Kodi inunso mumakonda kugwiritsa ntchito mankhwala ochepetsa ululu awa? Tiyeni tikambirane za Opioid Use Disorder!

Lero tikambirana za nkhani yovuta pang'ono, koma yofunika kwambiri. Mwina mwamvapo kuti pali mitundu ina ya mankhwala ochepetsa ululu omwe muyenera kusamala nawo kwambiri. Mankhwalawa amatchedwa opioids . Ngati muwagwiritsa ntchito molakwika, kutanthauza kuti, ngati muwamwa mopitirira muyeso popanda upangiri wa dokotala, kapena ngati muwamwa pazinthu zina, mutha kukhala chizolowezi chawo osazindikira. Ichi ndi chomwe timachitcha Opioid Use Disorder (OUD) .

Mwachidule, kodi vuto la kugwiritsa ntchito opioid ndi chiyani?

Tangoganizani kuti dokotala wakulemberani opioid yothandiza kupweteka kwina. Koma mumamwa mopitirira muyeso womwe mwapatsidwa, kapena kwa nthawi yayitali kuposa nthawi yomwe mwapatsidwa. Patapita kanthawi, simungathe kukhala popanda mankhwalawa, mumamva ngati muyenera kumwa, ndipo ngati simumwa, mumamva kusakhazikika ndipo mumavutika. Izi zimayamba kukhudza zochita zanu za tsiku ndi tsiku, ubale wanu ndi banja, ntchito yanu, ndi zina zonse. Mwachidule, apa ndi pamene kugwiritsa ntchito opioid kwanu kumalephera kulamulira ndipo kumabweretsa mavuto m'moyo wanu.

Izi zitha kuchitikanso m'njira zosiyanasiyana. Anthu ena akhoza kukhala ndi zizindikiro zochepa , ena zizindikiro zochepa , ndipo ena akhoza kukhala ndi zizindikiro zoopsa . Ikhozanso kukhala matenda a moyo wonse (osatha) . Chifukwa chake, ndikofunikira kwambiri kuzindikira ndikupeza chithandizo msanga.

Kodi ma opioid awa ndi chiyani?

Ma opioid ndi gulu la mankhwala, omwe amapezeka mwachilengedwe (Opiates) komanso opangidwa ndi mankhwala (Opioids), omwe amathandiza kuchepetsa ululu. Amagwira ntchito pogwira ntchito m'maselo athu a mitsempha kuti achepetse ululu.

Madokotala amalemba izi pa zinthu monga ululu waukulu pambuyo pa ngozi, ululu pambuyo pa opaleshoni, ndipo nthawi zina pa ululu wa nthawi yayitali. Mwachitsanzo:

• 'Oxycodone'
• `Oxymorphone`
• 'Morphine'
• `Kodeini`
• `Fentanyl`

Kupatula izi, Heroin, yomwe imapangidwa kuchokera ku Morphine, ndi mankhwala osokoneza bongo omwe ali m'gulu lomweli.

Mankhwala a opioid awa samangochepetsa ululu, komanso amapangitsa anthu ena kumva chimwemwe komanso kumasuka (euphoria). Pakapita nthawi, mlingo wa mankhwalawa uyenera kuwonjezeredwa kuti apeze mpumulo womwewo ( kulekerera ). Ichi ndichifukwa chake chiopsezo cha chizolowezi chimakhala chachikulu.

Koma kumbukirani kuti si aliyense amene amamwa mankhwalawa kwa kanthawi kochepa monga momwe dokotala wanenera adzakhala wozolowera. Ngati mutsatira malangizowo molondola, chiopsezo cha kuzolowera mankhwalawa chimakhala chochepa.

Kodi kusiyana pakati pa chizolowezi ndi kudalira kwambiri ndi chiyani?

Izi ziwiri ndi zosokoneza pang'ono, koma ndikofunikira kumvetsetsa.

Kudalira opioid kumachitika pamene thupi lanu lizolowera mankhwalawo. Izi zikutanthauza kuti pakapita nthawi, mlingo womwe mudamwa umakhala wosagwira ntchito (kulekerera) kapena mumakhala ndi zizindikiro zosiya kumwa mankhwala monga nseru, kusanza, ndi kupweteka kwa thupi mukasiya kumwa mankhwalawa.Zizindikiro zosiya kumwa mankhwala .

Matenda Ogwiritsa Ntchito Opioid (OUD) amapitirira apo. Apa, njira yanu yogwiritsira ntchito mankhwala osokoneza bongo ikuyambitsa mavuto m'moyo wanu, koma simungathe kuilamulira. Izi zitha kuphatikizapo kudalira thupi komanso kudalira maganizo. Izi zikutanthauza kuti mankhwalawa amalamulira malingaliro anu, momwe mumamvera, komanso zochita zanu, ndipo mumakhala ndi chilakolako champhamvu (chofuna) kumwa.

Ndani akumva izi? Kodi ndizofala bwanji?

Matenda a opioid angayambe mwa aliyense, mosasamala kanthu za msinkhu, fuko, jenda, kapena udindo wake m'gulu.

Akuti pakati pa 3% ndi 19% ya anthu omwe amamwa mankhwala ochepetsa ululu a opioid omwe amalembedwa ndi dokotala akhoza kukhala ndi vutoli. Mankhwalawa akavuta kupeza, anthu ena amagwiritsa ntchito zinthu zomwe zimapezeka mosavuta, monga heroin. Izi zikusonyeza kuopsa kwa matendawa.

Anthu opitilira 20 miliyoni padziko lonse lapansi, ndi opitilira 3 miliyoni ku United States, akuvutika ndi vutoli. Lakhala mliri m'maiko ena. Mankhwala ophera tizilombo toyambitsa matenda amenewa ndi omwe amachititsa imfa zopitilira 100,000 padziko lonse lapansi chaka chilichonse.

Kodi zizindikiro za vuto la kugwiritsa ntchito opioid ndi ziti?

Malinga ndi buku la American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), munthu amene ali ndi vutoli akhoza kusonyeza zizindikiro izi:

• Kumwa mankhwala a opioid ochuluka kuposa momwe mwalangizidwira kapena kwa nthawi yayitali kuposa momwe mwalangizidwira.
• Chilakolako champhamvu kapena chilakolako chofuna kumwa mankhwala ochepetsa ululu.
• Kuyesa kuchepetsa kapena kulamulira kugwiritsa ntchito koma kulephera.
• Kupitiriza kugwiritsa ntchito mankhwalawa ngakhale kungayambitse mavuto pa ubale ndi anthu kapena ubale wawo.
• Kuthera nthawi yambiri ndikupeza, kugwiritsa ntchito, kapena kuchira ku mankhwala a opioid.
• Kulephera kukwaniritsa maudindo kuntchito, kusukulu, kapena kunyumba chifukwa chogwiritsa ntchito mankhwala osokoneza bongo.
• Kusowa kapena kuchepetsa zochita zina zofunika.
• Kugwiritsa ntchito ma opioid ngakhale m'mikhalidwe yoopsa (monga, mukuyendetsa galimoto).
• Kupitiriza kugwiritsa ntchito ma opioid ngakhale muli ndi vuto lakuthupi kapena lamaganizo lomwe lingayambitse ma opioid okha.
• Pakapita nthawi, mlingo wokwera umafunika kuti munthu apeze zotsatira zomwezo ( kulekerera ).
• Kusamva bwino mukasiya kumwa mankhwala (opioid withdrawal syndrome) kapena kumwa mankhwala ochepetsa ululu kapena china chofanana ndi ichi kuti mupewe kusamva bwinoko.

Ngati mukuganiza kuti muli ndi chimodzi kapena ziwiri mwa zizindikirozi, ndikofunikira kwambiri kupeza upangiri wa dokotala mwachangu momwe mungathere.

Kodi zizindikiro zosiya kumwa opioid ndi ziti?

Ngati mumadalira mankhwala a opioid mwakuthupi, kuwasiya mwadzidzidzi kungayambitse mavuto awa:

• Ululu thupi lonse
• Kuzizira, malungo
• Kuwawa kwam'mimba
• Ophunzira otambasuka
• Kusakhazikika, kusokonezeka
• Nkhawa
• Kusanza, kusanza
• Kulakalaka
• Kuthamanga kwa mtima ndi kuthamanga kwa magazi
• Kutuluka thukuta
• Kusowa tulo

Kodi munthu amakhala bwanji ndi vutoli?

Pali zifukwa zingapo za izi. N'zovuta pang'ono.

• Ma opioid amakhudza kapangidwe ka ubongo: Ma opioid amalimbikitsa malo omwe ali muubongo wathu omwe amalamulira zinthu monga chisangalalo ndi mphotho. Akamwedwa, neurotransmitter yotchedwa `endorphins' imatulutsidwa. Izi zimachepetsa ululu ndikukupangitsani kukhala osangalala. Mphamvu ya mankhwalawa ikatha, chisangalalocho chimathanso. Kenako mukumva ngati mukufuna kumwanso mankhwalawa kuti mumve chisangalalocho. Kudalira thupi kumatha kukula ngakhale m'masabata 4 mpaka 8 okha.
• Kukumana ndi mankhwala a opioid ndi kupezeka kwawo: Kukumana ndi mankhwalawo kumawonjezeka kudzera mu mankhwala oletsa ululu, kugwiritsidwa ntchito ndi achibale kapena abwenzi, komanso nthawi zina kudzera mu mankhwala osokoneza bongo. Nthawi zina, heroin ndi yosavuta kupeza kuposa mankhwala ovomerezeka. Masiku ano, mankhwala ambiri ogulitsidwa ngati heroin, cocaine, ndi mapiritsi ena amatha kukhala ndi opioid fentanyl yoopsa kwambiri. Izi zitha kukhala zoopsa pamoyo.
• Zinthu zokhudza majini ndi zamoyo: Kafukufuku akusonyeza kuti 40% mpaka 60% ya chiopsezo chokhala ndi chizolowezi cha mankhwala aliwonse chimachitika chifukwa cha zinthu zokhudzana ndi majini. Ngati wina m'banja mwanu (makolo, abale anu) ali ndi vutoli, inunso muli ndi mwayi waukulu woti mudwale nalo.
• Thanzi la maganizo ndi matenda ena: Kafukufuku wapeza kuti pafupifupi theka la anthu omwe ali ndi matenda amisala ali pachiwopsezo chokhala ndi chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo, ndipo pafupifupi theka la anthu omwe ali ndi chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo ali pachiwopsezo chokhala ndi matenda amisala. Mwachitsanzo, matenda monga kuvutika maganizo , matenda a nkhawa , ADHD, bipolar disorder, ndi PTSD zingakhudze izi. Komanso, anthu omwe ali ndi matenda akuthupi monga kupweteka kosatha akhozanso kukhala pachiwopsezo chokhala ndi vuto la kugwiritsa ntchito opioid.
• Zochitika Zoipa za Ubwana (ACEs): Ubale woipa pakati pa makolo ndi ana, nkhanza zapakhomo, nkhanza za ana, ndi kumangidwa kwa makolo ndi zina mwazinthu zomwe zimawonjezera chiopsezo chogwiritsa ntchito mankhwala osokoneza bongo.

Kodi mumazindikira bwanji izi?

Palibe mayeso amodzi oti apeze izi. Dokotala adzawunikanso mosamala mbiri yanu yachipatala komanso momwe mumagwiritsira ntchito opioid. Angagwiritsenso ntchito zinthu monga mayeso a mankhwala, zolemba zowunikira mankhwala, ndi zina zambiri.

Matenda a Opioid use disorder (OUD) amapezeka ngati pali zizindikiro ziwiri mwa zizindikiro za DSM-5 zomwe zatchulidwa kale .

• Ngati makhalidwe 2-3: OUD yochepa
• Ngati pali zizindikiro 4-5: OUD yapakati
• Zizindikiro 6 kapena kuposerapo: OUD yoopsa

Kodi mankhwala ake ndi otani?

Mwamwayi, pali mankhwala othandiza pa vutoli. Komabe, njira zochiritsira zimatha kusiyana malinga ndi munthu. Popeza vutoli ndi la nthawi yayitali, kupitiriza chithandizo ndikofunikira kuti munthu achire komanso kupewa kubwereranso kwa matendawa.

Pali njira zingapo zochizira:

• Uphungu kwa odwala akunja
• Chithandizo chamankhwala chapadera chakunja kwa dokotala
• Chithandizo cha nthawi yochepa cha nyumba
• Madera ochiritsira odwala kwa nthawi yayitali, monga madera opanda mankhwala osokoneza bongo

Chothandiza kwambiri mwa izi ndi kuphatikiza mankhwala ndi uphungu (Medication-Assisted Treatment - MAT).

Chithandizo cha maganizo cha OUD

Chithandizo cha Maganizo (CBT) ndi njira yayikulu yochizira matenda amisala yomwe imagwiritsidwa ntchito pachifukwa ichi. Pano, dokotala wa matenda amisala kapena mlangizi amalankhula mozama za malingaliro ndi momwe mukumvera. Amakuthandizani kumvetsetsa momwe malingaliro anu amakhudzira zochita zanu. Kudzera mu izi, amakuthandizani kusintha malingaliro ndi machitidwe osafunikira komanso kupanga malingaliro ndi zizolowezi zabwino.

Mapulogalamu odzithandiza okha a OUD

Kutenga nawo mbali m'magulu odzithandiza okha monga `Narcotics Anonymous` ndi chithandizo chabwino kwambiri cha chithandizo. Kudzera mu izi, munthu amatha kumvetsetsa vuto lake, kugawana zomwe akumana nazo ndi ena, ndikudzithandiza kuti akhale bwino.

Mankhwala a OUD

Pali mankhwala ena omwe angathandize kuchiza vutoli mwa kusintha kapangidwe ka ubongo. Mankhwalawa amatha kuchepetsa chilakolako, kuchepetsa zizindikiro zosiya kumwa mankhwala, komanso kuletsa zotsatira za opioid.

Pali mitundu itatu ikuluikulu ya mankhwala ovomerezedwa ndi US Food and Drug Administration (FDA):

• `Methadone` : Izi zimachepetsa zizindikiro za kusiya kumwa mankhwala komanso chilakolako chofuna kusiya kumwa mankhwala. Zimapezeka m'zipatala zapadera zokha.
• Buprenorphine : Izi zimaletsa zotsatira za mankhwala a opioid, kuchepetsa zizindikiro zosiya kumwa mankhwala komanso chilakolako chofuna kusiya kumwa mankhwala. Itha kumwedwa ngati piritsi kapena jakisoni pamwezi.
• `Naltrexone` : Izi zimalepheretsa chisangalalo chomwe mumapeza kuchokera ku ma opioid. Akhoza kumwedwa ngati piritsi kapena jakisoni pamwezi.

Kodi pali zovuta zilizonse pa chithandizochi?

Mwatsoka, munthu amene ali ndi matenda a OUD amakhala pachiwopsezo chachikulu cha imfa mkati mwa milungu inayi yoyambirira atayamba kulandira chithandizo komanso mkati mwa milungu inayi yoyambirira atasiya kulandira chithandizo.

Chifukwa cha izi ndi chakuti amayesa kumwa mlingo womwewo womwe ankagwiritsa ntchito kale, koma chifukwa chakuti thupi silikulekerera mankhwalawa, mlingowo ukhoza kukhala wokwera kwambiri zomwe zimapangitsa kuti munthu agwiritse ntchito mankhwala mopitirira muyeso.

Kodi mungapewe bwanji izi?

• Ngati inu kapena wina m'banja mwanu akufunika chithandizo cha ululu, lankhulani ndi dokotala wanu za mankhwala ochepetsa ululu omwe si a opioid kapena mankhwala ena.
• Ngati mwapatsidwa mankhwala a opioid, imwani monga momwe dokotala wanu wanenera, mu kuchuluka kwa mankhwala omwe mwapatsidwa, komanso nthawi zomwe mwapatsidwa. Musamwe mankhwala owonjezera. Musamaswe, kuphwanya, kapena kusungunula mapiritsiwo.
• Ngati mukumva kuti mumadalira mankhwala, kapena ngati mlingo womwe mwapatsidwa sukuthandizani kuchepetsa ululu wanu, musawonjezere mlingo nokha. Uzani dokotala wanu nthawi yomweyo.
• Musagawire mankhwala anu ndi wina aliyense. Sungani pamalo otetezeka omwe ana sangafikire.
• Ngati muli ndi mankhwala aliwonse a opioid otsala omwe munalandira kuchokera ku chithandizo, atayeni mosamala. (Mutha kufunsa ku pharmacy yanu.)
• Lankhulani ndi ana anu za kuopsa kwa mankhwala a opioid ndi kufunika kowagwiritsa ntchito monga momwe mwalangizidwira.

Kodi chimachitika ndi chiyani ngati chithandizo sichiperekedwa? (Zomwe zimachitika nthawi zambiri)

Ngati sichinachiritsidwe, zotsatira za OUD nthawi zambiri zimakhala zoipa. Anthu omwe ali ndi OUD yayikulu ali pachiwopsezo chachikulu cha:

• Kuvulala monga kugwa ndi ngozi zamagalimoto.
• Matenda opatsirana m'magazi monga Hepatitis B (HBV), Hepatitis C (HCV), ndi HIV amatha kufalikira kudzera mu singano zogawana.
• Kumangidwa.
• Kugwiritsa ntchito mankhwala osokoneza bongo a opioid.
• Imfa chifukwa cha kumwa mankhwala osokoneza bongo a opioid.
• Kudzipha.

Chiwerengero cha imfa cha anthu omwe ali ndi matenda a OUD ndi chokwera ka 10 kuposa cha anthu onse.

Koma kumbukirani, matenda a OUD ndi ochiritsika. Komabe, munthu m'modzi yekha mwa anthu anayi omwe ali ndi matenda a OUD ndi amene amalandira chithandizo cha akatswiri.

Chithandizo chothandizidwa ndi mankhwala (MAT) chimachepetsa kugwiritsa ntchito opioid, imfa zopitirira muyeso, komanso kufalikira kwa matenda opatsirana. Chimawonjezera magwiridwe antchito a anthu komanso kusunga chithandizo.

Kodi zizindikiro za kumwa mankhwala osokoneza bongo a opioid ndi ziti?

Kumwa mankhwala mopitirira muyeso kungachitike ngati munthu wamwa mankhwala ochulukirapo a opioid, kapena ngati wamwa mankhwala ena pamodzi ndi mankhwala ochepetsa ululu. Zizindikiro zake ndi izi:

• Kusayankha, kutaya chidziwitso.
• Kupuma kumachepa kapena kumasiya.
• Maso akuda ndi ang'onoang'ono kwambiri (`pinpoint pupils`).
• Kulira kapena phokoso lochokera pakhosi.
• Khungu lozizira, lofewa.
• Milomo yabuluu kapena misomali.

Mu mkhalidwe wotere, kuchitapo kanthu mwachangu ndikofunikira. Zotsatirapo za kumwa mopitirira muyeso zimatha kuthetsedwa mwachangu popereka mankhwala otchedwa `Naloxone` (omwe nthawi zambiri amadziwika ndi dzina lodziwika bwino la `Narcan®`). Komabe, ngakhale `Naloxone` ataperekedwa, chithandizo chamankhwala mwachangu chikufunika.

Ngati munthu amene mumamudziwa ali ndi vuto ngati ili, mungamuthandize bwanji?

Kupeza kuti munthu amene mumamukonda ali ndi matenda a OUD kungakhale kovuta kwambiri komanso kovutitsa maganizo. Nazi zinthu zina zomwe mungachite kuti muthandize munthu wotere:

• Lankhulani msanga: Munthu amene ali ndi matenda a OUD akalandira chithandizo mwachangu, zimakhala bwino. Lankhulani naye za nkhawa zanu ndipo muthandizeni kupeza chithandizo.
• Chitani mwachifundo:Ngakhale simukugwirizana nazo, mvetserani mosamala zomwe akunena. Mukamawamvetsera kwambiri, adzakukhulupirirani kwambiri.
• Khalani oleza mtima: Musayembekezere kuti vutoli lidzathetsedwa ndi kulankhula kamodzi kapena kuchitapo kanthu kamodzi. OUD ndi vuto lovuta komanso la nthawi yayitali.
• Ganiziraninso za inu nokha: Banja ndi abwenzi a anthu omwe ali ndi matenda a OUD angamvenso kupsinjika maganizo, kukhumudwa, chisoni, komanso kusungulumwa. Ganiziraninso za thanzi lanu la maganizo. Pezani thandizo ngati mukufuna thandizo.
• Khalani ndi Naloxone (Narcan®) pafupi: Ngati wokondedwa wanu amwa mopitirira muyeso, Naloxone ikhoza kupulumutsa moyo. Ngati n'kotheka, khalani ndi Naloxone pafupi nthawi zonse.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati mukumwa kale mankhwala a opioid ndipo mukukayikira ngakhale pang'ono kuti mukuyamba kugwiritsa ntchito mankhwalawo, lankhulani ndi dokotala wanu nthawi yomweyo.

Ngati mukukayikira kuti mwana wanu kapena mnzanu akugwiritsa ntchito molakwika mankhwala ochepetsa ululu a opioid, funani thandizo lachipatala mwamsanga.

Matenda a opioid ndi vuto la maganizo ndi ubongo lomwe limayambitsa mavuto. Ma opioid amakhudza ubongo wanu komanso luso lanu lopanga zisankho. Kusintha kumeneku kungakupangitseni kukhala kovuta kusiya kumwa ma opioid, ngakhale mukufuna. Ngati inu kapena munthu amene mumamukonda ali ndi vutoli, pitani kwa dokotala mwamsanga. Dokotala wophunzitsidwa bwino angakutsogolereni pa chithandizo chomwe mukufuna.

Pomaliza, zinthu zoti muzikumbukira

• Ma opioid ndi mankhwala amphamvu ochepetsa ululu, koma akhoza kukhala osokoneza bongo ngati agwiritsidwa ntchito molakwika.
• Musagwiritse ntchito izi popanda upangiri wa dokotala. Tsatirani mlingo ndi nthawi yomwe mwapatsidwa.
• Ngati inu kapena ena mukuona zizindikiro za chizolowezi, musachite manyazi kapena mantha, ndipo funsani upangiri wa dokotala nthawi yomweyo.
• Pali chithandizo ndi kuchira. Choncho musavutike nokha, pemphani thandizo.
• Kuphunzitsa ena kumathandizanso polimbana ndi vutoli.

Ndikukhulupirira kuti izi zikuthandizani. Ngati muli ndi mafunso ena okhudzana ndi izi, chonde musazengereze kulankhula ndi dokotala.

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