Ka hare ho European Union 'marakeng oa lithethefatsi ka ho feletseng o thusoa ke tšebeliso ea mecha ea litaba ea sechaba kapa marang-rang a marang-rang le likopo, ho hlaha boemo bo eketsehileng ba lithethefatsi, ka ho eketseha ha thepa, tlhahiso le tšebeliso ea lithethefatsi tse sa laoleheng tsa maiketsetso tse bitsoang new psychoactive substances (NPS). Ntho ea kelello "e ama ditshebetso tsa kelello, mohlala, temoho, kelello, temoho kapa maikutlo le maikutlo".
Ho latela Keletso ea Temoso ea Pele ho Lintho Tse Ncha tsa Psychoactive (EWA-2022), NPS e hlalosoa e le. "Lintho tsa tlhekefetso, ebang ke ka mokhoa o hloekileng kapa boitokiso, tse sa laoloeng ke Kopano e le 'Ngoe ea 1961 ea Lithethefatsi tsa Narcotic kapa Tumellano ea 1971 ea Lintho tsa Psychotropic, empa e ka bakang tšokelo ea bophelo ba sechaba".
NPS ke letoto la litlhare tse etselitsoeng ho etsisa litlhare tse seng molaong mme li hlophisoa ho latela litlamorao tsa tsona.
Qetellong ea 2022, Setsi sa Tekolo sa Europe sa Temallo ea Lithethefatsi le Lithethefatsi (EMCDDA) se ne se lekola li-NPS tse ka bang 930, tse 41 li tlalehiloe ka lekhetlo la pele Europe ka 2022.
Europe, tšebeliso ea li-opioids (morphine, codeine, heroin, fentanyl, methadone, tramadol le lintho tse ling tse tšoanang) e qalile ho eketseha ho tloha qalong ea 21st lekholo la lilemo. Lilemong tsa morao tjena, ho bile le keketseho e kholo ea palo ea li-opioid tse ncha tsa psychotropic synthetic tse 74 tse tlalehiloeng ho EU Early Warning System (EWS).
Hlokomela: Li-opiate ke lithethefatsi tsa tlhaho tse tsoang semela sa opium poppy; Opioid ke lentsoe le akaretsang le kenyelletsang li-opiate, semi-synthetic (joalo ka oxycodone) le li-opioid tsa maiketsetso (joalo ka fentanyl).
Li-opioid tse ncha tsa maiketsetso li batla li theiloe hantle mebarakeng e meng ea lithethefatsi ea Europe moo li rekisoang hangata ka theko e tlase e le ho nkela li-opioid tse kang heroine. Litlamorao tsa ho lemalla opioid li phahame haholo esita le ka litekanyetso tse tlase.
Ho latela European Drug Report 2023, linaheng tse ngata tsa Europe, ts'ebeliso ea li-opioid tsa maiketsetso e ntse e eketseha joalo ka ha ho bonts'itsoe ke palo ea ho ts'oaroa ho tlalehiloeng ke EMCDDA. Ho sa le joalo, Mokomishinara oa Europe oa Litaba tsa Lehae, Mofumahali Ylva Johansson, le Mookameli oa EMCDDA, Monghali Alexis Goosdeel, ba lemositse ka ho eketseha ha tšebeliso ea e 'ngoe ea li-opioids tse mpe ka ho fetisisa: Fentanyl. O ile a re: "Re tlameha ho etsa bonnete ba hore hona joale Amerika ha e fetohe bokamoso ba Europe". Ehlile, selemong se fetileng USA, batho ba 109,000 ba bolailoe ke lithethefatsi tsa maiketsetso boholo ba bona ba tsoa fentanyl.
Ho ata ha ho itšetleha ka opioid har'a batho ba baholo ba Europe ho ntse ho le tlaase, ho fapana haholo pakeng tsa linaha 'me ho amahanngoa le mafu a tšoaetsanoang, mathata a bophelo bo botle, ho khetholloa ha sechaba, ho hloka mosebetsi, ho hloka bolulo, tlōlo ea molao le ho shoa. Ho batho ba kaholimo ho lilemo tse 40 ba sebelisang li-opioids, litlamorao tse eketsehang tsa kotsi e amanang le lithethefatsi tse kenyelletsang tšebeliso ea lithethefatsi tse ngata le bophelo bo botle ka lilemo tse ngata li etsa hore batho bana ba be kotsing ea ho tšoaetsoa, ho feta tekano le ho ipolaea.
Fentanyl (C22H28N2O) e entsoe ka lekhetlo la pele ho tloha benzyl-piperidone ka 1959 (e nang le tokelo ea molao ka 1964) ke setsebi sa k'hemistri Paul Janssen oa Belgium. Ho ile ha etsoa mekhoa e meng e meraro:
- Suh et al a. 1998: mokhoa ka kakaretso ea ho kopanya.
-Siegfried mathoasong a 2000 mme a sebelisoa li-labs tse seng molaong;
- Gupta PK et al a. 2005: motsoako oa pitsa e le 'ngoe e sebelisitsoeng ka mokhoa o seng molaong ka 2021 empa ka bohloeki bo tlase;
Fentanyl ka lebaka la ho qhibiliha ha eona ka bongata ba lipid e kenella habonolo tsamaisong ea methapo e bohareng ka litlamorao tsa sedative le tse potlakileng tsa analgesic le nako e khuts'oane ea ketso. Ho monya ha eona ho potlakile ke mucosa ea molomo (15/30 min-4 hrs) empa e ka boela ea tsamaisoa ka ente (2min-30 min), transdermal (patch) kapa e sebelisoa sebakeng sa gaseous e le spray (10min-60min).
Fentanyl analgesic effect e matla ho feta morphine ka makhetlo a 100 le makhetlo a 50 ho feta heroine. Tlas'a mofuta oa eona oa molao oa bongaka, opioid ena ea maiketsetso e sebelisoa ho phekola bohloko bo tebileng bo sa foleng le bo sa tsitsang. Ho tloha ka 2021 esale e le karolo ea "meriana ea bohlokoa" ea Mokhatlo oa Lefatše oa Bophelo mme e thathamisitsoe ho kemiso ea III ka morphine le oxycodone.
Ho ea ka pono ea bongaka ba liphoofolo, matla a phahameng a fentanyl a sebelisetsoa ho fokotsa bohloko, ho kokobetsa le ho thethefatsa liphoofolo hammoho le ho alafa ho tepella maikutlo le ho ferekana liphoofolong.
Empa, fentanyl e boetse e khelositsoe tšebelisong ea eona e le moriana o kokobetsang bohloko o lokelang ho nkoa e le moriana, o hlahisoang habonolo lilaboratoring tsa lekunutu ntle le ho ba le bothata ba ho lema le ho kotula limela! E hlahisitsoe China, Mexico le India, fentanyl e boetse e bitsoa China White, Apache, Jackpot, Murder 8,… e bile taba e kholo sebakeng sa hona joale sa lithethefatsi tsa Europe. K'hilograma e le 'ngoe ea phofo ea fentanyl e ka ba le litekanyetso tse 50,000.
Hona joale, har'a lihlahisoa tse ling tsa 1,400 tsa fentanyl, li-derivatives tse 700 li fumanoe Europe, tse ling hangata li matla ka makhetlo a 1,000 ho feta heroin. 3-methyl fentanyl e matla ka makhetlo a 3,200 joalo ka morphine le derivative., carfentanyl, e matla ho feta morphine ka makhetlo a 10,000 XNUMX.
Fentanyl e chefo haholo esita le ka ho kopana habonolo le letlalo. Ke limiligrama tse 2 feela tse ka bolaeang motho e moholo. Kotsi ke ha barekisi ba e kenya lithethefatsing tse ling, batho ba e sebelisa ba sa tsebe. Ka 'nete, fentanyl e atisa ho tsoakoa, ho khaoloa, le ho kenngoa hammoho le lithethefatsi tse ling, ho kenyeletsa k'hok'heine le heroine. Jobski K et al a. (2023) o entse thuto e khahlisang mabapi le tlhekefetso, ho itšetleha, ho itokolla le tsela ea eona ea tsamaiso Europe. Fentanyl e matla hoo ho ke keng ha khoneha ho khaola ka ho nepahala ka hona ho eketsa kotsi ea ho feta tekano.
Fentanyl e khethiloe e le lithethefatsi tsa machaba ho tloha ka 1964, ka lebaka la likotsi tsa bophelo bo botle, likotsi tsa tšebeliso e mpe, le ho rarahana ha ho sebetsana le eona. Ho batho, tekanyo e bolaeang (LD50) ea fentanyl e hakanngoa bakeng sa motho e moholo ka limiligrama tse peli (2mg).
Tlhokomeliso: Patch ea fentanyl (hangata e hlafunoa ke basebelisi ba lithethefatsi) ke e 'ngoe ea meriana e ka bang kotsi haholo,' me maemong a mang e ka bolaea, ka tekanyo e le 'ngoe feela, haeba e sebelisoa hampe ke ngoana (Taolo ea Lijo le Lithethefatsi, 2022). Liphello li ka nka pakeng tsa metsotso ea 30 le lihora tsa 4 ho itšetlehile ka sehlahisoa se sebelisitsoeng. Empa ka lebaka la bosieo ba morao-rao le lithuto tsa saense, nako ea liphello tsa bona ha e e-s'o tsejoe hantle.
Tšebeliso e pheta-phetoang ea fentanyl kapa li-derivatives tsa eona, esita le mekhoa ea phekolo, e ka lebisa kotsing ea ho itšetleha le haeba e sebelisoa haholo, ho na le kotsi ea ho feta tekano ka ho tepella maikutlong le ho holofala ha mesifa ea sefuba, ho tšoha, hypotension e matla, ho tiea ha mesifa kapa koma e ka lebisang lefung. Kotsi ea ho tšoaroa ha phefumoloho e eketseha ha tšebeliso ea fentanyl (kapa lihlahisoa tsa eona) e amahanngoa le joala, benzodiazepines le li-opioid tse ling. Tšebeliso ea tsona e seng molaong le eona e kotsi tabeng ea ho ima ho mosali le ho lesea le ka pōpelong.
Fentanyl le li-derivatives tse seng tsa bongaka li bonoa ho fihlela lihora tse 48 ka har'a moroto le lihora tse ka bang 12 maling.
Tšebeliso e seng molaong ea fentanyl le li-derivatives e akaretsoe hantle ke J. Botts (2023): E Potlakile, e Theko e tlaase ebile e bolaea.
Mokhoa oa ts'ebetso:
'Meleng ho na le li-neurotransmitters tse ka bang 20 tse hlahisoang ka tlhaho tsa opioid tse hlophisitsoeng ka palo ea li-amino acid. Li kenyelletsa mefuta e fapaneng ea:
- li-endorphin,qetellonggenous morphine), polypeptides e entsoeng ke hypophyse le hypothalamus. Ba pata bohloko ka nako e khutšoanyane (e leng se tlatsetsang ho pholoha) hape ba baka boikutlo ba ho phomola (anxiolytics), boiketlo kapa esita le maemong a mang, euphoria joaloka beta-endorphin.
- The enkephalins (ho tsoa ho Segerike enkephalos = hlooho) ke li-inhibitors tsa ho phatlalatsoa ha molaetsa oa bohloko bokong ho theha analgesia e khutšoanyane; ba boetse ba khona ho fetola palo ea dopamine (k'hemik'hale ea moputso) e hlahisoang le ho laola tšebetso ea mesifa e boreleli.
- Li-dynorphin (ho tsoa ho Segerike dynamis = matla) a hlahisoang ka hypothalamus, hippocampus le mokokotlo oa mokokotlo li laola le ho susumetsa mesebetsi ea bohlokoa e kang mocheso oa 'mele, mohopolo oa nako e telele, tlala, lenyora, boroko le ts'ebetso ea boitsebiso ba kutlo.
Ho ba teng ha li-receptor tse khethehileng tsa opioid bokong ho ile ha bontšoa ka lekhetlo la pele ka nako e le 'ngoe ka 1973 ke Pert CB. et al., Simon EJ et al a. le Terenius L. Li-receptor tsena tsa neurotransmitter li fumaneha bokong, mokokotlong le tsamaisong ea tšilo ea lijo. Ke li-receptor tse kopantsoeng tsa G-protein 'me ha li kenngoe li kenya letsoho ho fetola karabelo ea bohloko, maikutlo, khatello ea maikutlo le ho itšetleha ka' mele.
Ho na le mefuta e meraro ea li-receptor tsa opioid: mu, delta le kappa, tse ajoang haholo bokong. Haeba phello ea euphoric ea li-opiate e laoloa ke li-receptor tsa mu le delta, ts'ebetso ea li-receptor tsa kappa, ha e le hantle ke mokhoa oa homeostatic empa ts'ebeliso ea lithethefatsi e sa foleng e lebisa ho dysregulation ea eona e bakang mathata a kelello le maemo a mabe (Tejeda HA & Bonci A. 2019) .
Liphello tsa li-opioid li amahanngoa le ts'ebetsong ea tsamaiso ea opioid ea endogenous bokong boemong ba Nucleus Accumbens (NAc) le Ventral Tegmental Area (VTA) ea tsamaiso ea limbic. Kahoo, li-opioids le fentanyl li eketseha ka ho feteletseng ho lokolloa ha dopamine tsamaisong ea limbic ka ho kenya tšebetsong li-receptor tsa mu le delta ho NAc (Yoshida Y. et al a. 1999 - Hirose N. et al a. 2005). Boitšoaro bo qobelloang ba ho sebelisa lithethefatsi bo bakiloe ke liphetoho tse sa feleng tsa ts'ebetso ea mesolimbic dopamine system e hlahisoang ke ts'usumetso e pheta-phetoang ea dopamine e ts'oereng Nervous System e le motheo oa bokhoba.
Sena se ile sa etsa hore tšebeliso ea li-opioid qalong e be monate empa bothata ke hore ho na le tlhokahalo e eketsehileng ea ho fumana li-surges tse tšoanang tsa dopamine bakeng sa monyaka, thabo, 'me qetellong sena e ile ea e-ba tlhokahalo ea motheo e lebisang ka potlako ho overdose e bolaeang ea fentanyl le derivatives.
Meriana ea naloxone e sebelisetsoa ho khutlisa liphello tsa overdose ea opioid. Setlhare sena ka 2-3 min ka mor'a ente e sebetsa e le mohanyetsi oa tlholisano ea nang le kamano e phahameng bakeng sa receptor ea mu-opioid, e lumellang phetoho ea litlamorao tsa li-opioids (Jordan MR le Morrisonponce D., 2023) tahi e mpe ea heroin, fentanyl. , codeine, morphine, oxycodone, hydrocodone, joalo-joalo.
Ho bonts'itsoe hore fentanyl le li-analogues tse ling le tsona li ka ama ts'ebetso ea psychomotor mesebetsing ea letsatsi le letsatsi ea motho ho tsepamisitsoe maikutlo haholo ho khanna (Bilel S. et al. 2023). Ho phaella moo, Gasperini S. et al. (2022) e bonts'itse hore li-analogue tse seng molaong tse seng tsa meriana tsa fentanyl li fumanoe e le genotoxic, e bakang ho senyeha ha chromosomal ea sebopeho le lipalo.
Matšoao a ho tlohela fentanyl a hlaha hang ka mor'a lihora tse 12 ka mor'a tekanyo ea ho qetela ka takatso e matla, ho nyekeloa ke pelo, ho teneha, mahlaba ka mpeng, mokhathala, joalo-joalo, 'me a nka beke kapa ho feta. Lipatlisiso tsa morao-rao li bontšitse hore esita le ka mor’a hore ho fete mehato ea ho qetela ea ho khaotsa ho tsuba, boitšoaro ba ho batla lithethefatsi bo ka tsosolosoa haeba bo pepesehetse tšusumetsong e amanang le lithethefatsi kapa lithethefatsi.
Ka 2016, tlas'a moralo oa Lenaneo la WHO/UNODC mabapi le Phekolo le Tlhokomelo ea Tšebeliso ea Lithethefatsi. “Emisa Tšebeliso e Ntle ea Melaetsa ka Tsela e Sireletsehileng (SOS)” Bohato bo ile ba qalisoa, ho fana ka koetliso mabapi le ho lemoha kotsi ea ho feta tekano le ho fana ka tlhokomelo ea tšohanyetso. Ka bomalimabe, ho sa tsotellehe melao le mekhoa ea ho boloka li-opioid le li-derivatives ho tsoa matsohong a fosahetseng, batho ba limilione ba ntse ba itšetlehile ka 'mele' me ba hloka thuso.
Qetellong, sechabeng se pakang hangata ho fokotseha ha bohlale bo tebileng le ka bothata ba ho fokotsa chelete e utloahalang, ho sebetsana ka katleho joang le seoa sena sa lithethefatsi? Rafilosofi Socrates (470-399 BC) o ne a se a supile potso ena mabapi le ho hloka tsebo: "Empa haeba ho nka e le mosebetsi oa ho batla seo re sa se tsebeng, re fetoha ba betere, ba mahlahahlaha, ba botsoa ho e-na le ho nka e le ntho e ke keng ea khoneha ebile e le kantle ho mosebetsi oa rona ho batla 'nete e sa tsejoeng, ke tla iteta sefuba ho tšehetsa sena khahlano le motho e mong le e mong... ".
Mabapi le li-opioid, fentanyl le lithethefatsi tse ling, ho buuoa haholo literateng, sekolong, ka Inthanete, lifiliming le thelevisheneng; tse ding ke tsa nnete mme tse ding ha se nnete. Lipapatso tse bohlale hangata ha li tsamaellane le 'nete ea litlamorao le litlamorao tseo lithethefatsi li nang le tsona. Thuto e akaretsang ea baahi - le ho lokisetsoa bacha - e lokela ho etsoa ka matla ka lintlha tsa 'nete le tsa saense ho fana ka 'nete lefatšeng lena le sa bonahaleng le le nyenyefatsang la lithethefatsi le ho qoba ho lemalla ho tsona: "Thuto ke ntho e tsoelang pele ea ho sibolla ho hloka tsebo ha rona" ho boletse Will J. Durant (1885-1981).
Kaha bophelo le bophelo bo botle li le bohlokoa haholo hore li ka senngoa, fumana lintlha tsa 'nete mabapi le lithethefatsi tse seng molaong tse senyang kelello ho qoba leraba la tsona le bolaeang. Ho etsa qeto e nang le tsebo mabapi le lithethefatsi tsena le ho se etse pherekano bophelong ba hau, qala ho sheba letoto la libukana le livideo. 'Nete ka Lithethefatsi(*) hobane ho bonolo ho thibela ho feta ho phekola!
References:
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
(*) 'Nete ka Lithethefatsi, libukana le livideo li fumaneha ka lipuo tse 20 ho:
www.drugfreeworld.org
www.fdfe.eu - Motheo oa Europe e Se nang Lithethefatsi
