UNIVERSIDAD NACIONAL DE LANÚS

TRADUCTORADO PÚBLICO DE INGLÉS

TECHNICAL TRANSLATION III

Pharmacology

Booklet 1 – INTRODUCTION (Part II)

Trad. Públ. María Victoria Illas – 2017

Los Derivados del Opio son Adictivos

En Estados Unidos existe una epidemia causada por la adicción a las drogas derivadas del
opio. Las cifras estadísticas del Centro para el Control y la Prevención de las Enfermedades y
el Instituto Nacional sobre el Abuso de Drogas han informado que “existen 2.6 millones de
adictos a las drogas derivadas del opio (como la heroína y los analgésicos como el fentanilo y
la oxicodona) habiéndose registrado miles de sobredosis fatales: 8200 muertes en 1999 y
33.000 en 2015, superando al número de homicidios cometidos con armas de fuego.

Setenta y ocho personas mueren cada día por el abuso de opioides mezclados con alcohol, un
efecto sinérgico que produce dificultades respiratorias fatales. El gobierno federal ha solicitado
la inmediata atención a esta epidemia para que sea considerada una enfermedad social y no una
falla moral.
“La adicción es una enfermedad del cerebro donde los circuitos neurales han sido secuestrados
por el consumo de drogas”, definen los expertos. Sally Sattel, psiquiatra en Partners in Drug
Abuse Rehabilitation and Counseling, en Washington D.C., apoya “el tratamiento inmediato con
medicamentos antidrogas” y rechaza el castigo carcelario. Los tratamientos para rehabilitar a los
adictos a las drogas han demostrado que la adicción, para ser erradicada, necesita de un
tratamiento terapéutico profesional monitoreado con apoyo familiar, supervisión logística, la
medicación antidroga prescripta y control toxicológico habitual.

La guerra y las drogas

Muchos soldados que combatieron en Afganistán y sufrieron el dolor de alguna amputación
son ahora víctimas del estrés post-traumático de la guerra y de la adicción a las drogas contra el
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dolor. En este y otros casos parecidos, en el Veteran Medical Center prescribían drogas
altamente adictivas para combatir el dolor, lo que coadyuvó en la adicción. El US Department
of Veteran Affairs reconoció su error al haber creado un grupo de veteranos adictos a
medicamentos derivados del opio tras la prescripción de medicamentos “en demasía”.

Los medicamentos anti-adicción

Estos medicamentos previenen los síntomas de la falta de la droga en el cuerpo y tienen la
forma de una película bucal que se disuelve debajo de la lengua. Naloxona, Narcan, Metadona y
Buprenorfina (Bupe) son los más comunes. Bupe es la prescripción más diversificada después
de las que contienen oxycodona (Percocet) e hidrocodona (Vicodin). Las propiedades químicas
de Bupe son menos riesgosas que las de Methadone en caso de sobredosis y los médicos pueden
recetarlas para el uso por 30 días.

Problemas Colaterales:
-Volver a usar opioides ilegales mientras están tomando la antidroga Bupe.
-Vender trozos de bupe a otros adictos.
-Mezclar opioides con alcohol.
-Abandonar el tratamiento prematuramente.

¿Qué es el Fentanyl?
Es una droga sintética derivada del opio para combatir el dolor, altamente adictiva y 50 veces
más potente que la heroína. Su venta ha proliferado, ubicándose como un fármaco de stock “in
crescendo”, cuya compañía ganó $550 millones en el 2016.

¿Qué es el Carfentanil?
Es un nuevo y poderoso narcótico sintético producido en laboratorios clandestinos en China y
enviado a Estados Unidos. Es 100 veces más potente que el Fentanyl y 10 mil veces más
poderoso que la morfina, de acuerdo con la DEA (Drug Enforcement Administration). Esta
droga es conocida como “the murder weapon” y puede ser fatal, ya que es absorbida por la piel
instantáneamente.

______________________________________________________________________

The opioid epidemic or opioid crisis is the rapid increase in the use of prescription and non-
prescription opioid drugs in the United States and Canada in the 2010s. Opioids are a diverse
class of very strong painkillers, including oxycodone (commonly sold under the trade names
OxyContin and Percocet), hydrocodone (Vicodin), and fentanyl, which are synthesized to
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resemble opiates such as opium-derived morphine and heroin. The potency and availability of
these substances, despite their high risk of addiction and overdose, have made them popular
both as formal medical treatments and as recreational drugs. Due to their sedative effects on the
part of the brain which regulates breathing, opioids in high doses present the potential
for respiratory depression, and may cause respiratory failure and death.

According to the U.S. Drug Enforcement Administration, "overdose deaths, particularly from
prescription drugs and heroin, have reached epidemic levels. Nearly half of all opioid overdose
deaths in 2016 involved prescriptions. From 1999 to 2008, overdose death rates, sales,
and substance abuse treatment admissions related to opioid pain relievers all increased
substantially. By 2015, annual overdose deaths surpassed deaths from both car accidents and
guns.

Drug overdoses have since become the leading cause of death of Americans under 50, with two-
thirds of those deaths from opioids. In 2016, 62,000 Americans died from overdoses, 19 percent
more than in 2015, and had killed more Americans in one year than both the wars in Vietnam
and Iraq combined. By comparison, the figure was 16,000 in 2010, and 4,000 in 1999. Figures
from June 2017 indicate the problem has worsened. While death rates varied by state, public
health experts estimate that nationwide over 500,000 people could die from the epidemic over
the next 10 years.

In March 2017, the governor of Maryland declared a state of emergency to combat the opioid
epidemic and in July 2017 opioid addiction was cited as the "FDA's biggest
crisis. CDC director Thomas Frieden said that "America is awash in opioids; urgent action is
critical. The crisis has changed moral, social, and cultural resistance to street drug alternatives
such as heroin. On August 10, 2017, President Trump agreed with his Commission's report
released few weeks earlier and declared the country's opioid crisis a "national emergency”

Main causes
"The Opioid Crisis" likely began with over-prescription of powerful opioid pain relievers in the
1990s, which led to them becoming the most prescribed class of medications in the United
States. As of 2016 more than 289 million prescriptions were written for opioid drugs per year. In
the late 1990s, many Americans were diagnosed with chronic pain, estimated to affect around
100 million people or a third of the U.S. population. This led to a push by drug companies and
the federal government to expand the use of painkilling opioids. Between 1991 and
2011, painkiller prescriptions in the U.S. tripled from 76 million to 219 million per year. Among
the most common opioids prescribed have been oxycodone (OxyContin and Percocet)
and hydrocodone (Vicodin). With the increase in volume, potency of opioids also increased. By
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2002, one in six drug users were being prescribed drugs more powerful than morphine; by 2012,
the ratio had doubled to one-in-three.

Despite the increased use of painkillers, there has been no change in the amount of pain reported
in the U.S. This has led to differing medical opinions, with some noting that there is little
evidence that opioids are effective for chronic pain not caused by cancer.

Effects

When people continue to use opioids beyond what a doctor prescribes, whether to minimize
pain or to enjoy the euphoric feelings, it can mark the beginning stages of an opiate addiction,
with a tolerance developing and eventually leading to dependence, when a person relies on the
drug to prevent withdrawal symptoms.

As the number of opioid prescriptions rose, drug cartels began flooding the U.S. with heroin.
For many opioid users, heroin was cheaper, more potent, and often easier to acquire than
prescription medications. According to the CDC, tighter prescription policies by doctors did not
necessarily lead to this increased heroin use. The main suppliers of heroin to the U.S. have been
Mexican transnational criminal organizations.[8]From 2005–2009, Mexican heroin production
increased by over 600%, from an estimated 8 metric tons in 2005 to 50 metric tons in
2009. Between 2010 and 2014, the amount seized at the border more than doubled. According
to the DEA, smugglers and distributors "profit primarily by putting drugs on the street and have
become crucial to the Mexican cartels.

Buprenorfina sublingual y bucal (dependencia opiácea)

La buprenorfina y la combinación de buprenorfina y naloxona se usan para tratar la dependencia
a los opiodes (la adicción a los medicamentos opioides, incluso la heroína y los analgésicos
narcóticos). La buprenorfina sola y la combinación de buprenorfina y naloxona trabajan para
prevenir los síntomas de abstinencia cuando alguien deja de tomar medicamentos opiáceos al
producir efectos similares a los de estos medicamentos.

¿Cómo se debe usar este medicamento?

La presentación de la buprenorfina es en tableta sublingual. La combinación de buprenorfina y
naloxona viene como tableta sublingual (Zubsolv) y como película sublingual (Suboxona) para
colocarla debajo de la lengua y como película bucal (Bunavail) para aplicarla entre la encía y la
mejilla. Después de que su médico determine una dosis apropiada, estos productos se toman
usualmente una vez al día. Para ayudarle a recordar que tome o aplique la buprenorfina o
buprenorfina y naloxona, tómela o aplíquela aproximadamente a la misma hora todos los días.
Siga atentamente las instrucciones que se encuentran en la etiqueta de su receta médica y pida a
su médico o farmacéutico que le explique cualquier parte que no comprenda. Tome o aplique la
buprenorfina o la buprenorfina y naloxona exactamente como se le indica. No tome ni aplique
más o menos del medicamento, ni lo aplique con más frecuencia de lo que indica la receta de su
médico.

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Why is this medication prescribed?
Buprenorphine (Belbuca) is used to relieve severe pain in people who are expected to need pain
medication around the clock for a long time and who cannot be treated with other medications.
Buprenorphine (Belbuca) should not be used to treat pain that can be controlled by medication
that is taken as needed. Buprenorphine (Belbuca) in a class of medications called opiate partial
agonists. It works by changing the way the brain and nervous system respond to pain.

How should this medicine be used?

Buprenorphine (Belbuca) comes as a buccal film to apply inside the cheek. It is usually applied
twice a day. Apply buprenorphine (Belbuca) at around the same times every day. Follow the
directions on your prescription label carefully, and ask your doctor or pharmacist to explain any
part you do not understand. Use buprenorphine (Belbuca) exactly as directed.

Your doctor will probably start you on a low dose of buprenorphine (Belbuca), either once daily
or every 12 hours, and gradually increase your dose, not more than once every 4 days. Your
doctor may decrease your dose if you experience side effects. Tell your doctor if you feel that
your pain is not controlled or if you experience side effects during your treatment with
buprenorphine (Belbuca). Do not change the dose of your medication without talking to your
doctor.

Do not stop using buprenorphine (Belbuca) without talking to your doctor. Your doctor will
probably decrease your dose gradually. If you suddenly stop using buprenorphine (Belbuca),
you may have symptoms of withdrawal. Call your doctor if you experience any of these
symptoms of withdrawal: restlessness, teary eyes, runny nose, yawning, sweating, chills, muscle
and back aches, large pupils (black circles in the center of the eyes), irritability, anxiety,
difficulty falling asleep or staying asleep, diarrhea, nausea, vomiting, decreased appetite,
stomach cramps, pain in the joints, weakness, fast heartbeat, or rapid breathing.

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