I loko o ka European Union i loko o kahi mākeke lāʻau lapaʻau i ka holo piha i kōkua ʻia e ka hoʻohana ʻana i ka media media a i ʻole ke kūʻai aku ʻana i ka pūnaewele a me nā noi, ʻike ʻia kahi kūlana lāʻau hou, me ka hoʻonui ʻana i ka lawe ʻana mai, ka hana ʻana a me ka ʻai ʻana i nā lāʻau synthetic uncontrolled i kapa ʻia nā mea psychoactive hou (NPS). He mea psychoactive "pili i nā kaʻina noʻonoʻo, e laʻa me ka ʻike, ka ʻike, ka ʻike a i ʻole ke ʻano a me nā manaʻo".
Wahi a ka Early Warning Advisory on New Psychoactive Substances (EWA-2022), ua wehewehe ʻia ka NPS "ʻO nā mea hoʻomāinoino, ma ke ʻano maʻemaʻe a i ʻole ka hoʻomākaukau ʻana, ʻaʻole i mālama ʻia e ka 1961 Single Convention on Narcotic Drugs a i ʻole ka 1971 Convention on Psychotropic Substances, akā hiki ke hoʻoweliweli i ke olakino lehulehu".
ʻO ka NPS kahi ʻano o nā lāʻau lapaʻau i hoʻolālā ʻia e hoʻohālike i nā lāʻau lapaʻau i hoʻopaʻa ʻia a hoʻokaʻawale ʻia lākou e like me ko lākou hopena.
I ka hopena o 2022, ua nānā ka European Monitoring Center for Drug and Drug Addiction (EMCDDA) ma kahi o 930 NPS, 41 i hōʻike mua ʻia ma ʻEulopa i 2022.
Ma ʻEulopa, ua hoʻomaka ka hoʻohana ʻana i nā opioids (morphine, codeine, heroin, fentanyl, methadone, tramadol a me nā mea like ʻē aʻe) mai ka hoʻomaka ʻana o ka 21.st kenekulia. I nā makahiki i hala iho nei, ua piʻi nui ka helu o nā opioids synthetic psychotropic hou me 74 i hōʻike ʻia i ka EU Early Warning System (EWS).
'Ōlelo Aʻo: ʻO nā opiates nā lāʻau lapaʻau maoli mai ka mea kanu opium; ʻO ka Opioid kahi huaʻōlelo maʻamau me nā opiates, semi-synthetic (e like me ka oxycodone) a me ka synthetic (e like me fentanyl) opioids.
Hoʻokumu maikaʻi ʻia nā opioid synthetic hou i kekahi mau mākeke lāʻau lapaʻau ʻEulopa kahi i kūʻai pinepine ʻia ai lākou ma ke ʻano he mau mea pani no nā opioids e like me heroin. He kiʻekiʻe loa nā hopena addictive o ka opioid ma nā haʻahaʻa haʻahaʻa.
Wahi a ka European Drug Report 2023, ma nā ʻāina he nui o ʻEulopa, ke ulu nei ka hoʻohana ʻana i nā opioids synthetic e like me ka mea i hōʻike ʻia e ka nui o nā hopu i hōʻike ʻia e EMCDDA. I kēia manawa, ua makaʻala ke Komisina ʻEulopa no ka Home Affairs, Ms. Ylva Johansson, a me ka Luna Hoʻokele EMCDDA, ʻo Mr. Alexis Goosdeel, i ka hoʻonui ʻana i ka hoʻohana ʻana i kekahi o nā opioids ʻino loa: Fentanyl. Ua'ōleloʻo ia: "Pono mākou e hōʻoia i ka manawa o ʻAmelika ʻaʻole i lilo i hope o ʻEulopa". ʻOiaʻiʻo, i ka makahiki i hala ma USA, ua make ka poʻe 109,000 mai nā lāʻau synthetic ka hapa nui o lākou mai fentanyl.
He haʻahaʻa ka nui o ka hilinaʻi opioid ma waena o nā poʻe ʻEulopa, ʻokoʻa loa ma waena o nā ʻāina a pili pū me nā maʻi maʻi maʻi, nā pilikia olakino, ka hoʻokaʻawale ʻana i ka nohona, ka nele i ka hana, ka home ʻole, ka hewa, a me ka make. I ka poʻe ma luna o 40 mau makahiki e hoʻohana ana i ka opioids, ʻo nā hopena kumulative o ka pōʻino pili i ka lāʻau e komo pū ana me ka hoʻohana ʻana i ka polydrug a me ke olakino maikaʻi ʻole i nā makahiki he nui e maʻalahi kēia poʻe i ka maʻi, overdose a me ke pepehi kanaka.
ʻO ka fentanyl (C22H28N2O) i hana mua ʻia mai kahi benzyl-piperidone i 1959 (patented ma 1964) e ka mea hoʻokalakupua ʻo Paul Janssen ma Belgium. ʻEkolu mau ala ʻē aʻe i kūkulu ʻia:
-Suh ¶ AL. 1998: he ʻano hana ma ka hui pū ʻana.
-Siegfried i ka hoʻomaka ʻana o 2000 a hoʻohana ʻia i nā keʻena hana hewa;
-Gupta PK ¶ AL. 2005: hoʻokahi-pot synthesis i hoʻohana hewa ʻole ʻia ma 2021 akā me ka maʻemaʻe haʻahaʻa;
ʻO ka fentanyl ma muli o kāna lipid solubility kiʻekiʻe e komo maʻalahi i ka ʻōnaehana nerve waena me nā hopena analgesic sedative a wikiwiki a me kahi manawa pōkole o ka hana. ʻO ka wikiwiki o kona komo ʻana e ka mucosa waha (15/30 min-4 hrs) akā hiki ke lawelawe ʻia e ka injection (2min-30 min), transdermal (patch) a i hoʻohana ʻia i loko o kahi kūlana kinoea e like me ka spray (10min-60min).
ʻO ka hopena analgesic fentanyl ma kahi o 100 mau manawa ʻoi aku ka ikaika ma mua o ka morphine a me 50 mau manawa ma mua o ka heroin. Ma lalo o kāna ʻano lāʻau lapaʻau kānāwai, hoʻohana ʻia kēia opioid synthetic i ka mālama ʻana i ka ʻeha mau loa a me ke kūpaʻa. Mai ka makahiki 2021 ua lilo ia i ʻāpana o nā "lāʻau lapaʻau koʻikoʻi" o ka World Health Organization a hoʻopaʻa ʻia ma ka papa III me ka morphine a me ka oxycodone.
Mai ka nānā ʻana i nā holoholona, hoʻohana ʻia ka hopena kiʻekiʻe o ka fentanyl no ka analgesia, sedation a me ka anesthesia i nā holoholona a me ka mālama ʻana i ke kaumaha a me ka haʻalulu i nā holoholona.
Akā, ua hoʻohuli ʻia ka fentanyl mai kona hoʻohana ʻana i mea ʻeha e lawe ʻia ma ke ʻano he lāʻau lapaʻau, maʻalahi i hana ʻia i loko o nā hale hana huna me ka loaʻa ʻole o ka pilikia o ka mahiʻai a me ka ʻohi ʻana i nā mea kanu! Hana ʻia ma Kina, Mekiko a me India, ka fentanyl i kapa ʻia ʻo China White, Apache, Jackpot, Murder 8,… lilo i mea koʻikoʻi nui ma ke ʻano o ka lāʻau lapaʻau ʻEulopa. Hiki ke loaʻa i hoʻokahi kilo o ka pauda fentanyl he 50,000 mau pona.
I kēia manawa, ma waena o 1,400 fentanyl derivatives, 700 derivatives i ʻike ʻia ma ʻEulopa, ʻoi aku ka ikaika o 1,000 mau manawa ma mua o ka heroin. ʻO ka 3-methyl fentanyl he 3,200 mau manawa e like me ka morphine a me ka derivative., ʻO ka carfentanyl, he 10,000 manawa ʻoi aku ka ikaika ma mua o ka morphine.
He mea ʻawaʻawa loa ka fentanyl me ka hoʻopili maʻalahi me ka ʻili. Hiki i ka 2 milligrams ke pepehi i ke kanaka makua. ʻO ka pōʻino ke hoʻohui ʻia i nā lāʻau ʻē aʻe e nā mea kūʻai aku, hoʻohana nā kānaka me ka ʻike ʻole. ʻOiaʻiʻo, hui pinepine ʻia ka fentanyl, ʻoki ʻia, a ʻai pū ʻia me nā lāʻau lapaʻau ʻē aʻe cocaine a me ka heroin. ʻO Jobski K ¶ AL. (2023) hana i kahi noiʻi hoihoi e pili ana i ka hoʻomāinoino, ka hilinaʻi, ka haʻalele ʻana a me ke ala o ka hoʻokele ʻana ma ʻEulopa. He ikaika loa ʻo Fentanyl a hiki ʻole ke ʻoki ʻia me ka pololei e hoʻonui ai i ka hopena o ka overdose.
Ua helu ʻia ʻo Fentanyl ma ke ʻano he narcotic honua mai 1964, ma muli o kona mau pōʻino olakino, hoʻohana hewa ʻole, a me ka paʻakikī o ka lawelawe ʻana. I loko o ke kanaka, ua manaʻo ʻia ka make make (LD50) o ka fentanyl no ke kanaka makua ma ʻelua milligrams (2mg).
'Ōlelo Aʻo: ʻO ka fentanyl patch (e nau pinepine ʻia e ka poʻe hoʻohana lāʻau) ʻo ia kekahi o nā lāʻau liʻiliʻi e ʻoi aku ka pōʻino, a ma kekahi mau mea e make ai, me hoʻokahi wale nō maʻi, inā hoʻohana hewa ʻia e ke keiki (Food and Drug Administration, 2022). Hiki ke hopena ma waena o 30 mau minuke a me 4 mau hola ma muli o ka huahana i hoʻohana ʻia. Akā inā ʻaʻole i ʻike ʻia nā haʻawina ʻepekema, ʻaʻole i ʻike maopopo ʻia ko lākou lōʻihi o nā hopena.
ʻO ka hoʻohana pinepine ʻana i ka fentanyl a i ʻole nā mea derivatives, ʻo ia hoʻi nā therapeutics, hiki ke alakaʻi i kahi pilikia o ka hilinaʻi a i ka wā o ka hoʻohana nui ʻana, aia ka pilikia o ka overdose me ke kaumaha o ka hanu a me ka maʻi maʻi o nā ʻiʻo thoracic, haʻalulu, hypotension koʻikoʻi, rigidity muscle a i ʻole. koma e hiki ai ke make. Hoʻonui ʻia ka pilikia o ka hopu ʻana i ka hanu i ka wā e hoʻohana ʻia ai ka fentanyl (a i ʻole nā mea derivatives) me ka waiʻona, benzodiazepines a me nā opioids ʻē aʻe. He pōʻino nō hoʻi kā lākou hoʻohana ʻole ʻana i ka wā hāpai no ka wahine a no ka pēpē.
Hiki ke ʻike ʻia ka Fentanyl a me nā derivatives non-medical a hiki i 48 mau hola i loko o ka mimi a hiki i 12 mau hola i ke koko.
Ua hōʻuluʻulu maikaʻi ʻia ka hoʻohana hewa ʻana o ka fentanyl a me nā derivatives e J. Botts (2023): ʻO ka wikiwiki, ka uku a me ka make.
Mechanism o ka hana:
Aia i loko o ke kino kekahi 20 endogenous neurotransmitters opioid i hoʻokaʻawale ʻia e ka helu o nā waikawa amino. Loaʻa iā lākou nā ʻano like ʻole o:
- ʻO nā endorphins (endogenous morpine), polypeptides i hana ʻia e hypophyse a me hypothalamus. Hoʻopili lākou i ka ʻeha no ka manawa pōkole (ʻo ia ka mea e ola ai) a ke kumu hoʻi i kahi manaʻo hoʻomaha (anxiolytics), maikaʻi a i ʻole i kekahi mau hihia, euphoria e like me nā beta-endorphins.
-ʻO nā enkephalins (mai ka Helene enkephalos = poʻo) he mau mea pale i ka hoʻolaha ʻana o ka ʻeha i ka lolo e hana ana i ka analgesia pōkole; hiki iā lākou ke hoʻololi i ka nui o ka dopamine (ke kemika uku) i hana ʻia a hoʻoponopono i ka hana o ka ʻiʻo maʻemaʻe.
-ʻO nā dynorphins (mai ka Helene nā dynamis = mana) i hana ʻia i loko o ka hypothalamus, hippocampus a me ka spinal cord e hoʻoponopono a hoʻoikaika i nā hana koʻikoʻi e like me ka mahana o ke kino, ka hoʻomanaʻo lōʻihi, ka pōloli, ka makewai, ka hiamoe, a me ka hoʻoponopono ʻike ʻike.
Ua hōʻike mua ʻia ka noho ʻana o nā mea hoʻokipa transmembrane kikoʻī opioid i ka lolo i ka makahiki 1973 e Pert CB a me al., Simon EJ ¶ AL. a me Terenius L. Loaʻa kēia mau neurotransmitter receptors i ka lolo, spinal cord and digestive system. ʻO lākou nā mea hoʻokipa G-protein a i ka wā e hoʻāla ʻia ai lākou i ka hoʻololi ʻana i ka pane ʻeha, ke ʻano, ke kaumaha a me ka hilinaʻi kino.
ʻEkolu mau ʻano o nā mea hoʻokipa opioid: mu, delta a me kappa, hoʻolaha nui ʻia i ka lolo. Inā hoʻomaluʻia ka hopena euphoric o nā opiates e nā mu a me nā delta receptors,ʻo ka hoʻouluʻana o nā mea loaʻa kappa, he hana homeostatic wale nō akāʻo ka hoʻohanaʻana i ka lāʻau lapaʻau e alakaʻi ana i kāna dysregulation e hana ana i nā maʻi psychiatric a me nā moku'āina maikaʻiʻole (Tejeda HA & Bonci A. 2019) .
Hoʻopiliʻia nā hopena o ka opioids i ka hoʻouluʻana o ka pūnaewele opioid endogenous i ka lolo ma ke kiʻekiʻe o Nucleus Accumbens (NAc) a me Ventral Tegmental Area (VTA) o ka pūnaewele limbic. No laila, hoʻonui ka opioids a me ka fentanyl i ka hoʻokuʻu ʻana o ka dopamine i loko o ka ʻōnaehana limbic ma o ka hoʻoulu ʻana o nā mea loaʻa mu a me delta i ka NAc (Yoshida Y. ¶ AL. 1999 – Hirose N. ¶ AL. 2005). ʻO nā ʻano hana lāʻau koʻikoʻi ka hopena o nā loli mau loa i ka ʻōnaehana dopamine mesolimbic e kū mai ana mai ka hoʻoulu hou ʻana i ka dopamine e kahe ana i ka Nervous System ke kumu o ka addiction.
Ua hana kēia i ka hoʻohana ʻana i nā opioids i ka wā mua akā ʻo ka pilikia ʻo ka nui aʻe o ka pono e kiʻi i nā piʻi like o ka dopamine no ka leʻaleʻa, hauʻoli a ma hope ua lilo kēia i mea pono kumu e alakaʻi wikiwiki ai i ka overdose make o fentanyl a me nā derivatives.
Hoʻohana ʻia ka lāʻau naloxone e hoʻihoʻi i nā hopena o ka overdose opioid. ʻO kēia lāʻau lapaʻau i ka 2-3 min ma hope o ka hoʻopiʻi ʻana e hana ma ke ʻano he antagonist hoʻokūkū me kahi kiʻekiʻe kiʻekiʻe no ka mu-opioid receptor, e ʻae ana i ka hoʻohuli ʻana i nā hopena o opioids (Jordan MR a me Morrisonponce D., 2023) i ka ʻona nui e ka heroin, fentanyl. , codeine, morphine, oxycodone, hydrocodone, etc.
Ua hōʻike ʻia e pili ana ka fentanyl a me nā mea like ʻē aʻe i nā hana psychomotor i nā hana a ke kanaka i kēlā me kēia lā me ka nānā pono ʻana i ka hoʻokele (Bilel S. et al. 2023). Eia kekahi, ʻo Gasperini S. et al. (2022) ua hōʻike ʻia ua ʻike ʻia nā analogues non-pharmaceutical o ka fentanyl he genotoxic, e hoʻoulu ai i nā aberrations chromosomal structural a me ka helu.
Hōʻike koke ʻia nā hōʻailona hoʻihoʻi fentanyl ma hope o 12 mau hola ma hope o ka hoʻopaʻa hope ʻana me ka makemake nui, nausea, irritability, ʻōpū ʻōpū, luhi, etc. Ua hōʻike ʻia nā noiʻi hou ʻoiai ma hope o ka hala ʻana o nā pae hope o ka haʻalele ʻana, hiki ke hoʻihoʻi hou ʻia ka hana ʻimi lāʻau inā loaʻa i ka lāʻau a i ʻole nā mea hoʻoulu lāʻau.
I ka makahiki 2016, ma lalo o ke kahua o ka Polokalamu WHO/UNODC e pili ana i ka mālama ʻana i ka lāʻau lapaʻau a me ka mālama. "Hoʻopau i ka overdose me ka palekana (SOS)" Ua hoʻomaka ʻia ka Initiative, e hoʻolako i ka hoʻomaʻamaʻa ʻana i ka ʻike ʻana i ka pilikia o ka overdose a me ka hāʻawi ʻana i ka mālama pilikia. ʻO ka mea pōʻino, ʻoiai nā hoʻoponopono a me nā kaʻina hana e mālama ai i nā opioids a me nā derivatives mai nā lima hewa, miliona mau kānaka e hilinaʻi nei i ke kino a makemake i ke kōkua.
I ka hopena, i loko o kahi hui e ʻike pinepine ana i ka emi ʻana o ka naʻauao koʻikoʻi a me ka paʻakikī o ka hana ʻana i nā unuhi kūpono, pehea e kū pono ai i kēia pōʻino o nā lāʻau lapaʻau? Ua kuhikuhi mua ʻo Socrates (470-399 BC) i kēia nīnau no ka naʻaupō. "Akā inā e noʻonoʻo ʻia he kuleana e ʻimi i ka mea a mākou i ʻike ʻole ai e lilo mākou i ʻoi aku ka maikaʻi, ʻoi aku ka ikaika, ʻoi aku ka palaualelo ma mua o ka noʻonoʻo ʻana he mea hiki ʻole a haole i kā mākou hana i ka ʻimi ʻana i ka ʻoiaʻiʻo ʻike ʻole ʻia, e ʻaʻa wau e kākoʻo i kēia kūʻē i kēlā me kēia... ".
E pili ana i nā opioids, fentanyl a me nā lāʻau lapaʻau ʻē aʻe, he nui nā mea i ʻōlelo ʻia ma nā alanui, ma ke kula, ma o ka Pūnaewele, ma nā kiʻiʻoniʻoni, a ma ka TV; ʻoiaʻiʻo kekahi a ʻaʻole kekahi. ʻAʻole kūlike ka ʻoihana kūʻai maʻalahi i ka ʻoiaʻiʻo o nā hopena a me nā hopena i loaʻa i nā lāʻau lapaʻau. ʻO ka hoʻonaʻauao maʻamau o ka heluna kanaka - a hoʻololi ʻia no ka ʻōpio - pono e hana ikaika ʻia me ka ʻike maoli a me ka ʻepekema e hāʻawi i ka ʻoiaʻiʻo e pili ana i kēia honua pohihihi a me ka hoʻohaʻahaʻa o nā lāʻau lapaʻau a i ʻole e pili iā lākou: "ʻO ka hoʻonaʻauao kahi ʻike holomua o ko mākou naʻaupō ponoʻī" wahi a Will J. Durant (1885-1981).
No ka mea he waiwai nui ke ola a me ke olakino e hoʻopau ʻia, e kiʻi i nā ʻoiaʻiʻo e pili ana i nā lāʻau lapaʻau psychoactive e pale aku i kā lākou pahele make. No ka hoʻoholo ʻana i ka ʻike e pili ana i kēia mau lāʻau lapaʻau a ʻaʻole e hana ʻino i kou ola, e hoʻomaka e nīnau i nā pūʻulu puke a me nā wikiō. Ka Oiaio no na Laau Laau(*) no ka mea ʻoi aku ka maʻalahi o ka pale ʻana ma mua o ka mālama ʻana!
E hoʻomaopopo ':
https://www.emcdda.europa.eu/publications/mini-guides/
https://www.emcdda.europa.eu/publications/topic-overviews/eu-early-warning-system_en
https://www.emcdda.europa.eu/publications/european-drug-report/2023/heroin-and-other-opioids_en
https://www.unodc.org/unodc/en/scientists/global-smart-update-2017-vol-17.html
https://www.reuters.com/graphics/mexico-drugs/fentanyl/
https://www.who.int/news-room/fact-sheets/detail/opioid-overdose
https://www.cdc.gov/opioids/basics/fentanyl.html
(*) Ka Oiaio no na Laau Laau, loaʻa nā puke liʻiliʻi a me nā wikiō ma 20 mau ʻōlelo ma:
www.drugfreeworld.org
www.fdfe.eu - Ke kahua no ka ʻEulopa ʻAʻohe Laʻau
