Ingabe nawe umlutha walezi zinhlungu zobuhlungu? Ake sixoxe nge-Opioid Use Disorder!

Namuhla sizokhuluma ngesihloko esibucayi kancane, kodwa esibaluleke kakhulu. Kungenzeka ukuthi uke wezwa ukuthi kunezinhlobo ezithile zemithi yokwelapha izinhlungu okufanele uziqaphele kakhulu. Lezi zibizwa ngokuthi ama-opioid . Uma uzisebenzisa ngendlela engafanele, okungukuthi, uma uziphuza kakhulu ngaphandle kweseluleko sezokwelapha, noma uma uzisebenzisa ngezinye izinjongo, ungaba umlutha wazo ngaphandle kokuqaphela. Yilokhu esikubiza ngokuthi i-Opioid Use Disorder (OUD) .

Kalula nje, iyini i-Opioid Use Disorder?

Cabanga ukuthi udokotela ukunike i-opioid yobuhlungu obuthile. Kodwa uyithatha ngaphezu kwenani elibekiwe, noma isikhathi eside kunesikhathi esibekiwe. Ngemva kwesikhathi esithile, awukwazi ukuphila ngaphandle komuthi, uzizwa sengathi kufanele uwuthathe, futhi uma ungawuthathi, uzizwa ungakhululekile futhi ube nobunzima. Lokhu kuqala ukuthinta imisebenzi yakho yansuku zonke, ubudlelwano bakho nomndeni, umsebenzi wakho, nakho konke okunye. Kalula nje, yilapho ukusebenzisa kwakho i-opioid kuqeda amandla futhi kubangele izinkinga empilweni yakho.

Lokhu kungenzeka nangamazinga ahlukene. Abanye abantu bangase babe nezimpawu ezincane , abanye izimpawu ezilinganiselwe , kanti abanye bangase babe nezimpawu ezinzima . Kungaba futhi yisimo sokuphila konke (esingamahlalakhona) . Ngakho-ke, kubaluleke kakhulu ukuqaphela nokufuna ukwelashwa kusenesikhathi.

Ziyini lezi zidakamizwa ze-opioid?

Ama-opioid ayiqembu lemithi, eyenzeka ngokwemvelo (ama-Opiates) kanye nekhiqizwa ngamakhemikhali (ama-Opioids), esiza ekunciphiseni ubuhlungu. Asebenza ngokusebenza kumaseli ethu ezinzwa ukunciphisa ubuhlungu.

Odokotela banikeza lezi zinto ngenxa yobuhlungu obukhulu ngemva kwengozi, ubuhlungu ngemva kokuhlinzwa, futhi ngezinye izikhathi ngenxa yezimo zobuhlungu besikhathi eside. Isibonelo:

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

Ngaphandle kwalokhu, i-Heroin, eyenziwe nge-Morphine, nayo iyisidakamizwa esingekho emthethweni esikulesi sigaba esifanayo.

Lawa ma-opioid awagcini nje ngokuqeda ubuhlungu, kodwa futhi akhiqiza umuzwa wenjabulo nokuphumula (injabulo) kwabanye abantu. Ngokuhamba kwesikhathi, umthamo womuthi udinga ukukhushulwa ukuze uthole impumuzo efanayo ( ukubekezelelana ). Yingakho ingozi yokuba umlutha iphezulu.

Kodwa khumbula, akuwona wonke umuntu ophuza lo muthi isikhathi esifushane njengoba kunqunywe udokotela ozoba umlutha. Uma ulandela imiyalelo ngqo, ingozi yokuba umlutha iphansi.

Uyini umehluko phakathi kokulutheka kanye nokulutheka?

Lezi ezimbili ziyadida kancane, kodwa kubalulekile ukuziqonda.

Ukuthembela kuma-opioid kwenzeka lapho umzimba wakho ujwayela umuthi. Lokhu kusho ukuthi ngokuhamba kwesikhathi, umthamo owusebenzisile awusebenzi kahle (ukubekezelela) noma uba nezimpawu zokuhoxa njengesicanucanu, ukuhlanza, kanye nobuhlungu bomzimba uma uyeka ukuthatha umuthi.Izimpawu zokuhoxa .

Isifo Sokusetshenziswa Kwe-Opioid (OUD) sidlulela phambili. Lapha, indlela yakho yokusebenzisa izidakamizwa ibangela izinkinga empilweni yakho, kodwa awukwazi ukuyilawula. Lokhu kungabandakanya kokubili ukuthembela ngokomzimba kanye nokuthembela kwengqondo. Lokhu kusho ukuthi lesi sidakamizwa sithatha imicabango yakho, imizwa, kanye nezenzo, bese uba nesifiso esinamandla (isifiso) sokusithatha.

Ubani okuthola lokhu? Kuvamile kangakanani?

Isifo sokusebenzisa ama-opioid singakhula kunoma ubani, kungakhathaliseki ubudala, uhlanga, ubulili, noma isimo sakhe senhlalo.

Kulinganiselwa ukuthi phakathi kuka-3% no-19% wabantu abathatha imithi yokubulala izinhlungu ye-opioid kadokotela bangase babe nalesi simo. Uma le mithi kunzima ukuyithola, abanye abantu baphendukela ezintweni ezitholakala kalula, njenge-heroin. Lokhu kukhombisa ukuthi lesi sifo singaba yingozi kangakanani.

Abantu abangaphezu kwezigidi ezingu-20 emhlabeni jikelele, kanye nabantu abangaphezu kwezigidi ezintathu e-United States, bahlushwa yilesi simo. Sesibe ubhubhane kwamanye amazwe. Lawa ma-opioid abangela ukufa kwabantu abangaphezu kuka-100,000 emhlabeni jikelele minyaka yonke.

Ziyini izimpawu zokuphazamiseka kokusebenzisa i-opioid?

Ngokusho kwe-American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), umuntu onalesi simo angase abonise ezinye zalezi zimpawu:

• Ukuthatha ama-opioid ngobuningi obukhulu kunobunqunyiwe noma isikhathi eside kunobunqunyiwe.
• Isifiso esinamandla noma isifiso sokuthatha ama-opioid.
• Imizamo yokunciphisa noma yokulawula ukusetshenziswa kodwa yehluleka.
• Ukuqhubeka nokusebenzisa umuthi noma ngabe kubangela izinkinga ebudlelwaneni bomphakathi noma bomuntu siqu.
• Ukuchitha isikhathi esiningi uthola, usebenzisa, noma ululama emithini yama-opioid.
• Ukungakwazi ukufeza imithwalo yemfanelo emsebenzini, esikoleni, noma ekhaya ngenxa yokusebenzisa ama-opioid.
• Ukulahlekelwa noma ukunciphisa eminye imisebenzi ebalulekile.
• Ukusebenzisa ama-opioid ngisho nasezimweni eziyingozi ngokomzimba (isb., ngenkathi ushayela).
• Ukuqhubeka nokusebenzisa ama-opioid naphezu kokuba nenkinga yomzimba noma yengqondo engase ibangelwe ama-opioid ngokwawo.
• Ngokuhamba kwesikhathi, kudingeka umthamo ophezulu ukuze kufezwe umphumela ofanayo ( ukubekezelelana ).
• Ukungakhululeki lapho uyeka umuthi (i-opioid withdrawal syndrome) noma uthatha ama-opioid noma into efana nawo ukuze ugweme lokho kungakhululeki.

Uma ucabanga ukuthi unesinye noma ezimbili zalezi zimpawu, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha okukhulu.

Yiziphi izimpawu zokuhoxa uma uyeka ukuthatha ama-opioid?

Uma uthembele ngokomzimba kuma-opioid, ukuwayeka ngokuzumayo kungabangela lezi zinkinga:

• Ubuhlungu emzimbeni wonke
• Ukugodola, umkhuhlane
• Isisu esibuhlungu
• Abafundi abavulekile
• Ukungaphumuli, ukucasuka
• Ukukhathazeka
• Isicanucanu, ukuhlanza
• Ukufisa
• Ukwanda kwesilinganiso senhliziyo kanye nomfutho wegazi
• Ukujuluka
• Ukungalali

Umuntu uba kanjani umlutha walesi simo?

Kunezizathu eziningana zalokhu. Kuyinkimbinkimbi kancane.

• Ama-opioid athinta i-chemistry yobuchopho: Ama-opioid avuselela izikhungo ebuchosheni bethu ezilawula izinto ezifana nenjabulo nomvuzo. Uma ethathwa, kukhishwa i-neurotransmitter ebizwa ngokuthi 'ama-endorphin'. Lokhu kunciphisa ubuhlungu futhi kukwenze uzizwe ujabule. Lapho imiphumela yomuthi iphela, leyo njabulo nayo iyanyamalala. Bese uzizwa sengathi uzophinde uthathe umuthi ukuze uzizwe leyo njabulo. Ukuthembela ngokomzimba kungakhula ngisho nasemasontweni amane kuya kwayisishiyagalombili.
• Ukuchayeka kuma-opioid kanye nokutholakala kwawo: Ukuchayeka kuyanda ngemithi kadokotela yezinhlungu, ukusetshenziswa ngamalungu omndeni noma abangani, futhi ngezinye izikhathi ngezidakamizwa ezingekho emthethweni. Ngezinye izikhathi, i-heroin kulula ukuyithola kunemithi esemthethweni. Namuhla, izidakamizwa eziningi ezithengiswa njenge-heroin, i-cocaine, kanye namaphilisi athile zingaqukatha amazinga aphezulu e-opioid fentanyl eyingozi. Lokhu kungaba yingozi empilweni.
• Izici zofuzo kanye nezinto eziphilayo: Ucwaningo lubonisa ukuthi u-40% kuya ku-60% wengozi yokuba umlutha wanoma yimuphi umuthi ubangelwa izici zofuzo. Uma othile emndenini wakho oseduze (abazali, izingane zakini) enalesi simo, nawe unamathuba amaningi okuba naso.
• Impilo yengqondo nezinye izimo zezokwelapha: Ucwaningo luthole ukuthi cishe ingxenye yabantu abanezifo zengqondo basengozini yokuba umlutha wezidakamizwa, kanti cishe ingxenye yabantu abanezinkinga zezidakamizwa basengozini yokuba nezifo zengqondo. Isibonelo, izimo ezifana nokucindezeleka , izinkinga zokukhathazeka , i-ADHD, i-bipolar disorder, kanye ne-PTSD zingathinta lokhu. Futhi, abantu abanezifo zomzimba ezifana nobuhlungu obungapheli nabo bangaba sengozini yokuba nesifo sokusetshenziswa kwe-opioid.
• Okuhlangenwe Nakho Okubi Kwabantwana (ACEs): Ubudlelwano obubi phakathi kwabazali nengane, ubudlova basekhaya, ukuhlukunyezwa kwezingane, kanye nokuboshwa kwabazali nakho kuyizinto ezandisa ingozi yokusebenzisa izidakamizwa.

Ukubona kanjani lokhu?

Akukho ukuhlolwa okukodwa kokuxilonga lokhu. Udokotela uzobuyekeza ngokucophelela umlando wakho wezokwelapha kanye namaphethini akho okusebenzisa ama-opioid. Bangase basebenzise nezinto ezifana nokuhlolwa kwezidakamizwa, amarekhodi okuqapha izidakamizwa ezinikezwa ngudokotela, nokuningi.

Isifo sokusetshenziswa kwe-opioid (OUD) sitholakala uma okungenani kunezimpawu ezimbili ze-DSM-5 ezishiwo ngaphambilini .

• Uma izici ezingu-2-3: I-OUD encane
• Uma kunezimpawu ezingu-4-5: I-OUD ephakathi nendawo
• Izimpawu ezi-6 noma ngaphezulu: I-OUD Enkulu

Yiziphi izindlela zokwelapha?

Ngenhlanhla, kunezindlela zokwelapha ezisebenzayo zalesi simo. Kodwa-ke, izinketho zokwelapha zingahluka kumuntu nomuntu. Njengoba lesi kuyisimo sesikhathi eside, ukwelashwa okuqhubekayo kubalulekile ekululameni nasekuvimbeleni ukubuyela emuva.

Kunezindlela eziningana zokwelapha:

• Ukwelulekwa kweziguli zangaphandle
• Ukwelashwa okujulile kwangaphandle
• Ukwelashwa kwesikhashana kwezindlu
• Imiphakathi yokwelapha yesikhathi eside, njengemiphakathi engenazo izidakamizwa

Okungcono kakhulu kwalokhu inhlanganisela yemithi kanye nokwelulekwa (Ukwelashwa Okusiza Ngemithi - MAT).

Ukwelashwa kwengqondo kwe-OUD

Ukwelashwa Kokuziphatha Kokuqonda (i-CBT) kuyindlela enkulu yokwelapha ingqondo esetshenziselwa le njongo. Lapha, udokotela wezifo zengqondo noma umeluleki ukhuluma ngokujulile ngemicabango nemizwa yakho. Bakusiza ukuthi uqonde ukuthi imicabango yakho ithinta kanjani izenzo zakho. Ngalokhu, bakusiza ukuthi ushintshe imicabango nokuziphatha okungekuhle futhi udale amaphethini nemikhuba yokucabanga enempilo.

Izinhlelo zokuzisiza ze-OUD

Ukubamba iqhaza emaqenjini okuzisiza njenge-'Narcotics Anonymous' nakho kuyindlela enhle yokusekela ukwelashwa. Ngalezi zinto, umuntu angaqonda isimo sakhe, abelane ngolwazi nabanye, futhi azisize athuthuke.

Imithi ye-OUD

Kunemithi ethile engasiza ekwelapheni lesi simo ngokushintsha amakhemikhali obuchopho. Lokhu kunganciphisa izifiso, kunciphise izimpawu zokuhoxa, futhi kuvimbele imiphumela yenjabulo yama-opioid.

Kunezinhlobo ezintathu eziyinhloko zemithi ezivunyelwe yi-US Food and Drug Administration (`FDA`):

• `I-Methadone` : Lokhu kunciphisa izimpawu zokuhoxa kanye nezifiso. Kungatholakala kuphela emitholampilo ekhethekile.
• I-Buprenorphine : Lokhu kuvimbela imiphumela yama-opioid, kunciphisa izimpawu zokuhoxa kanye nezifiso. Ingathathwa njengephilisi noma njengomjovo wanyanga zonke.
• `Naltrexone` : Lokhu kuvimbela injabulo oyitholayo ngama-opioid. Ingathathwa njengephilisi noma njengomjovo wanyanga zonke.

Ingabe kukhona izinkinga ekwelashweni?

Ngeshwa, umuntu one-OUD usengozini enkulu yokufa emavikini amane okuqala okuqala ukwelashwa kanye namasonto amane okuqala okubuyela emuva ngemva kokuyeka ukwelashwa.

Isizathu salokhu ukuthi bazama ukuthatha umthamo ofanayo ababewusebenzisa ngaphambili, kodwa ngenxa yokuthi ukubekezelelana komzimba kuye kwehla, umthamo ungaba phezulu kakhulu futhi uholele ekweqiseni umthamo.

Ungakugwema kanjani lokhu?

• Uma wena noma othile emndenini wakho edinga ukwelashwa kobuhlungu, khuluma nodokotela wakho ngemithi yokunciphisa ubuhlungu engeyona i-opioid noma ezinye izindlela zokwelapha.
• Uma unikezwe ama-opioid, waphuze njengoba nje udokotela wakho ekutshelile, ngenani elibekiwe, nangezikhathi ezibekiwe. Ungathathi imithamo eyengeziwe. Ungawaphuli, uwachoboze, noma uwancibilikise amaphilisi.
• Uma uzizwa uthembele emuthini, noma uma umthamo onqunyiwe ungawulawuli ubuhlungu bakho, ungalokothi wandise umthamo ngokwakho. Tshela udokotela wakho ngokushesha.
• Ungalokothi wabelane ngemithi yakho nanoma ubani omunye. Yigcine endaweni ephephile kude nezingane.
• Uma une-opioid esele ekwelashweni, yilahle ngokuphephile. (Ungabuza ikhemisi lakho.)
• Khuluma nezingane zakho ngezingozi zama-opioid kanye nesidingo sokuwasebenzisa kuphela njengoba kuqondiswe.

Kwenzekani uma ukwelashwa kunganikezwa? (Isibikezelo)

Uma ingelashwa, umphumela we-OUD uvame ukuba mubi. Abantu abane-OUD enzima basengozini enkulu yalokhu okulandelayo:

• Ukulimala okufana nokuwa nezingozi zezimoto.
• Izifo ezithwalwa igazi njenge-Hepatitis B (HBV), i-Hepatitis C (HCV), kanye ne-HIV zingadluliselwa ngokwabelana ngezinaliti.
• Ukuboshwa.
• Ukweqisa i-opioid.
• Ukufa ngenxa yokudlula ngokweqile i-opioid.
• Ukuzibulala.

Izinga lokufa kwabantu abane-OUD liphakeme ngokuphindwe kayishumi kunelomphakathi jikelele.

Kodwa khumbula, i-OUD iyisimo esingelapheka. Kodwa-ke, umuntu oyedwa kwabane abane-OUD uthola ukwelashwa kochwepheshe.

Ukwelashwa okusiza ngemithi (MAT) kunciphisa ukusetshenziswa kwe-opioid, ukufa ngokweqile, kanye nokusabalala kwezifo ezithelelanayo. Kwandisa ukusebenza komphakathi kanye nokugcinwa kokwelashwa.

Ziyini izimpawu zokudlula ngokweqile kwe-opioid?

Ukudlula ngokweqile kungenzeka uma umuntu ethatha i-opioid eningi kakhulu, noma uma ethatha eminye imithi kanye ne-opioid. Izimpawu zifaka:

• Ukungasabeli, ukulahlekelwa ukwazi.
• Ukuphefumula kuyehla noma kuyeke.
• Ama-puppy amnyama emehlweni mancane kakhulu (`abafundi abakhombayo`).
• Ukuhona noma umsindo ovela emphinjeni.
• Isikhumba esibandayo nesinomswakama.
• Izindebe noma izinzipho eziluhlaza okwesibhakabhaka.

Esimweni esinjalo, kudingeka isinyathelo esisheshayo. Imiphumela yokudlula ngokweqile ingaguqulwa ngokushesha ngokunikeza umuthi obizwa ngokuthi `Naloxone` (ovame ukwaziwa ngegama lomkhiqizo `Narcan®`). Kodwa-ke, noma ngabe `Naloxone` inikezwa, kudingeka usizo lwezokwelapha ngokushesha.

Uma umuntu omaziyo enenkinga efana nale, ungamsiza kanjani?

Ukuthola ukuthi umuntu omthandayo une-OUD kungaba yinto enzima kakhulu futhi ekhathazayo. Nazi ezinye izinto ongazenza ukusiza umuntu onjalo:

• Khuluma kusenesikhathi: Uma umuntu one-OUD eshesha ukuthola ukwelashwa, kungcono. Khuluma naye ngezinto ezikukhathazayo futhi umsize athole ukwelashwa.
• Phatha ngozwela:Ngisho noma ungavumelani nakho, lalela ngokucophelela lokho abakushoyo. Uma ubalalela kakhulu, kulapho bezokwethemba khona kakhulu.
• Bekezela: Ungalindeli ukuthi le nkinga izoxazululwa ngengxoxo eyodwa noma ngesenzo esisodwa. I-OUD iyisimo esiyinkimbinkimbi nesihlala isikhathi eside.
• Cabanga ngawe futhi: Umndeni nabangane babantu abane-OUD nabo bangase bazizwe becindezelekile, becindezelekile, bedabukile, futhi benesizungu. Cabanga nangempilo yakho yengqondo. Thola usizo uma uludinga.
• Gcina i-Naloxone (Narcan®) iseduze: Uma othandekayo wakho ephuza ngokweqile, i-Naloxone ingasindisa impilo. Uma kungenzeka, gcina i-Naloxone iseduze ngaso sonke isikhathi.

Kufanele ngimbone nini udokotela?

Uma usuvele uthatha imithi ye-opioid futhi usola ngisho nokuncane ukuthi usuqala ukuyilutha, khuluma nodokotela wakho ngokushesha.

Uma usola ukuthi ingane yakho noma umngane wakho usebenzisa kabi ama-opioid, funa usizo lwezokwelapha ngokushesha okukhulu.

Isifo sokusebenzisa ama-opioid siyinkinga eyinkimbinkimbi yengqondo nobuchopho. Ama-opioid athinta ubuchopho bakho kanye nekhono lakho lokwenza izinqumo. Lezi zinguquko zingenza kube nzima ukuyeka ukuthatha ama-opioid, noma ngabe ufuna. Uma wena noma othile omthandayo enalesi simo, bona udokotela ngokushesha okukhulu. Udokotela oqeqeshiwe angakuqondisa ekwelashweni okudingayo.

Okokugcina, izinto okufanele uzikhumbule

• Ama-opioid ayimithi yokubulala izinhlungu enamandla, kodwa angaba umlutha oyingozi uma esetshenziswa ngendlela engafanele.
• Ungalokothi usebenzise lokhu ngaphandle kweseluleko sikadokotela. Landela umthamo onqunyiwe kanye nobude besikhathi ngqo.
• Uma wena noma abanye nibona izimpawu zokulutha, ningabi namahloni noma ningesabi, funa iseluleko sezokwelapha ngokushesha.
• Kukhona ukwelashwa futhi kungenzeka ukululama. Ngakho-ke ungahlupheki wedwa, cela usizo.
• Ukufundisa abanye nakho kuyasiza ekulweni nale nkinga.

Ngiyethemba ukuthi lolu lwazi luzokusiza. Uma uneminye imibuzo mayelana nalokhu, sicela ungangabazi ukukhuluma nodokotela.

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