Yintoni eyahlukileyo?
Kukho umahluko phakathi kokulutha, ukuxhomekeke emzimbeni, kunye nokunyamezela kwiinkonzo zentlungu. Kubalulekile ukuba ngamnye wethu uqonde ukubahluko.
Abantu abaninzi abaneemeko ezibuhlungu ezingapheliyo, kuquka iintlobo ezithile ze-arthritis, zichazwe ngamachiza enhlungu. Iimeko zabo zezokwelapha zichaza imfuno yeziyobisi-yingakho yanyulwe njengenxalenye yesicwangciso sazo.
Nangona kunjalo, ukuba ubeka ingqalelo kwiindaba, abantu abaneempawu zonyango ezivunyelwe ngokusemthethweni bayagxothwa kunye nabaxhaphazi. Singaqonda ngokucacileyo ukuba kuphuhliswe njani. Emva koko, kukho ubhubhane lwe-opioid e-US Izidakamizwa zithi zigqithiswe. Yongeza kuloo mntu udumo olufa ngenxa yokugqithisa iziyobisi kunye nephulo lokulwa neziyobisi elithintela umkhuhlane.
Ngenye yeengxaki ezikhankanywe ngasentla kukukhathazeka ngokusemthethweni. Kodwa ke, ukunganakwa abantu (umzekelo, izigulane ezingapheliyo) ezifanelekileyo zifuna imishanguzo yentlungu ukuba isebenze kwaye ibe nomgangatho wobomi. Ingxaki yabo ayikwazi ukuncitshiswa ngelixa ukukhawuleza kweminye imiba kuthethwa ngayo. Oku kuqondwa kuye kwalahleka ngenxa yokuba abaninzi abantu abaqondi ukuhlukana phakathi komlutha, ukuxhomekeka komzimba kunye nokunyamezela. Asikwazi ukuphazamisa imigca phakathi kwezi zinto ezintathu kwaye silindele ukucombulula iingxaki ezinxulumene nokusetyenziswa kweziyobisi nokusetyenziswa kakubi.
Yisinyathelo sokuqala sonke esinokuyithatha-ukuqonda isigama.
Yiyiphi Isiyobisi?
I-American Society of Addiction Medicine (ASAM), i-American Academy ye-Pain Medicine (AAPM), kunye ne-American Pain Society (APS) iyaqaphela le nkcazelo elandelayo yokuxilisa ngokubhekiselele ekusebenziseni i-opioids ekwenzeni unyango:
Umlutha yiyona nto isisigxina, esingapheliyo, isifo se-neurobiological, kunye nezofuzo zengqondo, yengqondo kunye neemeko zokusingqongileyo ezichaphazela ukuphuhlisa nokubonakaliswa kwayo. Ibonakala ngokuziphatha okuquka enye okanye ngaphezulu kwezi zinto ezilandelayo: ukulawulwa kakubi kokusetyenziswa kweziyobisi, ukusetyenziswa ngokunyanzeliswayo, ukusetyenziswa okuqhubekayo nxamnye nokulimala, nokuthanda.
Ukuxhomekeka Kwenyama?
I-American Society of Addiction Medicine (ASAM), i-American Academy ye-Pain Medicine (AAPM), kunye ne-American Pain Society (APS) iyaqaphela inkcazelo elandelayo yokuxhomekeke emzimbeni:
Ukuxhomekeke kwimizimba yimeko yokuzilungelelanisa ebonakaliswa yinkampu yeziyobisi ethile yokurhoxiswa kwesifo esinokuveliswa ngokukhawuleza, ukunciphisa umthamo ngokukhawuleza, ukunciphisa izinga legazi leziyobisi, kunye / okanye ukulawulwa komchasi.
Yintoni Ukunyamezela?
I-American Society of Addiction Medicine (ASAM), i-American Academy ye-Pain Medicine (AAPM), kunye ne-American Pain Society (APS) iyaqonda le nkcazelo elandelayo yokunyamezela:
Ukunyamezela kuyimeko yokulungelelanisa apho ukuchasana nezidakamizwa kubangela ukuba utshintsho olubangelwa ukunciphisa (oko kukuthi, ukunciphisa okanye ukunciphisa) enye okanye ngaphezulu kweziphumo zeziyobisi ngaphezulu kwexesha.
Oko kwathiwa, ininzi yeentlobo zonyango kunye neengxaki zokulutha umlutha zivuma ukuba izigulane ezingapheliyo ziphethe ixesha elide neziyobisi ze-opioid zihlala zixhomekeka.
Ezinye izigulane ziya kukhulisa ukunyamezela. Kodwa, ngokuqhelekileyo, eli qela lezigulane alinakho ukuxhatshazwa. Umngcipheko wobugqirha obonakalayo ungabonakali kwaye awunakulinganiswa, kodwa unokuthi unxulumene nemibandela emininzi, kubandakanya ukufakwa kwemfuyo.
Umlutha ngokwawo uyisifo esingasigxina. Ukuboniswa kweziyobisi kuyinto enye ekuphuhliseni kwayo. Enyanisweni, kwiimeko ezininzi, ukuchasana neziyobisi ezingakhuthaza isikhokelo somvuzo wengqondo akuvelisi umlutha.
Iimpawu zeMpawu kunye neentetho
Ukulawulwa kakubi, ukufunwa, kunye nokusetyenziswa ngokunyanzeliswa kwezidakamizwa, kunye nokusetyenziswa okuqhubekayo kwezidakamizwa nangona iziphumo ezingekho emzimbeni, ezingqondweni, okanye ezentlalo zibhekwa njengempawu ezibonakalayo zobunzima.
Kodwa, kunokuba nzima ngakumbi kunokuba nje ukuqonda ukuba khona kwezi zixhobo. Iinkalo ezifanayo zinokuthi zihambelane nokukhululeka kwentlungu. Ugqirha kufuneka akwazi ukusebenzisa isigwebo sawo kwaye aqonde phakathi kokutshabalala kunye nesinye isizathu.
Kukho iziganeko ezizodwa ezibonisa ukuba unobungozi. Ezi ziphatha ziquka:
- ayinamathelani kwishedyuli emiselweyo yeziyobisi
- kuthatha idosi enye ngexesha
- iingxelo eziphindaphindiweyo zezilwanyana ezibiwe okanye ezilahlekileyo
- ugqirha yokuthenga (ukufumana iziyobisi kumgqirha ongaphezu kweyodwa)
- ukwahlukana (ukufuna ixesha yedwa)
- Ukongeza ukusetyenziswa kweziyobisi ezingasimiselweyo
- usebenzisa imilenze yeentlungu ze-sedation, ukuxhatshazwa, ukukhulisa amandla, okanye ukunciphisa amanqanaba okuxhalabisa
- ukucela ezinye iinkqubo okanye iindlela zokulawulwa kweziyobisi
- ukuphepha okanye ukuphazamiseka kwindlela yokwenza unyango lwe-opioid
Ukuchasana ngokucacileyo kudibaniswa kunye nokuba nobunzima, nemiphumo emibi. Ngakolunye uhlangothi, ukuxhomekeka komzimba kuthathwa njengempendulo eqhelekileyo ngumzimba kwisifo esingapheliyo okanye sokuqhubeka kwamachiza athile-kwaye kungekhona nje imilenze yeentlungu ze-opioid. Ngokomzekelo, ukuxhomekeka komzimba kunokwenzeka nge-corticosteroids, ukuxhatshazwa kweengcinezelo, i-beta blockers, kunye namanye amayeza angathatyathwa njengomlutha. Ukuba iziyobisi ezinokuxhomekeka ekuxhomekeke emzimbeni ziyakucinywa, isilwanyana kufuneka sitshintshwe ukuze sigweme iimpawu zokurhoxisa (umzekelo, i-prednisone tapering).
Ukunyamezela kuyinto encinci ukuqonda. Ukunyamezela kuyenzeka kwimpembelelo efunwayo yeso sidakamizwa, kodwa inokuthi ifumaneke kwimiphumo engathandekiyo. Ukunyamezela kuyahluka, kuvela kumaxabiso ahlukeneyo kwimiphumo eyahlukileyo. Ukusebenzisa i-opioids njengomzekelo, ukunyamezela kwimiphumo ye-analgesic kwenzeka kancinci ngaphezu kokudandatheka okuphefumulayo.
Ngaphantsi
Umlutha yiyona nto ingxaki yokuziphatha, nangona ingaxhomekeke ekuxhomekeke emzimbeni. Ngokuqhelekileyo, umlutha uquka ukusetyenziswa kwezidakamizwa ngaphandle kwemiphumo emibi, ukukhanga izidakamizwa nangona kungenakubuhlungu emzimbeni, kwaye uyisebenzise ngenxa yezizathu ngaphandle kwesalathisi esicacisiwe. Ukuxhomekeke kwimizimba kubonakala xa umntu ekhulisa ukunyamezela kwisiza okanye ukuba umntu uya kuba neempawu zokuyeka ukuyeka isilwanyana ngokukhawuleza. Ukunyamezela kubakho xa umlinganiselo ofanayo ungagcini umphumo ofanayo, ngaloo ndlela ufuna ukuba amanani aphezulu aphumelele umphumo oyifunayo. Ngaphakathi, ngokwabo, ukuxhomekeke kwimizimba akuthethi ukuba kukho umlutha, kodwa inokuhamba kunye nomlutha xa kukho umlutha.
Imithombo:
Iinkcazo ezinxulumene nokusetyenziswa kweepioids kwiNyango yoBunzima: Ingxelo yokuBoniswa kweMelika ye-American Academy ye-Pain Medicine, i-American Pain Society kunye ne-American Society of Addiction Medicine. ASAM. 2001.
http://www.asam.org/docs/default-source/public-policy-statements/1opioid-engcaciso-census--011.pdf?svvnn=0
Imigaqo yeNyango yokuLungiswa kweziyobisi: I-Guide Based Based Guide (I-Edition YesiThathu). Ngaba kukho ukumahluko phakathi kokuxhomekeka komzimba kunye nokulutha? Isizwe seSizwe sokuLawulwa kweziyobisi. Disemba 2012.
https://www.drugabuse.gov/publications/principles-drug-addiction-reatreatment-research-based-guide-edition/frequently-asked-tionstions/there-ference--p--public-pend-
Ukuxhomekeka koMzimba kunye noMlutha - Ukubaluleka okubalulekileyo. NAABT. Ukuhlaziywa 03/12/2016.
http://www.naabt.org/addiction_physical- dependence.cfm/
Iziyobisi ngokusetyenziswa kakubi. IV. Isingeniso kwiiKlasi zeDrug. Ulungiso lwe-2011: I-DEA yeNcedisi yeZibonelelo.
http://www.dea.gov/docs/drugs_of_abuse_2011.pdf