How Likely is an Opioid Crisis in Latin America?

2022 began with the news that the pharmaceutical company Teva was found guilty for being responsible for contributing to the opioid crisis in the United States. This was not the only pharmaceutical company that was involved. In March 2019, the New York State Attorney’s Office sued more than 12 manufacturers and distributors for their responsibility in this crisis. However, before the trial, most of the defendant companies negotiated with the prosecution and signed agreements to pay large sums of money in order not to be taken to the stand.

The money received will be used to mitigate the devastating consequences that the opioid crisis has left in its wake in New York, through educational programs and for the rehabilitation of addicts.

With this process underway, pharmaceutical companies must also suspend the manufacture of these highly addictive drugs. The question that remains in the air is: what will be the consequence at a global level and, more specifically, if Latin America should prepare for an opioid crisis?

A market strategy that “cost” millions of lives

To understand what the consequences of the opioid crisis would be in Latin America, it is first necessary to understand what it consists of in the United States and Canada, the countries that have been most affected.

In the late 1990s, pharmaceutical companies claimed that prescription opioid pain relievers were effective in treating pain and were not addictive. Consequently, in the late 1990s and early 2000s, the medical community began to prescribe them more and there was an increase in the use of opioids that led to fatal consequences, as millions of people became dependent on these drugs since there was no specialized accompaniment after having prescribed them. This, in turn, brought with it overdose deaths, which is why this problem came to be described as a public health crisis and an opioid epidemic.

The response by the authorities was to restrict the distribution of these medicines, so people resorted to the illegal market to stock up due to the dependency they had already generated, which caused the crisis to increase even more and consumers were in a even higher risk.

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Other health crises such as HIV/AIDS and the COVID-19 pandemic increased risks, addictions and death tolls, as well as a demonization of consumers , which were the main victims of a very poorly directed and regulated sales strategy by the pharmaceutical industry.

What would happen in Latin America?

If we can learn anything from the opioid crisis in the United States, it is that terrible regulation and poor monitoring by the responsible entities can cost millions of lives. Although nothing similar to what has happened in the United States and Canada has happened in Latin America, the countries of the region and other parts of the world show a concern not to fall into this problem.

In the case of Latin America, we can take into account that, according to WHO data, more than 90% of the morphine that is legally produced is used by 20% of the world population, being the populations of the United States, Canada, Australia and Germany, respectively, the largest consumers. 66% of the world population (including countries in the region) do not have adequate access to opioids, despite the high prevalence of diseases with severe pain.

In other words, there is no functional spectrum that covers the medical needs of the population because, with the opioid crisis in North America, regularization has led to prohibition, which is why illegal markets are used, which puts at risk the life and integrity of people.

The States find themselves, then, with a paradox: they are highly addictive and potentially lethal, consequently an inspection and even legal prohibition is proposed. But on the other hand, opioids have analgesic and therapeutic properties, to which anyone who wants to assert their right to health should have access.

There is still ineffective regularization in some countries of the region. On the one hand, comprehensive health services in the region do not fully provide for decent and safe access to these drugs. In Colombia, for example, opioids are monitored by the National Narcotics Fund, and around 17 milligrams of morphine per capita are supplied annually, very low values ​​compared to places where access is legal, according to the magazine Ocean Medicine. . But, in contrast, Colombians can access medications such as codeine and tramadol without a prescription.

So far, this has not led to an opioid crisis, at least in Colombia, but it is more than clear that there is territorial disparity regarding access to these analgesic drugs that, with efficient regulation, can help people access a right to decent health.

Experts such as David Goodman Meza, a researcher at the University of California, and Alfredo Covarrubias Gómez, an Anesthesiologist expert in Pain Medicine and Geriatric Palliative Care, assure that an opioid crisis could be possible in Mexico, where the illegal market for opioids such as Fentanium increased by 486% in 2020 over 2019, according to the Associated Press.

In conclusion, Latin America must prepare to avoid an opioid crisis from regularization that takes into account not only the people who will have access to these drugs, but also the people who already depend on them in order to provide support that reduces risks of its consumption. Likewise, there must be comprehensive education plans to avoid future problems related to these.