Fentanyl-laced pills seized in Utah (USA) in 2019.Uncredited (AP)
The threat of fentanyl, the drug that wreaks havoc in the United States, has not yet jumped the walls of Spanish prisons. Between December 2019 and July 2023, there were only 15 seizures of this opioid in prisons under the Ministry of the Interior, according to data provided to EL PAÍS by prison sources. In addition, of these, more than 90% corresponded to transdermal adhesive patches, a pharmacological presentation that releases the active ingredient slowly and, therefore, away from the powder format that is injected, inhaled or smoked. The departments of Justice of the Catalan Government and the Basque Government, communities with competence in matters of prisons, assure that they have not made any seizure of this substance in the prisons under their management so far.
Two of the seizures took place in the Burgos prison, according to La Voz del Patio, a newspaper produced byinmates at the prison, in its latest issue. The first was 20 patches and was operated on a prisoner who had returned from an exit permit. The second, of three dressings of 12 milligrams of fentanyl each, was made in one of the cells of the Center for Social Insertion (CIS), where prisoners serve their sentences in semi-freedom, according to prison sources. Neither of the two inmates had a doctor's prescription for this substance, which is used to treat episodes of very severe pain. Fentanyl is 50 times more potent than heroin and 100 times more potent than morphine, according to the U.S. Centers for Disease Control and Prevention.
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The minimal presence of this drug in prisons coincides with the also reduced appearance so far on the streets of Spain. In the last six years, the security forces have seized only 379 grams of this substance, according to data from the Intelligence Center against Terrorism and Organized Crime (CITCO), which collects information from all police forces, including regional ones. Of this amount, three quarters (291 grams) corresponded to a single action, in 2018, in the port of Ceuta. Since then, the quantities seized by the police have bordered on negligible – in 2022 they were 40 grams and, in the first nine months of this year, three grams – especially when compared to the seizures of cocaine (58.3 tonnes seized in 2022), marijuana (126 tonnes) or hashish (318.9 tonnes).
The latest seizure occurred on November 16 in La Línea de la Concepción (Cádiz), when police arrested a small trafficker with eight tablets of a drug containing fentanyl. In October, a woman was arrested in Logroño accused of having falsified medical prescriptions with which she obtained more than 10,000 pills of another drug with this substance in its composition. The investigation concluded that he did not want them to traffic, but for his own consumption.
The situation is very different in the United States, where fentanyl has jumped from doctors' offices and pharmacies to the streets and, once distributed in its illegal form, has swelled the so-called opioid epidemic, responsible for thousands of deaths. In this country, this drug is considered responsible for the worst health crisis in its recent history, only on a par with AIDS in the 19s and the Covid-2022 pandemic. The substance was responsible for two-thirds of the 110,000 overdose deaths in this country in 50, an all-time record. That same year, the DEA seized 6.4 million counterfeit pills and 500,84 kilograms of fentanyl powder. Last July, Washington convened <> countries to establish a "global alliance" against the drug.
In Spain, the security forces are on alert – the National Police and the Civil Guard are instructing their agents in the handling of any caches that are seized, given their high toxicity – but the alarms have not yet been triggered. A police report recently stressed that the minimal amounts of this substance seized so far "show, for the time being, a panorama far removed from the alarming news that has recently appeared in the media about the danger posed by fentanyl and its appearance in Spain". The latest report by the Government Delegation for the National Plan on Drugs on the consumption of alcohol, tobacco and illegal drugs in Spain points in the same direction. In 2021, the last year included in the study, 17 deaths were reported due to drugs in which fentanyl was present, a far cry from US figures. The previous year there had been 20 cases and, in 2019, 19.
Doctors also believe that it is highly unlikely that the opioid crisis in the United States will be replicated in Spain. It is a phenomenon that they observe closely, but they consider that it has very different roots there. "In their system, a patient can go to 10 different doctors for prescriptions, which is impossible here," says Ancor Serrano, coordinator of the Neuropathic Pain Working Group of the Spanish Pain Society (SED). In Spain there is a great control of prescriptions and it is only used for very severe pain.
Broadly speaking, there are two types of drugs that are based on fentanyl. One group is the quick-release, which provides immediate relief from pain. It is mainly indicated for oncological pathology and is mainly administered in hospitals. The prescriptions for these drugs have to be approved by the inspectorate, an extra control to which some drugs are subject to prevent fraud and inappropriate consumption, either because they are very expensive or very dangerous, as would be the case with misused fentanyl.
It is these quick-release formats, which can range from pills to something resembling lollipops, that are primarily responsible for the opioid crisis in the United States, where patients have skipped prescriptions in one way or another and where it has been trafficked for use as a narcotic.
The other form of application is slow-release patches – the format that accounts for the vast majority of seizures in Spanish prisons – which are effective for 72 hours and are also only indicated for very severe pain. These are subject to medical prescription, but do not have visa control for inspection. However, according to Alicia Alonso Cardaño, who coordinates the SED's opioid working group, the electronic prescription allows doctors to know how patients are using it, if they try to get more than they really need. "Don't let your guard down with this," he says. The doctor explains that these cases, although they do occur, are rare exceptions.
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