OPİOİDLERİN TIBBİ AMAÇ DIŞI KULLANIMI VE KÜRESEL FENTANİL KRİZİ

Year 2024, , 455 - 470, 29.11.2024

Hayrettin Dursun

https://doi.org/10.28956/gbd.1487403

Abstract

Haşhaş bitkisinden elde edilen opiyatlar yüzyıllardır ağrı kesici olarak kullanılmanın yanında oluşturdukları öfori etkisi sebebiyle kötüye de kullanılmıştır. Morfin ve kodein gibi alkoloitleri içeren ilaçlar hala reçeteli olarak kullanılmaktadır. Morfinin bağımlılık yapma etkisinin görülmesi üzerine eroin sentezlenmiş; onun kötüye kullanımının da küresel bir salgına ulaşması sonucu ilaç olarak kullanımı yasaklanmıştır. Alkoloitlerin yapılarının ve etki ettikleri reseptörlerin tespiti yeni tip sentetik opioidlerin sentezlenmesine imkan sağlamış ve bu maddeler reçeteli olarak kullanılmaya başlamıştır. Sentetik opioidlerden özellikle fentanil ve analoglarının eroinin yerini alması ve tıbbi amaç dışında kötüye kullanılması yeni bir küresel salgına sebep olmuştur. Uzmanlar opioidlere bağlı salgınları; reçeteli opioidlere bağlı, eroine bağlı ve sentetik opioidlere bağlı olmak üzere üç dalga modeli ile açıklamaktadır. Kuzey Amerika ve Kuzey-batı Avrupa opioid salgınından en çok etkilenen bölgeler durumundadır. Salgın başladığından bu yana 750.000’den fazla Amerikalı opioid kaynaklı aşırı dozdan hayatını kaybetmiştir. Estonya başta olmak üzere Avrupa ülkelerinde de opioid kaynaklı aşırı doz ölüm sayıları hızlı bir şekilde artmaktadır. Sosyal medya ve karanlık ağlar gibi takibi zor kanallar kullanılarak yeni tip opioidler dünyanın farklı yerlerindeki kullanıcılara ulaşmaktadır. Kuzey Amerika’da yayılma hızını azaltmak için önlemler alma fırsatı azalırken; Avrupa’da hala salgının yayılmasını engellemek mümkün görülmektedir. Bu derleme çalışmasında fentanil başta olmak üzere sentetik opiodlere bağlı küresel salgının Kuzey Amerika ve Kuzey Avrupa özelinde ulaştığı durum literatüre dayalı sayısal verilerle açıklanacaktır. Uyuşturucu ile mücadele profesyonelleri nezdinde farkındalık oluşturmak amaçlanmıştır

Keywords

Opiyat, opioid, eroin, morfin, alkoloit, fentanil

Non-medical Use of Opioids and the Global Fentanyl Crisis

Abstract

Opiates obtained from the poppy plant have been used as painkillers for centuries, they also abused due to the euphoria effect they create. Drugs containing alkaloids such as morphine and codeine are still under use with prescription. Upon seeing the addictive effect of morphine, heroin was synthesized; as a result of its abuse reached to a global epidemic, its use as medicine was banned. Determination of the structures of alkaloids and the receptors they act enabled the synthesis of new types of synthetic opioids, and these substances began to be used as prescription drugs. The replacement of heroin by synthetic opioids, especially fentanyl and its analogues, and their misuse for non-medical purposes have caused a new global epidemic. Experts explains opioid-related epidemics in three wave models: due to prescription opioids, due to heroin and due to synthetic opioids. North America and Northwestern Europe are the regions most affected by the opioid epidemic. More than 750,000 Americans have died from opioid-related overdoses since the epidemic began. The number of opioid-related overdose deaths is increasing rapidly in European countries, especially in Estonia. New types of opioids are reaching users in different parts of the world by using difficult-to-track channels such as social media and dark networks. While the opportunity to take measures to reduce the rate of spread in North America is decreasing; it still seems possible to prevent the spread of the epidemic in Europe. In this review study, the situation of the global epidemic due to synthetic opioids, especially fentanyl related, in North America and Northern Europe will be explained with numerical data based on the literature. It is aimed to raise awareness among professionals in the fight against drugs.

Keywords

Opiate, opioid, morphine, heroin, alkaloid, fentanyl.

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