The first seizure of illicit fentanyl in Brazil, which occurred in March, in Espírito Santo, raised the alarm about strategies to control and prevent the circulation and use of the drug in the country. The risks and challenges of Brazil, however, must be interpreted in the context of important differentiating factors from the scenario of the United States, a country facing a severe opioid crisis. The analyses and recommendations are part of the commentary Reports of rising use of Fentanyl in contemporary Brazil is of concern, but a US-like crisis may still be averted by Francisco Inácio Bastos, full researcher at the Institute of Scientific and Technological Communication and Information in Health (Icict/Fiocruz), and Noa Krawczyk, assistant professor at the Center for Opioid Epidemiology and Policy at NYU Grossman School of Medicine. The article was published last Tuesday (5/9), in the online version of the journal The Lancet Regional Health - Americas.
The publication of the commentary on the increasing use of the drug coincides with the National Fentanyl Awareness Day. The date is promoted annually on May 9th in the United States, where the substance already ranks first in deaths caused by overdose. It is estimated that around 70,000 people die annually in the country due to misuse of the drug, which has attracted the attention of authorities in the areas of Health and Public Safety, since the product can quickly cause chemical dependence.
The article by the Fiocruz researcher and NYU professor highlights important measures that Brazil can adopt, through regulatory bodies and authorities, to control the use of the substance. To this end, the experiences that have already taken place in the USA bring major lessons. According to Inácio Bastos, the Brazilian alert system has been acting correctly. He stresses, however, the importance of focusing on actions related to the control of demand.
Investment in continuous surveillance and research to understand the changing patterns of substance use and abuse in the Brazilian population, and also integration of seizures with careful toxicological analysis, are some actions and measures recommended by experts. According to them, it is essential to improve the surveillance of medical fentanyl and other opioids, avoiding potential deviation and misuse, especially in outpatient settings. The Fiocruz researcher also emphasizes the importance of adopting treatment protocols and raising awareness among health professionals who work at the reception - emergencies - in the public and private sectors.
The authors point out that, despite the necessary alerts and actions, there is no reason for panic. "Until now, the emerging threat of a potential public health crisis driven by the spread of fentanyl has basically been dealt with by means of a proactive media, few research groups, and Anvisa's immediate responses. A commitment from civil society, the scientific community, and government at all levels is extremely necessary", state Francisco Inácio Bastos and Noa Krawczyk.
Francisco Inácio Bastos has a degree in Medicine from the State University of Rio de Janeiro (Uerj), a Master's Degree in Collective Health from Uerj, and a Doctoral Degree in Public Health from Fiocruz, with Post-Doctoral internships/visiting researcher in countries such as Germany, Canada, United Kingdom, and United States. He is a full researcher at the Laboratory of Information in Health (LIS) at Icict/Fiocruz.