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The dangerous pendulum of opioid drugs

The rapid increase in the prescription of analgesics derived from morphine alerts on the risk of overmedication

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The dangerous pendulum of opioid drugs

To die with dignity and without suffering is today something like a lottery: it depends on where you live and what you die For. " An extensive work published in this newspaper in 2005 explained that in Spain was not guaranteed a death without pain. The resistance of physicians to prescribe opioid analgesics for fear of addiction condemned terminally ill to endure unnecessary pain. Spain was one of countries that least used this resource of proven efficacy against pain. Eighteen years later, pendulum has placed us on opposite side. If y were n prescribed less than necessary, y are now prescribed too many. The danger is not now that many patients who need m do not have access to se potent analgesics derived from morphine, which include tramadol and fentanyl, but ir banalization to extent that a new health problem may be created Public overmedication.

In ten years, prescription has increased by more than 60%. Fentanyl is now prescribed in Spain twice as much as EU average. And more than in America. Initially, its use was limited to treatment of cancer terminal patients, large burnings or post-surgical treatments. Since European Medicines Agency extended indications to chronic pain by arthrosis or processes such as fibromyalgia, prescription has been shot. Although majority is concentrated in older people, it is increasingly used in young patients with pain that is often accompanied by anxiety and depression. In se cases, risk of addiction is greater because over time it generates a tolerance to drug that requires to increase doses to achieve same effect.

The problem is that se drugs, like heroin, affect certain neurotransmitters of central nervous system related to reward mechanism, so that, in addition to cushioning pain, generate a sense of well-being and euphoria that just Being addictive. They know it well in America. The misuse of se drugs has caused a large number of addicts and an increase in deaths from overdoses. To fentanyl, which may be up to 50 times more potent than heroin, was attributed in 2016 to Prince's death. In that country, when patients have trouble accessing medication because y have been left without health insurance or or causes, y resort to black mark of heroin. In 2016, anti-drug agency counted 12,898 overdose deaths, 328% more than five years earlier. The problem has claimed such a dimension that national emergency has been decreed.

The pendulum movement that has occurred in Spain is not alien to intense campaign of promotion that have carried out three major pharmaceutical companies that commercialize opioid drugs offering training to doctors and financing associations of Patients. But in health you have to go very carefully. Not always more is better. Many times it's worse.

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