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Historical analysis and social and health impact of fentanyl use in Colombia
Análisis histórico e impacto social y sanitario del consumo del fentanilo en Colombia
Análise histórica e impacto social e na saúde do uso de fentanil na Colômbia
DOI:
https://doi.org/10.15446/rcciquifa.v55n1.125082Palabras clave:
Fentanyl, illicit trafficking, non-medical use, overdose, pharmaceutical diversion, public health, social vulnerability (en)Fentanilo, tráfico ilícito, uso no médico, sobredosis, desviación de productos farmacéuticos, salud pública, vulnerabilidad social (es)
Fentanil, tráfico ilícito, uso não médico, overdose, desvio de medicamentos, saúde pública, vulnerabilidade social (pt)
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Introduction: Fentanyl, a synthetic opioid up to 100 times more potent than morphine, has ignited a global public health crisis. In Colombia, its increasing diversion from the medical system to illicit markets represents an emerging threat that demands in-depth analysis. Purpose: The objective of this research was to conduct a comprehensive analysis of the fentanyl phenomenon in the country, covering its history, current socio-health impact, and the systemic failures that facilitate its spread. Methodology: A qualitative methodology was employed, combining narrative documentary analysis with interviews of key informants directly involved in the legal control and institutional response to the opioid. Results: The results reveal that Colombia is in an early phase, defined by pharmaceutical diversion rather than clandestine production. A complex trafficking network exists, involving both legal and illegal actors, with hospitals and clinics being the primary point of leakage according to 67% of those interviewed. This diversion causes a severe health impact, including deaths by overdose (a link made by 78% of experts), and disproportionately affects at-risk youth (44%) and marginalized communities (33%). Conclusions: The study concludes that this problem is a symptom of deep-seated institutional flaws and social vulnerabilities. It highlights a critical window of opportunity to act, making a comprehensive response that combines public health strategies with the rigorous strengthening of controls imperative to contain the threat and prevent an escalation of the crisis.
Introducción: El fentanilo, un opioide sintético hasta 100 veces más potente que la morfina, ha provocado una crisis de salud pública global. En Colombia, su desvío desde el sistema médico hacia mercados ilícitos constituye una amenaza emergente que requiere un análisis profundo. Objetivo: Esta investigación tuvo como objetivo analizar integralmente el fenómeno en el país, abarcando su historia, impacto sociosanitario y las fallas sistémicas que facilitan su propagación. Metodología: Se utilizó una metodología cualitativa que combinó análisis documental narrativo y entrevistas a informantes clave directamente involucrados en el control legal y la respuesta institucional al opioide. Resultados: Los resultados revelan que Colombia está en una fase inicial, definida por el desvío farmacéutico en lugar de la producción clandestina. Existe una compleja red de comercialización con actores tanto legales como ilegales, siendo los hospitales y clínicas el principal punto de fuga según el 67% de los entrevistados. Este desvío provoca un grave impacto sanitario, incluyendo muertes por sobredosis (vinculado por el 78% de los expertos), y afecta desproporcionadamente a jóvenes en riesgo (44%) y comunidades marginadas (33%). Conclusiones: Se concluye que esta problemática es un síntoma de profundas fallas institucionales y vulnerabilidades sociales. El estudio destaca una ventana de oportunidad crítica para actuar, siendo imperativa una respuesta integral que combine estrategias de salud pública y un fortalecimiento riguroso de los controles para contener la amenaza y evitar una escalada de la crisis.
Introdução: O fentanil, um opioide sintético até 100 vezes mais potente que a morfina, desencadeou uma crise global de saúde pública. Na Colômbia, seu crescente desvio do sistema médico para mercados ilícitos representa uma ameaça emergente que exige uma análise aprofundada. Objetivo: O objetivo desta pesquisa foi realizar uma análise abrangente do fenômeno do fentanil no país, abordando sua história, o impacto socio-sanitário atual e as falhas sistêmicas que facilitam sua disseminação. Metodologia: Foi empregada uma metodologia qualitativa, combinando análise documental narrativa com entrevistas com informantes-chave diretamente envolvidos no controle legal e na resposta institucional ao opioide. Resultados: Os resultados revelam que a Colômbia está em uma fase inicial, definida pelo desvio de medicamentos em vez da produção clandestina. Existe uma complexa rede de tráfico, envolvendo atores legais e ilegais, sendo hospitais e clínicas os principais pontos de desvio, segundo 67% dos entrevistados. Esse desvio causa um grave impacto na saúde, incluindo mortes por overdose (relação apontada por 78% dos especialistas), e afeta desproporcionalmente jovens em situação de risco (44%) e comunidades marginalizadas (33%). Conclusões: O estudo conclui que esse problema é sintoma de falhas institucionais profundas e vulnerabilidades sociais. Ele destaca uma janela de oportunidade crítica para agir, tornando imperativa uma resposta abrangente que combine estratégias de saúde pública com o fortalecimento rigoroso dos controles para conter a ameaça e evitar a escalada da crise.
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