Researchers from USP and Unicamp identified the presence of the synthetic opioid nitazene – a substance 500 times more potent than heroin – in drugs seized in São Paulo. This was the first time that this substance had been found in Brazil.
The emergence of synthetic drugs has been on the rise in recent years, according to health authorities. The best-known of these is “synthetic marijuana,” which is known as K2 or K9, among other names.
This year alone, health units in the city of São Paulo have attended to 483 cases of possible use of these substances, with an average of more than two notifications per day.
New drug market
Doctor Álvaro Pulchinelli, a toxicologist at the Pardini Toxicology Laboratory, explains that there are currently over 120 known types of cannabinoids. He adds that the emergence of new substances is increasingly common.
According to him, one of the main risks in using these substances is the fact that it is not known exactly how these new drugs work. “The big challenge is to understand both the clinical and laboratory aspects of these substances,” the specialist highlights.
Pulchinelli points out that the technical and laboratory issues are a major challenge. The synthetic drug manipulates fragments of a natural molecule and reproduces other independent molecules.
“While natural cannabinoids tend to lower blood pressure, synthetic cannabinoids tend to increase blood pressure,” explains Álvaro.
Immediate effects
The expert says that synthetic drugs are sought after because they are more incisive. In general, they cause a “heavier” effect on the user.
“The attractiveness of synthetic drugs is that they have a more exuberant effect in a shorter period of time,” explains the toxicologist.
The doctor explains that the drug is designed to target certain brain receptors, and that this does not differentiate it from non-synthetic drugs.
“We can’t tell the difference right away. We know that synthetic marijuana is made to hit these receptors more strongly, and that makes it a more potent drug,” he adds.
Long-term effects
Pulchinelli explains that long-term effects depend on a series of factors and contexts, in addition to the type of substance, highlighting that there is a difference between cannabinoids and opioids.
They follow the same pattern as other drugs, which is dependence, affecting the central nervous system, as well as damaging the kidneys, heart and brain.
The central nervous system is what triggers the withdrawal crisis in the absence of the substance.
“This does not mean that natural drugs are less dangerous. It is not. All drugs are dangerous.”
Interactions with other drugs
In addition to the use of synthetic drugs, it is not uncommon for users to interact with other substances. The toxicologist recalls “cocaethylene,” the effect of combining cocaine and alcohol.
The doctor highlights the danger of using sedative drugs to “control” the effects of euphoric drugs, as well as combinations for illegal purposes.
“A classic is the use of drugs like ‘good night Cinderella’ and alcohol, to carry out scams”, highlights the toxicologist.
He emphasizes that the use of more than one substance causes a “dilemma” in the body, which needs to “decide” which substances it will metabolize.
Overdose risks
The greatest risk of overdose due to the use of synthetic drugs is due to the difficulty in differentiating the symptoms of an overdose, according to the doctor.
This difficulty in elucidating the case delays the treatment that will be applied, increasing the risk of death.
“Even trained doctors may have difficulty identifying the substance,” warns the toxicologist, regarding occasions when the user arrives at a health unit without the help of someone to provide more information.
Treatment
Treatments for synthetic drug users must be separated into two stages: the acute phase and the chronic phase.
The specialist explains that some synthetic drugs, such as opioids, can be given antidotes that help reduce the effect of the drug. However, in the case of other substances, such as cocaine, for example, the only option is supportive treatment.
“Certain groups of substances require one path or another, which is what gives the treatment a high level of criticality,” he highlights.
He emphasizes that people in the acute phase, after excessive drug use, should be taken to the hospital. Among the most common symptoms are respiratory problems, tremors, agitation, unconsciousness, increased heart rate and extremely dry skin.
“Treatment of the acute phase should always be carried out under medical supervision. The person should not wait for the effects to wear off at home. This could be crucial for someone’s life or death,” says the doctor.
For chronic users, treatment is provided by individualizing cases and understanding the reasons that led to use. Monitoring is carried out by a multidisciplinary team of health professionals.
The treatment basically consists of the process of detoxifying the drug user, which occurs in several stages. This is because, according to the professional, a user in the addiction phase needs broader support.
Source: CNN Brasil
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