Iposi eliqhelekileyo lokuLawula i-Syndrome elibhekiselele kwiNinzi yokubuyela kwakhona
Sibanzi
I-post ye-withdrawal syndrome (PAWS) ikhutshwe iminyaka emininzi ngamalungu oluntu ekuphumeni njengesona sizathu esibalulekileyo sokuphindaphinda kwalabo abazama ukuhlala behlambulukile kwaye banobuchule.
Emva kokubuyisela izidakwa kunye noomlutha ukugqithisa uxinzelelo kunye nobuqhamo bokuqala ukuyeka ukuyeka ukuzibulala, ezinye iingcali zithi, enye iimpawu zeempawu zihamba kunye ezingenakonwabisayo okanye zenze ixhoba ngokwaneleyo ukuze kubangele ukuba abanye baphinde baphinde baphuphe iimpawu zabo.
Kodwa, into eyaziwa ngokuba yi-sucrative withdrawal syndrome okanye nje ukuhoxiswa ixesha elide akukho nto iphikisanayo. Akusiyo i-diagnostic esemthethweni yexilongo kwaye ayifumanekanga kwiNcwadana yokuHlola kunye neSatistim of Disabilities.
Kukho izifundo ezimbalwa zopapasho zenzululwazi ezipapashiweyo eziqinisekisa ukuba kukho i-PAWS kwaye kukho ukungabikho kokuphandwa kwangoko kutshatyalaliswa ngokukhawuleza.
Ukuphikisana
Ukunqongophala kobungqina benzululwazi kunye nokukhutshwa kwiincwadi zokuxilonga ze-syndrome kubangele ukudideka kwiindawo zonyango eziqhelekileyo malunga nokuba i-PAWS yinto engokoqobo, okanye nje isizathu esithandwayo sokuphindaphinda .
Abanye baye babuza ukuba loo nto ebizwa ngokuba yi-syndrome ikhona okanye iveliswe yoshishino lotywala kunye neziyobisi zonyango ukuze zizame ukulungelelanisa imfuneko yeenkonzo zabo zangexesha elide.
Kwabo baye bafumana iimpawu ezingalindelekanga ze-PAWS, nangona kunjalo, i-post-withdrawal syndrome yeyona nto iyinyani.
Parameters
Olunye uphando luqhutyelwe ngokukodwa ukufumana ukuba i-PAWS imele ifakwe kwi-DSM-IV. Emva kokuphononongwa kweencwadi ezikhoyo ngelo xesha, iSatel kunye nabalingane kwiYunivesithi yeSikole seMicrophelo yeYevesithi bagqiba ukuba ukuxilongwa akufanele kufakwe.
Kodwa, izazi ze-Yale zafika esi sigqibo, kungekhona ngenxa yokuba i-syndrome ayikho, kodwa ngenxa yeendlela "zokunciphisa iindlela zokufunda kunye nokungahambisani kwemvumelwano yegama ngokwalo."
Izifundo ezenza rhoqo zichaza iimpawu ezidlulayo ngaphandle kokuhoxiswa ngokukhawuleza zahluleka ukubonakalisa ngokukodwa ukuxothwa ngokukhawuleza kotywala kunye ne-opiates kuba bengenalo:
- Yenza isampuli esithile sexesha
- Sebenzisa izixhobo zokusebenza
- Sebenzisa amaqela okulawula
- Ukuphinda ulawule le nkunkuma ukucima iimpawu
Uphando
Nangona izifundo ezimbalwa kule minyaka ziye zavuma ngokucacileyo inkcazo kunye nemigqaliselo yokuhoxiswa ngokukhawuleza, abanye abaphandi baye babhala ezinye zeempawu ezinxulumene nesifo.
Olunye uhlolisiso lwaseJamani lubone ukuba ukusetyenziswa kotywala ixesha elide kuthintela imiphumo yeekhemikhali ezithile kwi-brain (i-pearde ene-natriuretic pearde). Oku kubangele ukwandisa ukunxila kotywala kunye nokwanda kweemvakalelo zokuxhalabisa ngexesha lokukhutshwa kwexesha elide.
Ucwaningo lwexesha elide kwiYunivesithi yaseYohn Hopkins kwi-312 etywalayo ezinxilisayo zifumanise ukuba ezinye zeempawu "zokudambisa" ukukhutshwa-ityala, ukudandatheka, ukungazibandakanyi-ukuhlaliswa kwezinto-zancipha ngokuthe gqolo, kodwa kwezinye iimeko zingathatha iminyaka eyi-10 ukuba ibuyele "amanqanaba aqhelekileyo."
Ababhali be-Johns Hopkins ukuphelisa ukuba iziphumo zabo "zihambelane nomgaqo wesifo sokukhutshwa kwexesha elide."
Izizathu
Njengoko iimpawu zokurhoxisa ngokukhawuleza ekuqhoxeni kwangaphambili ziqala ukunciphisa nokuzinza, iimpawu zesikhokelo sokukhutshwa ngokukhawuleza ziqala ukuvela, zidla phakathi kweentsuku ezisixhenxe neye-14 zibe zingenangqondo .
Ukusetyenziswa kwexesha elide nokusetyenziswa kweziyobisi kunokubangela ukuba utshintsho lweekhemikhali kwingqondo . Xa umntu ngokukhawuleza eyeka ukusebenzisa, ingqondo kufuneka ilungelelanise nokuba engenakho ezo zinto. Kuze kube nini lohlengahlengiso luhlala luxhomekeke ekubeni umonakalo omkhulu wokusetyenziswa kakubi kweziyobisi wenziwa njani kwinkqubo yomzimba wesifo.
Inkqubo yengqondo eguqula ukungenazo iziyobisi okanye utywala ingadlwengulwa ngumthwalo wokuzama ukuzigcina ubambela emva kweminyaka yokusela okanye ukusebenzisa iziyobisi.
Ngenxa yokuba abaninzi abantu ekusebenziseni utywala osetyenziswayo kunye nokusetyenziswa kweziyobisi ekujonganeni noxinzelelo kwixesha elidlulileyo, naluphi na uxinzelelo abanalo xa bezama ukuhlala bexakekile kunokukwenza ukuba iimpawu zabo zokuyeka ukukhutshwa zikhuphe.
Iingcali zokubuyiselwa zikholelwa ukuba ubunzima beempawu ezixakekayo zokuxotha zixhomekeke kwizinto ezimbini: umonakalo wokusetyenziswa kotywala kunye nokusetyenziswa kweziyobisi kwenzelwa inkqubo yeentloni ngaphezu kweminyaka kunye nomlinganiselo wokuxinezeleka kumntu oye wafumana ngexesha lokuphulukana.
Iimpawu
Abantu abafumana isifo sengqondo sokurhoxisa ngokukhawuleza bayichaza impawu ezayo "kumagagasi" okanye ekuhlaseleni kweemvakalelo kunye nokuhla. Ukubuyisela izidakwa kunye nezilutha, iiveki zokuziyeka, zibika ukuba zezi ntlobo zeempawu:
Imizwa engaqinisekiyo kunye engaqinisekanga - Enye yeempawu eziqhelekileyo ezichazwe ngabantu abachaphazelekayo yi-PAWS ziguquguquke okanye ziguquke ngendlela engafanelekanga. Bika iimvakalelo eziphawulezileyo zokudandatheka okukhulu ngaphandle kwesizathu okanye ukucaphukisa, ngelixa emva koko bafumana ukuxhalabisa okanye ukuxhalaba.
I-Anedonia - Anedonia ilahlekelwa ngumdla kwizinto owake wathanda ukuzenza, ngamanye amaxesha uchazwa njengokuba unakho ukukwazi ukuziva ujabule. Kwiimeko ezinzima, i-anedonia ingakwazi ukunweba ukulahlekelwa ngumdla ifuna izidingo ezisisiseko, njengokutya.
Iimvakalelo ezinzulu okanye iimvakalelo zobungqina - Le mpawu inokuhluka ngokubanzi ekubuyiseleni abantu. Abaninzi bavame ukucaphukisa. Ngamanye amaxesha banokuxhamla ngokugqithiseleyo kwaye banomsindo ngokugqithiseleyo kwimicimbi emincinci, ke baye kwisigaba sokungabi noluvo lwabo. Abanye bachaza njengento engenanto okanye engenazo ngaphakathi.
Ukungakwazi ukugxila okanye ucinge ngokucacileyo - Abantu abanokupheliswa kade kwangexesha amaninzi abanakho ukulungisa iingxaki ezilula ngenxa yokungakwazi kwabo ukucinga ngokucacileyo. Bachaza ubunzima bokugxila kwaye ngamanye amaxesha kuba kukufumanisa kunzima ukucinga ngantoni na ngaphandle kokuba bangaphuzi okanye basebenzise iziyobisi. Ukucinga okuqhelekileyo okanye okuphindaphindiweyo kuyaqhelekileyo.
Ulungelelaniso olubi kunye nokuxhamla - Le mpawu ayiqhelekanga njengezinye iimpawu ze-PAWS, kodwa yinto ebalulekileyo. Abanye abantu abakwixesha elide lokuxothwa, ukuxilwa, ukuxotha, iingxaki kunye nokukhathazeka. Abantu abafumana ukukhubeka kunye nokuxhamla ngexesha lokurhoxisa ixesha elide banokubonakala bexiliswe xa besenqabileyo.
Ukuphazamiseka kokulala - Mhlawumbi iimpawu ze-PAWS ezinoxanduva lokubuyisela kwakhona kwakhona zizinto ezihlobene nokuphazamiseka kokulala. Akunakukufumana nje kunzima ukulala, bafumane ukulala kwabo kuphazamisekile. Abaninzi babika ukuba ukulala kwabo kuphazamiseka xa bevuka emva kokuba "basebenzisa iphupha" apho basebenzisa utywala okanye iziyobisi.
Ukukhanga Okuqinileyo - Yiyo ke, esinye isizathu sokuba abaninzi bezama ukuyeka ukugqiba. Nangona emva kweeveki-kwaye ngamanye amaxesha-ekuzikhumbuleni, abantu abayifumanayo ngokukhawuleza banokukhangela izifiso ezinamandla kwiziyobisi zabo ezikhethiweyo.
Ukwandisa Ubuninzi kwiinkxalabo - Iimpawu ezinokungalindelekanga zokukhutshwa kwabantu abaninzi ukufumana izilonda kukunyusa ukwanda kwengcinezelo kunye neziganeko ezixinzelelekileyo. Abanye babika ukuba abagqithisi nje kuphela, kodwa banokugandatheka nakwiimeko ezincinci. Iingcali zonyango zikholelwa ukuba le ngxaki yokuxininisa inokunyusa zonke ezinye iimpawu zokurhoxisa.
Izibonakaliso zengxaki yeMood
Kubalulekile ukuba uqaphele ukuba ezininzi iimpawu ze-PAWS ezichazwe ngasentla-ezinjengeemvakalelo ezingazinzileyo, i-anedonia, ukuxinwa kwezinto ezikhuselekileyo kunye nokuphazamiseka kokulala-kunokubonakalisa ukuphazamiseka kwemizwelo njengengcinezelo enkulu. Iingxaki zemizimba zihlala ziqhubana ngokusetyenziswa kweziyobisi. Ukuba ezi zimpawu ziqhubeka, zinzima, kwaye ingakumbi ukuba zihamba kunye neengcinga zokuzibulala, kufuneka kuhlolwe i-psychiatric assessment.
Ukujamelana
Nangona ulwazi malunga nokuhoxisa ngokukhawuleza kwimeko eninzi kwiincwadi zenzululwazi, kubhalwe ngokucacileyo kwindawo yokubuyisela. Abo baphatha iimpawu zokurhoxisa kunye nokuzama ukukhusela ukuphindaphinda bajwayelene nokuyeka ukuhlala ixesha elide.
Ukuba uye wangena kwinkqubo yonyango yonyango okanye ube yilungu leqela lokuxhasa ezifana nezoNxila ezingabonakaliyo kwiminyaka engama-20 edlulileyo, mhlawumbi uye wakuva okuninzi malunga nesifo sengqondo sokurhoxisa.
Umbhali othengisa ngokugqithiseleyo kunye nobuchwephesha bokusetyenziswa kakubi kweziyobisi uTerrence T. "Terry" UGorski wabhala ngokucacileyo le ncwadi kwiposi ekhutshwa ngokukhawuleza. Incwadi Yakhe, "Ukuhlala Unobungozi: Isikhokelo Sokuthintela Ukuphindaphinda" (ukuthenga kwi-Amazon) akuchazi nje kuphela i-syndrome ngokucacileyo kodwa ichaza iindlela zokubuyisela abantu abanokujamelana ne-PAWS.
LeMfundo
Ngokutsho kweGorski, isicatshulwa sokungavumeli ukuba iimpawu zokuyeka ukuxotha zibangele ukuphindaphinda ukuzifundisa malunga neempawu ukuze ukwazi ukuba ungalindela ntoni, uzilungiselele ukujongana nesifo ngasinye njengoko kuvela, kwaye uphuhlise icebo lokusingatha uxinzelelo ngaphandle iziyobisi kunye notywala.
"Iimeko ezibeka emngciphekweni ophezulu wokufumana iziganeko zokuhoxiswa ngokugqithiseleyo ngokuqhelekileyo azikwazi ukuzinyamekela kunye nokungabikho kokuqwalaselwa kwenkqubo yakho yokubuyisela," uGorski wabhala. "Ukuba uya kubuyela ngaphandle kokubuyela kuphinda udinga ukuba uqaphele imeko ezixinzelelekileyo ebomini bakho ezinokunyusa umngcipheko wokufumana ii-PAWS."
Ulawulo lweengxaki
"Njengoko ungeke ukwazi ukususa kuzo zonke iimeko ezixinzelelekileyo kufuneka uzilungiselele ukuba uziphathe xa zivela. Akusiyo imeko eyenza ukuba uhambe, kwaye usabela ngayo kwimeko," kusho uGorski.
UBob Carty, umlawuli weenkonzo zeekliniki eHazelden e Chicago, uyavuma ukuba ukwazi ukuba iimpawu zokuyeka ukukhupha kubalulekile ukuba ufunde indlela yokuzilawula.
"Ukulawulwa ngempumelelo kweempawu zakho zokuphuza utshwala okanye iziyobisi kunokukunceda uzive ungcono ngokomzimba nangokwemvakalelo, ukuphucula ukuzithemba kwakho, nokunciphisa umngcipheko wokuphindaphinda," uCarty uthi kwiwebhusayithi yeHazelden Betty Ford.
Ulawulo lweMpawu
Ngenxa yokuba uxinzelelo lunokwenza ukuba uphawu lwe-PAWS lube lukhulu, ukufunda ukulawula uxinzelelo kunokukunceda ukulawula iimpawu zakho zokuyeka ukukhupha, uGorski uthe.
Ngokutsho kokuthi "Hlalani nizibonele" zezi zixhobo onokuzisebenzisa ukulawula iimpawu zokurhoxa:
- Ukuchonga imithombo yakho yoxinzelelo
- Ukuphuhlisa izakhono zokuthatha izigqibo kunye nezakhono zokusombulula iingxaki
- Gcina ukutya okufanelekileyo
- Ukuzivocavoca rhoqo
- Ukuphuhlisa imikhuba rhoqo
- Gcina isimo sengqondo esihle
- Funda izakhono zokuphumla
Bobabini iGorski kunye neCarty bayavuma ukuba ukuthetha ngeempawu zakho kunye noxinzelelo oluxhomekeke kumntu osithembayo, njengomcebisi okanye umxhasi we-AA, unokukunceda ukuhlangabezana nokuhoxiswa ixesha elide. Ukuxelela abanye ngezinto ojamelene nazo kunokukunceda ubone imeko ngokubhekiselele.
Ubude
Abanye abantu abayeke utywala kunye neziyobisi abazange bafumane iimpawu zokuyeka ukukhutshwa kwamanye amazwe, ngelixa abanye banokujamelana neempawu ezithile kwiminyaka yokuyeka. Ubungakanani bexesha iimpawu ezingapheliyo zixhomekeke kwindlela yesilwanyana esivela kuyo.
Iingcali zokuvuselela zithi izigulane ezilahla kwi-alcohol and based opiate based based painkillers ziza kubakho ikhefu elikhutshwayo emva kweenyanga ezintandathu ukuya kwezi-24. Nangona kunjalo, kukho iingxelo zabantu abayekile kwi-benzodiazepines abanokufumana iimpawu ezili-10 kamva.
"Iimpawu ze-PAWS zikhula ziba namandla ngaphezu kweenyanga ezintathu ukuya kweziyisithandathu emva kokuqala ukuyeka," kusho uGorski. "Umonakalo uvame ukuguqulwa, oku kuthetha ukuba iimpawu ezinkulu zihamba ngexesha xa kunikwa unyango olufanelekileyo. Ngoko akukho mfuneko yokwesaba ."
Imithombo:
DeSoto CB, no-al. "Symptomatology kwizoNxila kwiindawo ezahlukeneyo zokuzilahla." Utywala: Uphando lwezonyango kunye novavanyo lukaSeptemba 2007
Kiefer F, et al. "Ukubandakanywa kweplasma ye-peptide ye-ayriyriyriyriyriyriyriyritic in-withdrawled withdrawal". I-Acta Psychiatrica Scandinavica ngoJanuwari 2002
Satel SL, et al. "Ngaba kufuneka ukuxothwa ngokukhawuleza kweziyobisi ku-DSM-IV?" I-American Journal ye-Psychiatry ngo- Apreli 2006