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Fentanyl: the epidemic of broken dreams

Quality of life of health professionals: a pending issue

Our natural nocturnal narcosis, in which we immerse ourselves in dreams that seem real, some even with premonitory overtones and ranging from pleasant unrealities to terrifying awakenings, are led by Morpheus, the god of sleep according to Greek mythology.
This son of Hypnos had the mission of creating dreams and through them delivering messages from the gods. According to the legend of him, his ability to travel the world again and again with his powerful wings, never stopping to fabricate fantasies for human beings, was incredible. Even if someone had a problem letting themselves be rocked in his arms, this deity was extremely seductive and made it almost impossible to resist his call to the dream world. It is narrated how he led human beings to his abode, which was a cave surrounded by poppies with which he touched the foreheads of the guests to plunge them into a deep sleep, having at one end the entrance to pleasant dreams and at the other the exit to dark nightmares.
Well, this last part seems to be the most pressing in recent years, in which a synthetic opioid, fentanyl, 100 times more powerful than morphine (understand the origin of the name of this drug with the previous story) is wreaking havoc in many regions of the world, being one of the main contributors to deaths related to overdose at the international level.
Although its development was intended to treat severe pain, especially in patients undergoing major invasive procedures or to treat cancer pain, its illicit use stemmed from high-potency heroin-like effects , with a characteristic of greater propensity to addiction and therefore greater danger in its use.
It must also be understood that the fentanyl that is consumed associated with this new outpost of cases of overdose and mortality is the one manufactured illegally in apocryphal laboratories. Trafficked in a multitude of presentations and mixed with other narcotics (cocaine, methamphetamine, MDMA, for example) have made it a cheaper and more powerful “option” than what is usually consumed. However, this is especially dangerous, since consumers do not know that this aggregate is present or in what proportion it is found and therefore the greater propensity for an overdose.
Already considered a public health tragedy in the United States, due to the high mortality that it has caused (especially in the young population), it should be noted that the dissemination and use of this narcotic is knocking on our doors and every day there is a greater use in the Mexican population.
Now, why is it important to be aware of the situation of consumption of this drug, talking about its potential impact on public health? It is essential to understand that we are facing a substantial problem and derived from it, public policies must be designed and implemented for the prevention of consumption and treatment of addictions, taking into account education for users and health personnel, which allows them to be attentive and vigilant to overdose and use of reversal drugs such as naloxone, and in the same way to mitigate the effects associated with the health status of users and also take into account the social, economic, family and labor impact that prevails in those dependent on these drugs, due to their specific action at the level of the nervous system.
It is not a minor issue and it is important to learn from the current experience of our neighbor to the north, since it is a reality that consumption is growing in our country. Planning and prevention actions will always be more effective than acting reactively. Let’s avoid being victims of broken dreams and nightmares. Let’s act now.

***Clinical Pathologist. Specialist in Laboratory Medicine and Transfusion Medicine, specialty professor and promoter of altruistic blood donation

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