to intensify the surveillance and control of these substances, as well as to implement public policies that guarantee adequate access to these drugs for those who have actually passed”, he warns.
According to Danilo Avelar, in addition to increased supervision of prescriptions and releases of batches that leave industries, associated with public policies for access to these medications for those who really need them, it is necessary to increase surveillance actions and control over substances (pharmaceuticals/ toxic) that can be produced in clandestine laboratories and sold illegally. “Measures like these are imperative right now, to avoid a ‘pandemic of dependence and misuse of opioids’ in Brazil”, points out the professor.