Drogas Emergentes: conocimientos más relevantes / Most relevant knowledge: Emerging drugs

Introducción: Las drogas emergentes se suman a la tragedia mundial de las drogas con una tendencia creciente de la oferta y la demanda, de lo cual no queda exenta Cuba. Objetivo: aumentar los conocimientos más relevantes de las drogas emergentes, para lo cual se realizó un análisis sobre ciertas características que ha cobrado este fenómeno en los últimos años, y las condiciones que favorecen su elaboración, consumo, distribución, proliferación y enganche en poblaciones cada vez más jóvenes. Métodos: Para ello se realizaron búsquedas en la Biblioteca Cochrane Plus, MEDLINE, EMBASE, PsyclNFO, EBsCO, HINARI, Dissertation Abstracts y en los artículos identificados en sus bibliografías, además de las búsquedas individuales en MEDLINE de autores que han reportado información relacionada con el consumo de drogas emergentes en los últimos cinco años. Conclusiones: La línea entre drogas legales e ilegales se vuelve cada vez más tenue. La actualización permanente de las drogas emergentes, el conocimiento de las limitaciones en las determinaciones analíticas y la sospecha clínica, son las únicas armas para seguir de cerca el cambiante mundo de estas sustancias, que devienen en un grave problema social y de salud. Por su desarrollo, comercialización y disponibilidad, no caben dudas de que estamos ante la irrupción de un mercado innovador y tremendamente dinámico, enormemente accesible, globalizado, sofisticado y muy atractivo para los jóvenes, que favorece a las grandes mafias narcotraficantes internacionales por los grandes beneficios económicos que se derivan de su comercio ilegal en un mundo globalizado y neoliberal(AU)

Introduction: Emerging drugs are added to the global tragedy of drugs with a growing trend of supply and demand, of which Cuba is not exempt. Objective: To increase the relevant knowledge of emerging drugs, for which an analysis of certain characteristics that has taken this phenomenon in recent years, and the conditions that favor its production, consumption, distribution, proliferation and engagement was performed in populations each younger time. Methods: For this we searched the Cochrane Library, MEDLINE, EMBASE, PsyclNFO, EBSCO, HINARI, Dissertation Abstracts and articles identified in their bibliographies, in addition to individual searches of MEDLINE of authors who have reported information regarding the emerging drug consumption in the last five years. Conclusions: The line between legal and illegal drugs becomes increasingly tenuous. The continuous updating of emerging drugs, knowledge of the limitations in the analytical determinations and clinical suspicion, are the only weapons to monitor the changing world of these substances, which become a serious social and health problem. For its development, commercialization and availability, there is no doubt that we are facing the emergence of an innovative market and extremely dynamic, highly accessible, globalized, sophisticated and very attractive to young people, favoring large international drug mafias for the great benefits economic derived from illegal trade in a globalized and neoliberal world(AU)

Características generales de los principales grupos de Drogas Emergentes: catinonas, piperacinas y spices / General characteristics of the main groups of Emerging Drugs: cathinones, piperazines and spices

Introducción: el extenso, cambiante y muy diverso grupo de las drogas emergentes, de variado origen, composición y efectos de naturaleza diversa, ha invadido al mundo entero en el siglo XXI, y como una pandemia se extiende y devora al hombre, a su familia y a la comunidad, donde los más vulnerables continúan siendo los más jóvenes. Objetivo: aumentar el conocimiento de los principales grupos de drogas emergentes: catinonas, piperacinas y spices, surgidas en los últimos cinco años. Método: para ello se realizaron búsquedas en la Biblioteca Cochrane Plus, MEDLINE, EMBASE, PsyclNFO, EBsCO, HINARI, Dissertation Abstracts y en los artículos identificados en sus bibliografías, además de las búsquedas individuales en MEDLINE de autores que han reportado información relacionada con el consumo de drogas emergentes en los últimos cinco años. Conclusiones: la gravedad del fenómeno las drogas emergentes radica en que de ellas no escapa casi ningún país. Son sustancias que pues se encuentran en plena y continua evolución al obtenerse a través de sofisticados procesos de síntesis que, en la mayor parte de los casos, constituyen un enigma. La información obtenida, es habitualmente pseudo científica que con frecuencia se utiliza como justificación para la promoción del uso desde muchas páginas web. La naturaleza virtual y globalizada de internet, dificulta aplicar medidas restrictivas legales y, su relativo anonimato favorece el comercio y la distribución. Su proliferación deviene en una alerta para las comunidades modernas porque amenazan la vida y la estabilidad del planeta tierra(AU)

Introduction: the vast, changing and diverse group of emerging drugs, of varied origin, composition and effects of various kinds, has invaded the whole world in the twenty-first century, and as a pandemic spreads and devours the man, his family and the community, where the most vulnerable are still younger. Objective: To increase awareness of the main groups of emerging drugs: cathinones, piperazines and spices emerged in the last five years. Method: for it searched the Cochrane Library, MEDLINE, EMBASE, PsyclNFO, EBSCO, HINARI, Dissertation Abstracts and articles identified in their bibliographies, in addition to individual searches of MEDLINE of authors who have reported information regarding the emerging drug consumption in the last five years. Conclusions: The severity of the emerging drug phenomenon is that of them not escape almost any country. They are therefore substances are in full and continuous evolution to sophisticated obtained by synthesis processes which, in most cases, an enigma. The information obtained is usually pseudo science that is often used as a justification for promoting the use from many websites. The virtual and globalized nature of the Internet makes it difficult to apply restrictive legal measures and their relative anonymity favors trade and distribution. Their proliferation becomes an alert for modern communities that threaten life and stability of the planet earth(AU)

Consumo de drogas emergentes en Medellín, Colombia / Use of Emerging Drugs in Medellín, Colombia

Resumen Introducción: La continua aparición de nuevas sustancias sintéticas que se puede utilizar como drogas de abuso supone un desafío constante para la salud pública. Drogas emergentes es el término acuñado en este trabajo para definir la aparición de nuevas sustancias psicoactivas en un momento dado y un contexto y un grupo particulares, la reaparición de otras que en los estudios epidemiológicos habían perdido su prevalencia y el aumento repentino en las prevalencias de drogas que se mantenían en consumos bajos. Método: Bajo un enfoque empírico-analítico, se planteó un estudio con un enfoque mixto. Conformaron la muestra de conveniencia 510 drogodependientes que en 2011 asistieron a centros de tratamiento, en la modalidad de internamiento, en el municipio de Medellín, en quienes se exploró el consumo de drogas emergentes. A todos los usuarios de drogas se les aplicó un instrumento ad-hoc para detectar consumo de las que el estudio consideraba drogas emergentes. Detectados los consumidores y seleccionados por la frecuencia del consumo y la prevalencia en el último año y el último mes, se les solicitó una entrevista semiestructurada, que indagaba por detalles de la sustancia y las características del consumo. Resultados: Del grupo estudiado en el caso de Medellín, el 82,2% son varones y el 17,8%, mujeres. El 58,2% cursa secundaria y el 26,8% tiene estudios superiores técnicos o de universidad. El 1,4% no ha ido a la escuela. Solo un 27,8% trabaja con un empleo fijo, ocasional o independiente. El 40,7% son estudiantes y el 8,9%, amas de casa. El 76,3% son solteros y el 17,8% tiene pareja estable. En la muestra están representados todos los estratos socioeconómicos. Entre las drogas emergentes halladas, se destacan las prevalencias de las benzodiacepinas flunitrazepam y clonazepam: prevalencia de vida (PV), 97,5%; prevalencia en el último año (PA), 67,9%, y prevalencia en el último mes (PM), 46,7%. Les siguen las drogas de síntesis (LSD, «éxtasis¼, anfetaminas, HGB, «éxtasis vegetal¼, fenciclidina, metanfetamina, ketamina, 2CB): PV, 96,5%; PA, 44,5%, y PM, 23,5%. Luego aparecen las cocaínas fumables (basuco, crack y free-base): PV, 80%; PA, 52,1%, y PM, 31,7%. Siguen los derivados opiáceos (heroína, morfina, opio, codeína, dextrometorfano, meperidina, fentanilo): PV, 61,4%; PA, 26,7%, y PM, 16%. Los alucinógenos como los hongos, el cacao sabanero y el yagué también aparecen entre los consumos: PV, 73,5%; PA, 23,2%, y PM, 12,2%. Hay también consumo de inhalantes como el popper y el diclorometano («Dick¼): PV, 87,9%; PA, 37,6%, y PM, 21,6%. Conclusiones: Estos resultados alertan sobre la necesidad de hacer seguimiento a las denominadas drogas emergentes por los riesgos que pueden implicar para la salud pública.

Abstract Introduction: The ongoing emergence of new synthetic substances that are used as drugs is a constant challenge to public health. Emerging drugs is the concept used in this research project to define the emergence of new psychoactive substances at a given time, a specific context and group, the reemergence of others that some epidemiologists considered had lost their prevalence, and the sudden prevalence of drugs that had low levels of consumption. Method: This research project was carried out using an empirical-analytical approach using a mixed methods study. The convenience sample was made up of 510 drug dependents institutionalized in treatment centers in Medellin in the year 2011. The examination was carried out related to the consumption of emerging drugs. An ad hoc tool was applied to all the drug users in order to identify which of the drugs of this study they considered to be emergent. Once the consumers were identified and selected based on the frequency of consumption, and the prevalence in the last year and last month, a semi-structured interview was carried out to find out details on the substances and their consumption characteristics. Results: Based on the new drug consumers in Medellin, 82.2% were male and 17.8% female. As regards education levels, 58.2% were in high school, 26.8% hold higher technical or college degrees, and 1.4% had no schooling. Only 27.8% held a steady job, occasional employment, or were independent business owners, 40.7% were students and 8.9% were housewives. More than three-quarters (76.3%) were single, and 17.8% had a steady partner. The sample represented all social classes. Of all the emerging drugs found in this study, the prevalence of benzodiazepines stands out (flunitrazepam and clonazepam), life prevalence (LP), 97.5%; last year prevalence (LYP), 67.9%, and last month prevalence (LMP), 46.7%. These were followed by the synthetic drugs (LSD, Ecstasies, amphetamines, GHB, Vegetable Ecstasies, Phencyclidine; Methamphetamine, Ketamine, 2CB), with LP, 96.5%; LYP, 44.5%, and LMP, 23.5%. Then there was smokable cocaine (Crack and Free-Base), with LP, 80%, LYP, 52.1%, and LYP=31.7%. The opiate derivatives (heroine, morphine, opium, codeine, dextromethorphan, meperidine, fentanyl) had an LP, 61.4%; LYP, 26.7% and LMP, 16%. The consumption statistics of the hallucinogens such as mushrooms, scopolamine and "yague", had an LP, 73.5%; LYP, 23.2% and LMP, 12.2%. Finally, use of inhalants such as popper and dichloromethane (Dick) had an LP, 87.9%; LYP, 37.6% and LMP, 21.6%. Conclusion: These results are an alert to the need to track the development of these so called emergent drugs due to the risks they pose for public health.

[Use of Emerging Drugs in Medellín, Colombia]. / Consumo de drogas emergentes en Medellín, Colombia.

INTRODUCTION: The ongoing emergence of new synthetic substances that are used as drugs is a constant challenge to public health. Emerging drugs is the concept used in this research project to define the emergence of new psychoactive substances at a given time, a specific context and group, the reemergence of others that some epidemiologists considered had lost their prevalence, and the sudden prevalence of drugs that had low levels of consumption. METHOD: This research project was carried out using an empirical-analytical approach using a mixed methods study. The convenience sample was made up of 510 drug dependents institutionalized in treatment centers in Medellin in the year 2011. The examination was carried out related to the consumption of emerging drugs. An ad hoc tool was applied to all the drug users in order to identify which of the drugs of this study they considered to be emergent. Once the consumers were identified and selected based on the frequency of consumption, and the prevalence in the last year and last month, a semi-structured interview was carried out to find out details on the substances and their consumption characteristics. RESULTS: Based on the new drug consumers in Medellin, 82.2% were male and 17.8% female. As regards education levels, 58.2% were in high school, 26.8% hold higher technical or college degrees, and 1.4% had no schooling. Only 27.8% held a steady job, occasional employment, or were independent business owners, 40.7% were students and 8.9% were housewives. More than three-quarters (76.3%) were single, and 17.8% had a steady partner. The sample represented all social classes. Of all the emerging drugs found in this study, the prevalence of benzodiazepines stands out (flunitrazepam and clonazepam), life prevalence (LP), 97.5%; last year prevalence (LYP), 67.9%, and last month prevalence (LMP), 46.7%. These were followed by the synthetic drugs (LSD, Ecstasies, amphetamines, GHB, Vegetable Ecstasies, Phencyclidine; Methamphetamine, Ketamine, 2CB), with LP, 96.5%; LYP, 44.5%, and LMP, 23.5%. Then there was smokable cocaine (Crack and Free-Base), with LP, 80%, LYP, 52.1%, and LYP=31.7%. The opiate derivatives (heroine, morphine, opium, codeine, dextromethorphan, meperidine, fentanyl) had an LP, 61.4%; LYP, 26.7% and LMP, 16%. The consumption statistics of the hallucinogens such as mushrooms, scopolamine and "yague", had an LP, 73.5%; LYP, 23.2% and LMP, 12.2%. Finally, use of inhalants such as popper and dichloromethane (Dick) had an LP, 87.9%; LYP, 37.6% and LMP, 21.6%. CONCLUSION: These results are an alert to the need to track the development of these so called emergent drugs due to the risks they pose for public health.