Iimpawu ezivela kwiNgxelo Yogqirha Jikelele kwiNxila, iziyobisi kunye neMpilo
Ngenxa yokwanda kwenani labantu abasebenzisa i-marijuana kunye nesifo sengqungquthela yokusetyenziswa kweziyobisi ngokungekho mthethweni, ukusetyenziswa kakubi kweziyobisi kakubi yinkinga ebalulekileyo yezempilo e-United States.
Ekuphenduleni iingxaki zokusetyenziswa kakubi kweziyobisi ezijongene nelizwe, i-US Surgeon General General Vivek H. Murthy uye wakhupha ingxelo engumlando, ethi "Ukujongana nomlingo eMelika: Ingxelo yeDioron General Report on Alcohol, Drugs, and Health," inethemba lokuphelisa uluntu ingxaki yempilo yobunzima.
Kuyo yonke ingxelo epheleleyo yiphepha le-428, ebonisa ukujonga ngokubanzi kuzo zonke iinkalo zengxaki yokusetyenziswa kakubi kweziyobisi , izicatshulwa ezichaziweyo zizinikele ekuchazeni izinto ezibandakanyekayo ezinokuba ziyaziwa, zingacaciswanga okanye ziyiyo ngcamango malunga nokusetyenziswa kakubi kweziyobisi. Ezinye ezimbalwa zezihloko zixutyushwa ngezantsi.
1 - Izifo zokusetyenziswa kwezixhobo zifana ne-Diabetes
Phantse abantu abayizigidi ezingama-21 ubudala abaneminyaka eli-12 nangaphezulu e-US bahlangabezane neendlela zokuxilonga ukuba ne-drug use disorder. Leyo malunga neepesenti eziyi-8 yomntu osemtsha kunye nabantu abadala kwaye iyafaniswa nenani labantu abanesifo sikashukela.
Abantu abane-disorder usetyenziso lwezinto ezisetyenziswayo ngokugqithiseleyo kunanikelele kwiimeko ze -roid kwaye balingana nama-1.5 ngamaxesha abantu abaye bafumanisa ukuba banayo yonke i-cancer yebele, umhlaza womphunga, umhlaza wesibeletho, umhlaza wesibeletho, umdlavuza wesibindi kunye nabo bonke ezinye iisomhlaza ezidibeneyo.
Izigidi ezingama-21 zaseMerika ezinokusetyenziswa kwezidakamizwa zingasebenzisi izigidi zabantu ababenobungozi bokuphuza (ukusela ngokweqile nokusela kakhulu ) okanye abaye basebenzisa iziyobisi ezingekho mthethweni kwiinyanga ezili-12 ezidlulileyo kodwa abahambelani nemigaqo yokusetyenziswa kweziyobisi ngxaki.
Ngokwemibiko yeDigeon General, yezigidi ezingama-265 zaseMelika ezingaphezu kwe-12:
- Izigidi ezili-175 (65.7%) zisela utywala
- Izigidi ezingama-66.7 (24.9%) zachaza ukusela utywala
- Izigidi ezili-17,3 (6.5%) zazizisela kakhulu
- Izigidi ezingama-36 (13.5%) zasebenzisa inambuzane
- 18.9 yezigidi (7.1%) iziyobisi ezingekho mthethweni
- 300,000 basebenzisa i-heroin
Ukuxiliswa ngokwexilongo , ngokwemibiko, "ukusela ezintlanu (abesilisa) / ezine (amabhinqa) okanye iziphuzo ezingaphezulu kweso sihlandlo kwimihla engama-30 edlulileyo" kunye nokuphuza kakhulu ukuba amadoda namabhinqa batywala ubuncinane amahlanu kwiintsuku ezingama-30 ezedlulileyo.
2 - Ukugqithisa i-Opioid Ukufelwa kweeNtlupheko Kuye kwanda ezine
Umgangatho wokunyamezela ngaphezulu iipilisi zeentlungu ze-opioid ezaqala ngawo-1990 zaphumela ekunyuseni ngokukhawuleza ekusebenziseni nasekusebenzisweni kakubi kwezi ntlungu. Ukunyuka kwe-opioid kusetyenziswe kuyo yonke imimandla yelizwe kunye nemigca yabantu.
Xa amagunya aqhekeza "iipilisi zetilisi" kunye no "ugqirha wokuthenga" kulo lonke uhlanga, iipilisi zentlungu zazinzima kakhulu ukuzithengela kwaye zibiza kakhulu. Ngenxa yoko, abaninzi abasebenzisi baqala ukusebenzisa i-heroin eyayingabizi kwaye ikhona.
Lo mboniso waboniswa ngokunyuka kwama-opioid overdose ukufa kuwo wonke ama-US, okwandisa phantse amane phakathi ko-1999 no-2014, ngokwemibiko.
3 - Ukwahlukana phakathi kokusetyenziswa kakubi nokusetyenziswa kakubi
Awukwazi ukubahluko phakathi kwegama elithi "ukusetyenziswa kakubi kweziyobisi" kunye "nokusetyenziswa kakubi kweziyobisi" kuba, ngokuqinisekileyo, akukho mpelahluko. Ingumcimbi we-semantics.
Ingxelo kaGqirha-Jikelele kwi-alcohol, iziyobisi kunye nempilo yecandelo lokuba kuphela abantu abangama-10 ekhulwini labantu abafuna unyango lweziyobisi base-US ngokwenene bafumana unyango kunyaka nawuphi na unyaka. Esinye sezizathu zokuba sisicalulo esisekho kuluntu ngokuphathelele utywala kunye nokulutha.
Ngoko ke, kukho umgangatho phakathi kwabanikezeli bonyango bezonyango ukubhekisela ekusebenziseni igama elithi "ukusetyenziswa kakubi kweziyobisi" kuba kubonakala kungenangcikivo kunokuba "ukusetyenziswa kakubi kweziyobisi." Ingxelo ye-Surgeon General ka-2016 ibhekisela kwiziyobisi ezingasebenzisi kakubi kulo lonke uxwebhu.
4 - Ukungenelela kokuBambisana kunokusebenza ngokukhawuleza
Nangona ukunyamekela kwintsapho yokuxhatshazela ukuzama ukufumana abantu abathandekayo ukuba bangene kunyango lweengxaki zotywala kunye neziyobisi baye bafumanisa ingqalelo ngenxa yokubonakaliswa kwazo kwiiprogram zikamabonakude, ngokwenene, abaphumelelanga.
Ukungenelela kokubambisana, ngamanye amaxesha kuthiwa ngu "Johnson Intervention," kuye kwavela ukususela ngowe-1960, kodwa akuzange kufumaneke kwizifundo zesayensi ukuba ziphumelele ekutholeni abantu kwaye, eneneni, ngokwenene, ingaba yiphumli-eyenza umntu ojoliswe ngakumbi ukuchasene nokufuna unyango.
Kulo lonke ingxelo kaGqirha Jikelele, "ukungenelelo" akubhekiseli kulezi ntlobo, kodwa "kwiprogram ekhutshwe ngokusemthethweni, inkonzo, okanye umgaqo-nkqubo owenzelwe ukukhusela kakubi ukusetyenziswa kweziyobisi okanye ukuphatha ingxaki yokusetyenziswa kwezidakamizwa."
5 - Unyango lwezoNyango alukho iziPhene
Enye into engazange yenzeke ngokude ngayo malunga nokusetyenziswa kweyeza zonyango ukunceda abantu abaneengxaki zokusetyenziswa kotywala kunye nokusetyenziswa kweziyobisi kukuba ukusebenzisa imishanguzo yokunyanga ukukhanga nokurhoxisa kuthatha indawo yokulutha komnye umntu .
Ukusetyenziswa kwe-methadone kunye ne- buprenorphine ukulawula ukulangazelela i-opioid kunye nokuhoxiswa kufunyenwe kwizifundo zesayensi ukunciphisa ukusetyenziswa kakubi kweziyobisi, ukunciphisa umngcipheko wokuphindaphinda nokugqithisa, ukunciphisa ukuziphatha kakubi, ukunciphisa ukusasazwa kwezifo ezithathelwanayo, kwaye kunceda abaxhamli babuyele kwimpilo kwaye indlela yokuphila.
Isimo seendlela ezininzi zokunxaxha ezisekelwe ekusetyenzisweni kwezi zonyango zifaka umlutha omnye kwesinye isayensi kwaye ayinciphise kakhulu ukusetyenziswa kwabo ngabantu abanokuzuza kubo, iingxelo zeDigeon General zichazwe.
Izilungiso malunga nendlela i-methadone kunye ne-buprenorphine enokumiselwa kwaye ihanjiswe nazo zanciphise ukufumaneka kwazo, ingxelo ithi.
6 - Akunakudinga Ukuba Nobubele Ukuba Uthathwe
Ngokwesiko, iingxaki zotywala kunye neziyobisi azizange zonyangwe zize zitshatyalaliswe " ukuhlaselwa phantsi " emva kokusetyenziswa kakubi kweziyobisi. Xa unyango lwalufunwa, kwakusoloko lubonelelwa ngeenkqubo ezizodwa zonyango ezizinzileyo ezahlukileyo kwaye zodwa kwiinkqubo zonyango.
Ingxelo-jikelele ye-Surgeon General 2016 inethemba lokuba kusetyenziswe imimiselo emitsha kwindlela yokusetyenziswa kweengxaki zokusetyenziswa kwezifo ezifana ne:
- Ubunzima bokusetyenziswa kweziyobisi ezinokusetyenziswa kweziyobisi nako nako ukuphathwa
- Naliphina kakubi lokusetyenziswa kakubi kufuneka lifumane ukungenelela
- Ukungenelela kwangethuba kunokuthintela emva koko iingxaki ezinzima
- Ukusetyenziswa kakubi kokusetyenziswa kwezinto kufuneka kube yinxalenye yonyango lokuqala lwempilo
- Ukungenelela kunye nokubeka iliso kufuneka kulandelwe kwinkqubo yokunakekelwa kwezempilo
Ingxelo igxininisa ukuba bonke abantu abaneengxaki zokusebenzisa izidakamizwa badinga unyango oluqhubekayo kwaye abaninzi banokungenelela ngoncedo olufutshane kunye nokubeka iliso, ngoko ke izigulane ezininzi zifumana unyango kubanikezeli bonyango abaqhelekileyo.
Ukuba ukusetyenziswa kweziyobisi kakubi nokungenelela okufutshane kunye nokubeka iliso kwimiqathango yenkqubo yokunakekelwa kwempilo yonyango kunokunciphisa kakhulu ukuphuhliswa kweengxaki zokusetyenziswa kweziyobisi ezinzima, ingxelo ithi.
I-7 - Abaqeqeshi baTywala abaFundiweyo bangaba ngempumelelo
Indlela esandula ukuyisebenzisa ngayo ukusetyenziswa kweengxaki zokusetyenziswa kwezidakamizwa kukusetyenziswa kwabaqeqeshi bokubuyiselwa koontanga, abo bantu bazama ukuzibuyisela bona basebenzise ulwazi lwabo kunye namava okuphila ukuze bancede abanye abatsha ukuba bafumaneke.
Ngamanye amaxesha ubizwa ngokuba ngabaqeqeshi abanobuchule, abaqeqeshi bazama ukuphucula abanye ukuba bafumane ukuxhaswa ngeemvakalelo, ezinokwazi, kunye nenkxaso ekuncedeni ukuba bahlaziye .
Nangona usenokuba weva ngabadumileyo abaqeshisa abaqeqeshi ababuyiselwa ngasese, abaqeqeshi baontanga banokudityaniswa nemibutho yoluntu yokubuyiselwa, iikliniki, amakhaya ahlala phantsi kunye nezikolo eziphakamileyo.
Bangaba ngabaqeshwa kwizicwangciso zokunyamekela okuphambili, amasebe angxamisekileyo, iiklinikhi zempilo yengqondo, iinkqubo zobulungisa bezobugebengu, inhlalakahle yabantwana kunye namaziko angenamakhaya.
Abaqeqeshi bokubuyiselwa koontanga abangekho ukusetyenziswa kweengxaki zokusetyenziswa kweengxaki zonyango okanye abaphathi bee-case case. Akunjalo abaxhasi beprogram ye-12 , kuba abakhuthazi nayiphi indlela yokubuyisela, kodwa baququzelele zonke iindlela.
Kukho izifundo ezimbalwa zophando malunga nokuphumelela kwabaqeqeshi bokubuyiselwa koontanga, kodwa oko kuqhutywe kuyathembisa, ngokwemibiko yeDigeon General.
Iindlu ze-8 zokubuyisela ziyasebenza kakhulu
Izindlu zokubuyisela, ezaziwa ngokuqhelekileyo njengezindlu eziqhelekileyo, ziye zafunyanwa zisebenziseka kakhulu ekuncediseni abo bazalise utywala kunye neyezabisi okanye unyango ukuba bahlale bengabikho.
Enye imodeli ekhankanywe kwingxelo, i-Oxford House, Inc. yinkonzo yokujonga idibanisa iiNdlu ze-Oxford ezingama-43 kunye nesithili sase-Columbia. Izindlu ze-Oxford zibonelela ngezindlu ezinokwenza iindleko kunye nezindlu ezingenazo iindleko kubantu abathile.
Uhlolisiso lwabahlali be-Oxford House lufumene iziphumo ezilandelayo:
- I-87% yabemi yayingabikho emva kweminyaka emibili
- Amanani angabikho amanani angama-4-5 aphezulu kuneziphumo eziqhelekileyo
- Amazinga aphezulu, amaqondo amaninzi okuzimelela nokuzimela
- Imali yenyanga yenyanga
- Amanqanaba afakwa phantsi
Ukuya kwindlu yokubuyisela emva kokuba i-detox okanye iziphumo zonyango zihlala kwiziphumo ezingcono kunokuba zibuye ngqo emphakathini, uphando lufumene.
ILizwi
Ukuba wena okanye umntu owaziyo ukusela okanye ukusebenzisa iziyobisi ngendlela eyingozi kubo okanye kwabanye ababajikelezile, akufanele balinde kude kube yinkinga yokufumana uncedo. Kukho ukusetyenziswa kwezilwanyana zonyango eziye zenzelwe ngokukodwa abo abangakalilwa.
Imithombo:
ISebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu (HHS), i-Ofisi yoMgqirha Jikelele, "Ukujongana nomlingo eMelika: Ingxelo yeDioron General Report on Alcohol, iDrugs, kunye neMpilo, iSishwankathelo seSigqeba." Washington, DC: HHS, ngoNovemba 2016.