Ngaba nawe ukhotyokiswe zezi pilisi zokuphelisa iintlungu? Masithethe nge-Opioid Use Disorder!

Namhlanje siza kuthetha ngesihloko esinobuzaza kancinci, kodwa esibaluleke kakhulu. Usenokuba ukhe weva ukuba kukho iintlobo ezithile zeentlungu ekufuneka uzilumkele kakhulu. Ezi zibizwa ngokuba zii-opioids . Ukuba uzisebenzisa ngendlela engafanelekanga, oko kukuthi, ukuba uzithatha kakhulu ngaphandle kwengcebiso kagqirha, okanye ukuba uzithatha ngezinye iinjongo, unokuba likhoboka lazo ngaphandle kokuqaphela. Oku sikubiza ngokuba yi -Opioid Use Disorder (OUD) .

Ngamafutshane, yintoni i-Opioid Use Disorder?

Khawucinge ukuba ugqirha ukunike i-opioid yokunceda intlungu ethile. Kodwa uyithatha ngaphezu komlinganiselo omiselweyo, okanye ixesha elide kunexesha elimiselweyo. Emva kwexesha elithile, awunakuphila ngaphandle kwale yeza, uziva ngathi kufuneka ulithathe, kwaye ukuba awuyithathi, uziva ungakhululekanga kwaye ube nobunzima. Oku kuqala ukuchaphazela imisebenzi yakho yemihla ngemihla, ubudlelwane bakho nosapho, umsebenzi wakho, nayo yonke enye into. Ngamafutshane, kulapho ukusebenzisa kwakho i-opioid kungasebenzi khona kwaye kubangela iingxaki ebomini bakho.

Oku kunokwenzeka nangamanqanaba ahlukeneyo. Abanye abantu banokufumana iimpawu ezibuthathaka , abanye iimpawu eziphakathi , kwaye abanye banokufumana iimpawu ezinzima . Isenokuba yimeko yobomi bonke (engapheliyo) . Ke ngoko, kubaluleke kakhulu ukuqaphela nokufuna unyango kwangethuba.

Zithini ezi opioids?

Ii-opioids liqela lamayeza, afumaneka ngokwendalo (ii-Opiates) kunye nalawo aveliswa ngamachiza (ii-Opioids), anceda ekunciphiseni iintlungu. Asebenza ngokusebenza kwiiseli zethu zemithambo-luvo ukunciphisa iintlungu.

Oogqirha banika ezi zinto xa kukho iintlungu eziqatha emva kwengozi, iintlungu emva kotyando, kwaye ngamanye amaxesha xa kukho iintlungu ezihlala ixesha elide. Umzekelo:

• 'I-Oxycodone'
• `I-Oxymorphone`
• `I-Morphine`
• `I-Codeine`
• `I-Fentanyl`

Ngaphandle kwezi, iHeroin, eyenziwe ngeMorphine, ikwaliyeza elingekho mthethweni elikweli candelo linye.

Ezi opioid azipheleli nje ekunciphiseni iintlungu, kodwa zikwavelisa uvuyo nokuphumla (uvuyo) kwabanye abantu. Ekuhambeni kwexesha, umthamo weyeza kufuneka wonyuswe ukuze ufumane isiqabu esifanayo ( ukunyamezelana ). Yingakho umngcipheko wokulutha uphezulu.

Kodwa khumbula, ayinguye wonke umntu othatha eli yeza ixesha elifutshane njengoko ugqirha emyalele ukuba abe likhoboka. Ukuba ulandela imiyalelo ngqo, umngcipheko wokuba likhoboka uphantsi.

Yintoni umahluko phakathi kokulutha kunye nokuxhomekeka?

Ezi zimbini ziyadida kancinci, kodwa kubalulekile ukuziqonda.

Ukuxhomekeka kwi-opioid kuxa umzimba wakho uqhelana neziyobisi. Oku kuthetha ukuba ngokuhamba kwexesha, idosi oyithathileyo ayisebenzi kakuhle (ukunganyamezelani) okanye ufumana iimpawu zokurhoxa ezifana nokucaphuka, ukuhlanza, kunye neentlungu zomzimba xa uyeka ukusebenzisa iziyobisi.Iimpawu zokurhoxa .

Ingxaki Yokusetyenziswa Kwe-Opioid (OUD) idlulela ngaphaya koko. Apha, indlela osebenzisa ngayo iziyobisi ibangela iingxaki ebomini bakho, kodwa awukwazi ukuyilawula. Oku kunokubandakanya ukuxhomekeka ngokwasemzimbeni kunye nokuxhomekeka ngokwasengqondweni. Oku kuthetha ukuba iyeza lithatha iingcinga zakho, iimvakalelo kunye nezenzo zakho, kwaye uphuhlisa umnqweno onamandla (ukunqwenela) ukulisebenzisa.

Ngubani ofumana oku? Kuxhaphake kangakanani?

Ingxaki yokusebenzisa i-opioid inokukhula nakubani na, kungakhathaliseki ubudala, uhlanga, isini, okanye imeko yakhe yentlalo.

Kuqikelelwa ukuba phakathi kwe-3% ne-19% yabantu abasebenzisa amayeza okubulala iintlungu e-opioid kagqirha banokuba nale meko. Xa la mayeza kunzima ukuwafumana, abanye abantu baphendukela kwizinto ezifumaneka lula, ezifana ne-heroin. Oku kubonisa indlela esi sifo esinokuba yingozi ngayo.

Abantu abangaphezu kwezigidi ezingama-20 kwihlabathi liphela, kunye nabantu abangaphezu kwezigidi ezi-3 eMelika, banesifo esinjalo. Sele singubhubhane kwamanye amazwe. Ezi opioids zibangela ukufa kwabantu abangaphezu kwe-100,000 kwihlabathi liphela minyaka le.

Ziziphi iimpawu zesifo sokusetyenziswa kwe-opioid?

Ngokutsho kwe-American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), umntu onesi sifo unokubonakalisa ezinye zezi mpawu:

• Ukuthatha ii-opioids ngobuninzi kunokuba kumiselwe okanye ixesha elide kunokuba kumiselwe.
• Umnqweno onamandla okanye umnqweno wokuthatha ii-opioids.
• Imizamo yokunciphisa okanye yokulawula ukusetyenziswa kwayo kodwa iyasilela.
• Ukuqhubeka nokusebenzisa amayeza nangona kubangela iingxaki kubudlelwane babantu okanye bomntu.
• Ukuchitha ixesha elininzi ufuna, usebenzisa, okanye uphola emva kwee-opioids.
• Ukungakwazi ukufezekisa uxanduva emsebenzini, esikolweni, okanye ekhaya ngenxa yokusebenzisa i-opioid.
• Ukuphoswa okanye ukunciphisa eminye imisebenzi ebalulekileyo.
• Ukusebenzisa ii-opioids nokuba kwiimeko eziyingozi emzimbeni (umz., ngelixa uqhuba).
• Ukuqhubeka nokusebenzisa ii-opioids nangona unengxaki yomzimba okanye yengqondo enokubangelwa zii-opioids ngokwazo.
• Ekuhambeni kwexesha, kufuneka idosi ephezulu ukuze kufunyanwe isiphumo esifanayo ( ukunyamezelana ).
• Ukungakhululeki xa uyeka amayeza (i-opioid withdrawal syndrome) okanye uthatha ii-opioids okanye into efana nayo ukuze uphephe ezo ntlungu.

Ukuba ucinga ukuba unenye okanye ezimbini kwezi mpawu, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngokukhawuleza.

Zithini iimpawu zokurhoxa xa uyeka ukusebenzisa ii-opioids?

Ukuba uxhomekeke kwi-opioids ngokwasemzimbeni, ukuyiyeka ngequbuliso kunokubangela ezi ngxaki:

• Intlungu emzimbeni wonke
• Ukugodola, umkhuhlane
• Isisu esibuhlungu
• Abafundi abavulelekileyo
• Ukungazoli, ukuphazamiseka
• Ixhala
• Isicaphucaphu, ukuhlanza
• Ukunqwenela
• Ukwanda kwesantya sentliziyo kunye noxinzelelo lwegazi
• Ukubila
• Ukungalali

Umntu uba likhoboka lale meko njani?

Kukho izizathu ezahlukeneyo zoku. Kunzima kancinci.

• Ii-opioids zichaphazela ikhemistri yobuchopho: Ii-opioids zivuselela amaziko engqondo yethu alawula izinto ezifana nolonwabo kunye nomvuzo. Xa zithathwa, kukhutshwa i-neurotransmitter ebizwa ngokuba yi-'endorphins'. Oku kunciphisa iintlungu kwaye kukwenze uzive wonwabile. Xa isiphumo sesiyobisi siphela, olo lonwabo nalo luyanyamalala. Emva koko uzive ufuna ukuthatha esi siyobisi kwakhona ukuze uzive olo lonwabo. Ukuxhomekeka ngokwasemzimbeni kunokwenzeka nakwixesha elifutshane njengeeveki ezi-4 ukuya kwezi-8.
• Ukuvezwa kwii-opioids kunye nokufumaneka kwazo: Ukuvezwa kuyanda ngokusetyenziswa kwemithi yokuthomalalisa iintlungu, ukusetyenziswa ngamalungu osapho okanye abahlobo, kwaye ngamanye amaxesha ngeziyobisi ezingekho mthethweni ezifana ne-heroin. Ngamanye amaxesha, kulula ukufumana iziyobisi ezingekho mthethweni kunezo zisemthethweni. Namhlanje, iziyobisi ezininzi ezithengiswa njenge-heroin, i-cocaine, kunye nezinye iipilisi zinokuba namanqanaba aphezulu e-opioid fentanyl eyingozi. Ezi zinokuba yingozi ebomini.
• Izinto ezibangela ufuzo kunye nebhayoloji: Uphando lubonisa ukuba i-40% ukuya kwi-60% yomngcipheko wokuba likhoboka lazo naziphi na iziyobisi ubangelwa zizinto ezibangela ufuzo. Ukuba umntu okwintsapho yakho esondeleyo (abazali, abantakwenu noodadewethu) unesi sifo, nawe unokuba naso.
• Impilo yengqondo nezinye iimeko zonyango: Izifundo zifumanise ukuba malunga nesiqingatha sabantu abanezifo zengqondo basengozini yokuba likhoboka leziyobisi, kwaye malunga nesiqingatha sabantu abaneengxaki zeziyobisi basengozini yokuba nezifo zengqondo. Umzekelo, iimeko ezifana nokudakumba , iingxaki zokuxhalaba , i-ADHD, i-bipolar disorder, kunye ne-PTSD zinokuchaphazela oku. Kwakhona, abantu abanezifo zomzimba ezifana neentlungu ezingapheliyo banokuba semngciphekweni wokuba ne-opioid use disorder.
• Amava Amabi Obuntwana (ACEs): Ubudlelwane obubi phakathi kwabazali nabantwana, ubundlobongela basekhaya, ukuxhatshazwa kwabantwana, kunye nokuvalelwa entolongweni kwabazali nazo zizinto ezibangela umngcipheko wokusetyenziswa kweziyobisi.

Uyibona njani le nto?

Akukho vavanyo lunye lokuxilonga oku. Ugqirha uza kuhlola ngononophelo imbali yakho yezonyango kunye neendlela zakho zokusebenzisa i-opioid. Basenokusebenzisa izinto ezifana novavanyo lwamayeza, iirekhodi zokubeka esweni amayeza kagqirha, nokunye.

Ingxaki yokusebenzisa i-opioid (OUD) ifunyaniswa ukuba kukho ubuncinane iimpawu ezimbini ze-DSM-5 ezikhankanyiweyo ngaphambili .

• Ukuba iimpawu ezi-2-3: I-OUD engephi
• Ukuba kukho iimpawu ezi-4-5: I-OUD ephakathi
• Iimpawu ezi-6 nangaphezulu: I-OUD eqatha

Zithini iindlela zonyango?

Ngethamsanqa, kukho unyango olusebenzayo kwesi sifo. Nangona kunjalo, iindlela zonyango zinokuhluka kumntu nomntu. Ekubeni esi sisifo sexesha elide, unyango oluqhubekayo lubalulekile ekuchacheni nasekuthinteleni ukubuyela umva kwesi sifo.

Kukho iindlela ezininzi zonyango:

• Ingcebiso yezigulane zangaphandle
• Unyango olunzulu lwezigulane zangaphandle
• Unyango lwexesha elifutshane lokuhlala
• Iindawo zonyango zexesha elide, ezifana neendawo ezingenazo iziyobisi

Eyona isebenzayo kwezi yindibaniselwano yamayeza kunye neengcebiso (Medication-Assisted Treatment - MAT).

Unyango lwengqondo lwe-OUD

Unyango Lokuziphatha Oluqondayo (i-CBT) yindlela ephambili yonyango lwengqondo esetyenziselwa le njongo. Apha, ugqirha wengqondo okanye umcebisi uthetha nzulu ngeengcinga zakho neemvakalelo zakho. Bakunceda uqonde indlela iingcinga zakho ezichaphazela ngayo izenzo zakho. Ngale ndlela, bakunceda utshintshe iingcinga nezenzo ezingalunganga kwaye udale iipateni nemikhuba yokucinga esempilweni.

Iinkqubo zokuzinceda ze-OUD

Ukuba yinxalenye yamaqela okuzinceda afana ne-'Narcotics Anonymous' kukwaluncedo olukhulu kunyango. Ngale ndlela, umntu unokuyiqonda imeko yakhe, abelane ngamava nabanye, aze azincede aphucule impilo yakhe.

Amayeza e-OUD

Kukho amayeza athile anokunceda ukunyanga le meko ngokutshintsha ikhemikhali yobuchopho. La mayeza anokunciphisa inkanuko, anciphise iimpawu zokurhoxa, kwaye athintele iziphumo zovuyo ze-opioids.

Kukho iintlobo ezintathu eziphambili zamayeza ezivunyiweyo yi-US Food and Drug Administration (`FDA`):

• `I-Methadone` : Oku kunciphisa iimpawu zokurhoxa kunye nokunqwenela iziyobisi. Ingafumaneka kuphela kwiikliniki ezikhethekileyo.
• I-Buprenorphine : Oku kuthintela imiphumo ye-opioids, kunciphisa iimpawu zokurhoxa kunye nokunqwenela. Ingathathwa njengepilisi okanye njengenaliti yenyanga.
• `Naltrexone` : Oku kuthintela ulonwabo olufumana kwii-opioids. Zingathathwa njengepilisi okanye njengenaliti yenyanga.

Ngaba kukho naziphi na iingxaki kunyango?

Ngelishwa, umntu one-OUD usengozini enkulu yokufa kwiiveki ezine zokuqala emva kokuqala unyango kwaye kwiiveki ezine zokuqala emva kokuyeka unyango.

Isizathu soku kukuba bazama ukuthatha idosi efanayo naleyo babeyisebenzisa ngaphambili, kodwa ngenxa yokuba ukunyamezelana komzimba kuye kwehla, idosi inokuba phezulu kakhulu kwaye ikhokelele ekugqithiseni kakhulu.

Ungayiphepha njani le nto?

• Ukuba wena okanye umntu osapho lwakho ufuna unyango lwentlungu, thetha nogqirha wakho malunga neziyobisi ezingeyo-opioid okanye ezinye iindlela zonyango.
• Ukuba unikwe ii-opioids, zithathe kanye njengoko ugqirha wakho ekuxelele, ngobungakanani obumiselweyo, nangamaxesha amiselweyo. Musa ukuthatha iidosi ezongezelelweyo. Musa ukuphula, ukutyumza, okanye ukunyibilikisa iipilisi.
• Ukuba uziva uxhomekeke kumayeza, okanye ukuba idosi emiselweyo ayilawuli iintlungu zakho, ungaze wandise idosi ngokwakho. Xelela ugqirha wakho ngoko nangoko.
• Ungaze wabelane ngamayeza akho nabanye abantu. Wagcine kwindawo ekhuselekileyo kude nabantwana.
• Ukuba une-opioids eseleyo kunyango, yilahle ngokukhuselekileyo. (Ungabuza ikhemesti yakho.)
• Thetha nabantwana bakho malunga neengozi zee-opioids kunye nemfuneko yokuzisebenzisa kuphela njengoko kuyalelwe.

Kuza kwenzeka ntoni ukuba unyango alunikwanga? (Ukuxela kwangaphambili)

Ukuba ayinyangwa, iziphumo ze-OUD zihlala zimbi. Abantu abane-OUD enzima basengozini enkulu yoku:

• Ukwenzakala okufana nokuwa kunye neengozi zeemoto.
• Izifo ezithwalwa ngegazi ezifana ne-'Hepatitis B (HBV), 'Hepatitis C (HCV),' kunye ne-'HIV' zinokudluliselwa ngokusebenzisa iinaliti ezahlukeneyo.
• Ukuvalelwa entolongweni.
• Ukugqithisa i-opioid.
• Ukufa ngenxa yokugqithisa i-opioid.
• Ukuzibulala.

Izinga lokufa kwabantu abane-OUD liphezulu ngokuphindwe kalishumi kunelo labantu ngokubanzi.

Kodwa khumbula, i-OUD yimeko enokunyangeka. Nangona kunjalo, ngumntu omnye kuphela kwaba-4 abane-OUD ofumana unyango lobuchwephesha.

Unyango oluncediswa ngamayeza (MAT) lunciphisa ukusetyenziswa kwe-opioid, ukufa ngokugqithisileyo, kunye nokusasazeka kwezifo ezosulelayo. Lunyusa ukusebenza kwezentlalo kunye nokugcinwa konyango.

Zithini iimpawu zokusebenzisa i-opioid overdose?

Ukugqithisela kunokwenzeka xa umntu ethatha i-opioid eninzi kakhulu, okanye xa ethatha ezinye iziyobisi kunye ne-opioids. Iimpawu ziquka:

• Ukungaphenduli, ukulahlekelwa zingqondo.
• Ukuphefumla kuyehla okanye kuyeke.
• Iimbombo ezimnyama emehlweni zincinci kakhulu (`i-pinpoint pupils`).
• Ukurhona okanye isandi esiphuma emqaleni.
• Ulusu olubandayo noluthambileyo.
• Imilebe okanye iinzipho eziluhlaza okwesibhakabhaka.

Kwimeko enjalo, kufuneka amanyathelo akhawulezileyo. Iziphumo zokusebenzisa i-overdose zinokuguqulwa ngokukhawuleza ngokunika iyeza elibizwa ngokuba yi-`Naloxone` (elidla ngokubizwa ngegama lebrendi elithi `Narcan®`). Nangona kunjalo, nokuba i-`Naloxone` inikwe, kufuneka unyango olukhawulezileyo.

Ukuba umntu omaziyo unengxaki efana nale, ungamnceda njani?

Ukufumanisa ukuba umntu omthandayo une-OUD kunokuba nzima kakhulu kwaye kuyakhathaza. Nazi ezinye izinto onokuzenza ukunceda umntu onjalo:

• Thetha kwangethuba: Okukhona umntu one-OUD efumana unyango ngokukhawuleza, kokukhona kungcono. Thetha naye ngezinto ezikuxhalabisayo uze umncede afumane unyango.
• Phatha ngovelwano:Nokuba awuvumelani nayo, mamela ngononophelo oko bakuthethayo. Okukhona ubaphulaphula, kokukhona baya kukuthemba.
• Yiba nomonde: Musa ukulindela ukuba le ngxaki isonjululwe ngencoko enye okanye ngesenzo esinye. I-OUD yimeko enzima nehlala ixesha elide.
• Cinga ngawe nawe: Usapho kunye nabahlobo babantu abane-OUD nabo banokuziva bexinezelekile, bedakumbile, belusizi, kwaye benesizungu. Cinga nangempilo yakho yengqondo. Fumana uncedo ukuba uyalufuna.
• Gcina iNaloxone (Narcan®) ikufutshane: Ukuba umntu omthandayo usela kakhulu, iNaloxone inokusindisa ubomi. Ukuba kunokwenzeka, yigcine iNaloxone ikufutshane ngamaxesha onke.

Ndifanele ndimbone nini ugqirha?

Ukuba sele usebenzisa amayeza e-opioid kwaye unesikrokro sokuba uyalikhoboka lawo, thetha nogqirha wakho ngoko nangoko.

Ukuba ukrokrela ukuba umntwana wakho okanye umhlobo wakho usebenzisa kakubi ii-opioids, funa uncedo lwezonyango ngokukhawuleza.

Ingxaki yokusebenzisa i-opioid yimeko entsonkothileyo yengqondo nengqondo. Ii-opioid zichaphazela ingqondo yakho kunye nokukwazi kwakho ukwenza izigqibo. Olu tshintsho lunokwenza kube nzima ukuyeka ukusebenzisa ii-opioid, nokuba uyafuna. Ukuba wena okanye umntu omthandayo unale meko, bona ugqirha ngokukhawuleza. Ugqirha oqeqeshiweyo unokukukhokela kunyango olufunayo.

Okokugqibela, izinto ekufuneka uzikhumbule

• Ii-opioids zizinto ezinamandla zokuthomalalisa iintlungu, kodwa zinokuba ngumlutha oyingozi ukuba zisetyenziswa gwenxa.
• Ungaze uzisebenzise ezi zinto ngaphandle kwengcebiso kagqirha. Landela idosi emiselweyo kunye nobude bexesha ngokuchanekileyo.
• Ukuba wena okanye abanye nibona iimpawu zokulutha, musani ukuba neentloni okanye ningoyiki, kwaye funa ingcebiso kagqirha ngokukhawuleza.
• Kukho unyango kwaye kunokwenzeka ukuba uphile. Ngoko ke musa ukubandezeleka wedwa, cela uncedo.
• Ukufundisa abanye kukwaluncedo ekulweni nale ngxaki.

Ndiyathemba ukuba olu lwazi luza kukunceda. Ukuba unemibuzo engaphezulu malunga noku, nceda ungathandabuzi ukuthetha nogqirha.

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