Opioid and Substance Abuse in Latin America

Scenario: Opioid and Substance Abuse in Latin America

Carla is a 26-year-old woman from Medellin, Colombia. She works as a server in a local restaurant. Her employer found her unresponsive in the restaurant's staff room and took her to the local hospital. After she was revived with the opioid antagonist naloxone (called la naloxona in Colombia), Carla was found to have nearly overdosed on opioids. Carla admitted to hospital staff that this was part of a pattern of episodic drug use she had engaged in over the past decade of her life.

Additionally, read the World Opioid and Substance Use Epidemic: A Latin American Perspective article to get a more holistic view of the opioid crisis in Latin America.

Prompt

Apply your disciplinary perspective to analyze and prioritize the major determinants of health implied by the case. In other words, defend your professional viewpoint regarding the most important factors that contribute to the health challenge. Then, in your responses, work as a group to refine those initial assessments.

In your initial post, address the following elements. Provide at least one scholarly source from the last five years to support your claims:

Identify the most important mental health considerations for this case. In other words, which mental health challenges are most relevant for understanding and addressing Carla's case? Be sure to substantiate your claims with evidence.
Identify the most important nutritional considerations for this case. In other words, which nutrient deficiencies are most relevant for understanding and addressing Carla's case? Be sure to substantiate your claims with evidence.
Identify the most important food safety and insecurity considerations for this case. In other words, which drivers of food insecurities are most relevant for understanding and addressing Carla's case? Be sure to substantiate your claims with evidence.

Full Answer Section
  • Depression: Depression is characterized by feelings of sadness, hopelessness, and fatigue. People with depression may use drugs like opioids to escape from their negative emotions. A study published in the journal "Journal of Affective Disorders" found that depression was more common among people with SUD than among the general population.

Nutritional Considerations

Opioid use can lead to a number of nutritional deficiencies, including:

  • Iron deficiency anemia: Iron is an essential mineral that is needed to produce hemoglobin, which carries oxygen throughout the body. Opioid use can interfere with iron absorption. A study published in the journal "Nutrition" found that iron deficiency anemia was common among people with SUD.

  • Vitamin D deficiency: Vitamin D is important for bone health and immune function. Opioid use can interfere with vitamin D absorption. A study published in the journal "Journal of Clinical Endocrinology and Metabolism" found that vitamin D deficiency was common among people with SUD.

  • B vitamin deficiency: B vitamins are important for energy production and brain function. Opioid use can interfere with the absorption of B vitamins. A study published in the journal "American Journal of Clinical Nutrition" found that B vitamin deficiency was common among people with SUD.

Food Safety and Insecurity Considerations

Food safety and insecurity can contribute to substance use in several ways:

  • Stress: Food insecurity can be a major source of stress, which can lead to unhealthy coping mechanisms such as substance use. A study published in the journal "Public Health Reports" found that food insecurity was associated with an increased risk of substance use.

  • Limited access to healthy food: People who are food insecure may have limited access to healthy food choices, which can lead to nutritional deficiencies that can exacerbate substance use problems. A study published in the journal "Addiction" found that people who were food insecure were more likely to use opioids than those who were not food insecure.

  • Exposure to trauma: People who are food insecure may be more likely to experience trauma, such as childhood neglect or abuse. Trauma can increase the risk of developing SUD. A study published in the journal "Journal of Trauma and Dissociation" found that people with a history of trauma were more likely to have a SUD than those who did not have a history of trauma.

Conclusion

Carla's case highlights the complex interplay of mental health, nutrition, food safety, and food insecurity that can contribute to substance use. Addressing these underlying factors is essential for preventing and treating substance use disorders.

Source:

  • Pacurucu-Castillo, R. A., & Altamura, A. C. (2019). World Opioid and Substance Use Epidemic: A Latin American Perspective. Psychiatric Research and Clinical Practice, 19(10), 1-16.
Sample Answer

Mental Health Considerations

Carla's history of episodic drug use over the past decade suggests that she may be struggling with mental health challenges, such as:

  • Substance use disorder (SUD): SUD is a chronic relapsing brain disorder characterized by compulsive drug use despite harmful consequences. Carla's repeated use of opioids despite the risk of overdose suggests that she may have developed a dependence on these substances.

  • Anxiety: Anxiety disorders are characterized by excessive worry, fear, and restlessness. People with anxiety disorders may use drugs like opioids to self-medicate their symptoms. A study published in the journal "Addiction" found that anxiety disorders were more common among people with SUD than among the general population.