Mortality from cocaine in Medellín is three times higher than the world rate

To seek the sensation of pleasure, many cocaine addicts are nearing death, which in Medellín and Antioquia is almost three times the world rate: while here 3.8% of the intoxicated die, in the world the studies speak of 1%.

This has just been determined by the Hospital San Vicente Fundación in an investigation carried out on patients who arrived at the highly complex emergency room intoxicated by the high consumption of the hallucinogen.

The study also confirmed that the effects on consumers do not occur only at the level of the mind and brain but also on the body, with compromises for organs such as the kidneys, liver, heart and central nervous system.

If the patients live in conditions of poverty the consequences are worse, because there is little chance to intervene and start detoxification treatments on time.

The most worrying finding for the researchers, however, was the mortality rate detected among the patients, since it is at a level of prevalence of 3.8%, in contrast to the global one, which according to the researchers is 1%, warned Juliana Quintero Aguirre, a toxicologist at the clinic and a member of the research team.

This higher prevalence, Dr. Quintero and her team attribute to factors such as the ease of acquiring cocaine due to its low price at the national level local, its high potency in the country and the mixtures that are made to achieve greater effects among consumers.

“Here the cocaine is made more potent and mixed with caffeine, anesthetic drugs and even for veterinary use,” says the health professional.

He emphasizes that acquiring it is so easy, that even in Medellín there is tourism associated with the consumption of narcotics, which increases the number of consumers.

Other aggravating factors

In addition to the above, a large number of the patients who consult also have a low educational level and a condition of poverty that limits their access to health, which means that when they go to seek help their affectations are much more advanced and aggravated, which triggers greater consequences, such as death.

“These people do not have the resources to start a detoxification process, the costs of which are generally high, and more sick people come to the consultation,” warns the professional Quintero, spokesperson for the hospital for this investigation.

This study adds to an investigation by the Ministry of Justice carried out in Colombia in the period 2013-2020 and recently disclosed, in which 28,541 deaths associated with drug use were identified, “taking into account that (the victims) presented positive toxicology results associated with psychoactive substances; the main substances found were alcohol, cocaine and marijuana, although 37 cases were found associated with morphine and 19 with tramadol”, says the report. The investigation also identified five deaths associated with the consumption of fentanyl, a substance for which there was no known mortality reference in Colombia, but which currently causes thousands of deaths in the United States and Canada (see graph on type of consumption).

The seriousness of the situation is that mortality due to drugs, established the Ministry of Justice, is that beyond the consumers themselves, there are third parties who receive the impact. According to the conclusions, various local and international studies refer to a relationship between traffic accidents, as well as the commission of crimes and the consumption of psychoactive substances, which makes it relevant to carry out toxicological tests to identify psychoactive substances in each of the victims who enter the hospital. Institute of legal medicine.

Sequelae in the organism

On the other impacts left by the consumption of the hallucinogen, the San Vicente investigation found sequelae at the renal and hepatic level. These, although known in advance, were thoroughly analyzed in the 159 patients included in the study to take advantage of the fact that the institution has a team of professionals to support research.

“In the country, toxicologists are scarce, not all hospitals have them and they generally cover basic consultations,” Quintero said to explain the few advances that were made to detect affectations at the body level.

The study covered four years and was carried out among patients who came to a highly complex consultation and who were attended between the years 2016 and 2019, according to clinical history, positive cocaine test and no underlying disease that directly affected survival.

The investigation found that the majority of the patients were men, with a low educational level and a mean age of 31 years, and in addition to the high prevalence of mortality, they also suffered acute kidney injury (AKI) in 29.6% of the cases; acute liver failure in 8.8%; acute myocardial infarction in 4.4%; and cerebrovascular attack (CVA) also in 4.4% of cases.

“Elevated levels of phosphocreatine kinase (CPK), which are residues after muscle destruction caused by intoxication, which in their normal values ​​are close to 100, were greater than 1,000 in 80% of patients with these organ failures. , a value that is very high and correlates with the severity of the poisoning and the probability of injuries such as kidney damage”, details the study in question.

An article published by the Nida (National Institute on Drug Abuse), a US government institution whose mission is to advance knowledge of the causes and consequences of drug use and addiction, states that more research is needed on the combined use of stimulants and opioids and how their combination accelerates the risk of falling into an overdose of consumption.

“Unfortunately, death certificates do not always mention the drugs identified And when they do, they may not be precise about which drugs were the main contributors to death, making it difficult to know exactly what role opioids and stimulants play when people deliberately or accidentally use the two substances together. ”, says the text of Nida.

difficult treatment

In general, the cure for all these ills for those addicted to cocaine and hallucinogens in general is to overcome the dependency, that is, to stop using it. But it is known how complex this situation is. If the patient arrives intoxicated it is more difficult.

We must start from the fact that beyond the cases of overdose, frequent users of stimulants begin to suffer from health problems such as heart and lung diseases and even at a cognitive level.

But there are additional risks, such as infection with the HIV virus (AIDS) and hepatitis B and C, due to the fact that the addict shares syringes and anxiety makes it easy for them to fall into relationships in order to obtain a dose. sex without proper protection.

Another aggravating circumstance that increases the risk of suffering from diseases such as those mentioned is that consumers tend to require higher doses with increasing anxiety, which generates states of irritability and paranoia, even reaching hallucinations.

The toxicologist Quintero Aguirre points out that timely consultation and acceptance of the treatments, which are aimed at stopping consumption, would be enough for the risks of suffering from the indicated diseases to disappear.

“Only under consumption at 30 years can one die of a myocardial infarction or bleeding in the head, ills that are typical of elderly people,” he conceptualized.

But under the conditions in which consumption is taking place in the city and the department, a high percentage of patients are requiring treatments such as heart mesh, dialysis, and even surgeries.

29,6%

is the prevalence of acute kidney injury in patients treated in San Vicente.

45

years is the mean age of patients who presented acute myocardial infarction.

Infographic

360

registered cases of perforated partitions, in a period of two years, set off the alerts.

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