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Summary:
Spain is not experiencing a heroin surge. Nor is it experiencing an opioid health crisis comparable to that in the United States. All indicators related to heroin use exclude an increase. Prevalence of use, hospital emergencies due to acute reactions, mortality, treatment demand, administrative sanctions for possession or use in public places and arrests for retail sales are stable or tending to decrease. Some of these indicators refer to 2015 or 2016, although through fieldwork and complementary documentation we can confirm that the trend is similar in subsequent years. We do not have any solid evidence that would allow us to affirm that the prevalence of consumption or the other indicators will increase in the coming years. As a result, Spain is far from experiencing an upsurge in heroin use or other problems related to opioid abuse. Moreover, heroin cannot “come back” because it never left, remaining invisible in the eyes of public opinion, but present in marginal contexts.
Spain faces multiple socio-health challenges in the field of opioids. There are five scenarios that require attention and socio-political responses: fentanyl trends, the situation of the user population, the fear of an alleged relapse, the scenario of opioid drugs and the phenomenon of “narcopisos”. Young people far removed from the world of heroin will never be attracted to it as long as the social representation that associates it with addiction and death remains in the collective memory. Moreover, the psychoactive pool available on the Spanish market offers a wide range of substances; as long as this remains the case, nothing will lead young people to seek heroic effects. In the case of opioids, the national health system and all its implications act as a protective mechanism against any hypothetical crisis. And if the various opioids were to cause problems, Spain has a high-quality healthcare network that would quickly and effectively mitigate the ravages of the new scenario.
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