“People never knew they were taking an opioid. They thought it was cocaine.”

The health authorities in the province of Buenos Aires, in Argentinaremain on high alert after at least 23 people died after consuming what they believed to be cocaine.

However, it is still not clear what exactly the victims consumed or why it caused their death.

LOOK: “Dad doesn’t wake up”: the drama experienced by the family of one of the victims who used adulterated cocaine in Argentina

After analyzing the symptoms of some of the patients, some doctors in the province of Buenos Aires have begun using drugs to treat opioid overdoses, in some cases with success.

BBC Mundo spoke with Dr. Carlos Damin, head of the toxicology service at the Fernández hospital, in the Argentine capital, who is also a member of the International Scientific Network of the United Nations Commission on Drugs and Crime and scientific director of the NGO Fundartox, about what is known about the case.

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What do we know about the substance that led to the death of these 23 people in the province of Buenos Aires?

In this case, what we assume, because we still do not have confirmation, is that there was an adulteration of the cocaine with an opioid. Actually, we still have no certainty that there was cocaine, we are waiting for the results of the analysis of the samples.

People bought cocaine, used what they thought was cocaine, and in some cases met death. There is talk of adulterated cocaine, but since we still do not have the samples and the symptoms of the patients were opioids and not cocaine, the truth is that we do not know if it was adulterated cocaine or if it is simply opioids.

Health workers take a person on a stretcher to the emergency room in a hospital. (GETTY IMAGES).

We had a hard time realizing what it was. We found out some time later, when we saw how the patients presented themselves at the hospital. We thought it was an opioid. We treated him with the opioid antidote and they responded favorably.

But we suppose that it is possible that even some rodenticide was involved. Why? Because we have several patients with hemorrhages. That is not a symptom of opioid or cocaine.

What types of substances are commonly used to cut cocaine?

Normally, what you see is that they adulterate cocaine with stolen drugs, with paracetamol, ibuprofen, powdered sugar, talcum powder, whatever. There is bicarbonate. We have found many substances. Once we found an antifungal.

What happens is that many times these medications are stolen and those crushed medications are a white powder and end up in the illegal cocaine trade. But normally these cutting substances, of adulteration, do not have an impact on the health of the consumer. They are simply selling you adulterated merchandise for an economic purpose.

Nobody can think that they have cut cocaine with a much more expensive substance.

GETTY IMAGES.

With this case, can it be said that the consumption of opioids, such as fentanyl, is seeing a similar increase in Argentina to what they are having in other countries such as the US?

The issue is that in Argentina there were never opioids.

In this country we do not have illegal consumption of opioids, there is very little through tramadol [un opioide vendido bajo fórmula médica para el dolor]. Someone who consumes, who gets the prescription, goes and buys it and takes the tramadol tablets.

But we have a handful of patients, no more.

According to several studies, Argentina is the third country with the highest consumption of cocaine in America. Why do you think that happens?

I think there are several factors: on the one hand, the idiosyncrasies of society. Cocaine clearly appears here in the 90s and appears accompanied by a social change that was that everything had to be on top and you had to always be first. And cocaine accompanied that.

Then smokeable cocaine was installed [crack], Argentina was very high in the consumption of smokeable cocaine. Then smoked cocaine disappeared and recently injectable cocaine began to appear again.

There will also be social, economic and educational variables that lead to cocaine being chosen. And I think that the economic and market formats have favored this consumption.

It is likely that if opioids enter this country they will also be a success. They never got in. And I think that has to do with distance. We live very far from the world and so I imagine that the circulation route of illegal substances must be complicated for them to come here.

It is not yet known with certainty what substances the intoxicated people consumed. (GETTY IMAGES).

Unfortunately, cocaine use has become increasingly common in certain settings, with people using it recreationally thinking they are not addicted. How addictive is cocaine really?

When one talks about the table of capacity to generate dependence after opiates, cocaine has the second place, that is, cocaine has an enormous capacity to generate dependence.

It is true that when one looks at the consumer universe there are more people using than abusing and being dependent. This does not mean that cocaine does not have a very high capacity to generate dependence.

In fact, that person who begins to consume ends up as with alcohol, convinced that he consumes because he wants to and not because he needs to. There is a denial of necessity. But that’s part of the dependency

Cocaine is far above marijuana and even above nicotine.

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Source: Elcomercio