Ukujonga iMilication, Counseling and Practicing Therapies
Ndiyabulela kwiminyaka yophando, oogqirha kunye nabaqeqeshi bezempilo ngoku sele benemenyu epheleleyo yokukhetha ukunyangwa kweengxaki zokusetyenziswa kotywala. Ukwakha kule nkqubela phambili, izazinzulu ziyaqhubeka nokusebenza ngamachiza amatsha kwaye zifumene iindlela ezintsha zokuphucula ukusebenza, ukufikeleleka, umgangatho, kunye neendleko-mpu melelo kubantu abanezidakamizwa zokusetyenziswa kotywala.
Ukuma kwiiNqanaba zamaZiko amakhulu
Uphando olukhulu olupapashwe ngo-2006 lwalulandelayo lwabafundi abangaphezu kwe-1,300 abathathi-nxaxheba kwiindawo ezili-11 zemfundo ngaphezu kwexesha eliyiminyaka emithathu ukufumana ukudibanisa unyango, amachiza kunye nokucebisa kwaba yinkqubela phambili yokuphatha izidakamizwa zokusetyenziswa kotywala.
Ukuxhaswa kwamayeza kunye nokuNgeniswa kokuPhathwa koTywala okuThotyayo (COMBINE) kuveze iziphumo ezimangalisa xa kutyhilwa ukuba enye yamachiza omtsha asetyenziselwa unyango lotywala ayiphumelelanga ukuphucula iziphumo zonyango.
Njengoko kuboniswe kwi-COMBINE, akukho mayeza athile okanye isicwangciso sonyango sisebenza ngolu hlobo okanye kuwo wonke umntu.
I-Anti-Alcohol yobisi iRevia, iVivitrol kunye neCampral
Uphononongo lufumene ukuba xa kudibaniswe neengcebiso eziphathekayo zolawulo lwezokwelapha ezibandakanya iiseshoni ezifutshane ezithoba ezenziwa yinkonzo yezobuchopho ukuba amayeza enkunkuma ephuza utshwala eRevia kunye neVivitrol (naltrexone) kunye neeseshoni ezingama-20 zokwelulekwa ngotywala zinobuchule obuchanekileyo bokunxila kotywala .
Ezi ziphumo zibonisa ukuba i-naltrexone okanye ukucebisa ngokukhethekileyo kotywala-kunye nolawulo lwezocwangco oluhle- luyindlela efanelekileyo yokuphatha ukuxhomekeka kotywala, "kusho uMarko L. Willenbring, MD, umlawuli, ukwahlula unyango kunye nophando lophando, iNational Institute of Alcohol Abuse Utywala. "Nangona ulawulo lwezokwelapha luba lukhulu ngakumbi kuncedo lokuxhomekeka kotywala olwenziwe kwiindawo ezininzi zokunakekelwa kwezempilo, alufani nezinye iindlela zokunyamekela izigulane ezifana nokuqalisa unyango lwe-insulin kwizigulane ezineesifo seswekile."
Uphononongo lufumene ukuba ukudibanisa nezinye izidakamizwa eziphuza utshwala iCampral ( acamprosate ) kunye neprogram yolawulo lwezonyango ayizange iphucule iziphumo. I-Campral ayizange ibenze ibe bhetele kunepalbobo okanye ipilisi. Oku kufunyanwe ngabaphandi abaphambukayo kwiiphando zangaphambilini ezenziwa eYurophu basebenzisa iCampral babeneziphumo zonyango ezintle.
QHUBA Iimpawu eziPhambili
Emva kweeveki ezili-16, uvavanyo lwe-COMBINE lubonise iziphumo ezilungileyo ezichaphazelekayo.
| HLAZA I ziphumo zo kufunda |
|---|
| Wonke amaqela afundisisa kakhulu anciphisa ukusela xa kunyango. Iipesenti ezipheleleyo zeentsuku ezingabikho eziphindwe kabini, ukusuka kwi-25 ukuya kuma-73 ekhulwini, kunye nokusetyenziswa kotywala ngeveki kwehla ukusuka kwiisiphuzo ezingama-66 ukuya kwezi-13, ukuhla kwe-80 ekhulwini. |
| Izigulane ezafumana ulawulo lwezonyango kunye neRevia okanye i-Vivitrol ( naltrexone ) okanye ukucebisa ngokukhethekileyo kwabonisa iziphumo eziphuculweyo zokuzila utywala (iipesenti ezingama-80) xa kuthelekiswa nezigulane ezithe zafumana ukuphathwa kwezonyango kunye neepilisi ze-placebo (75 ekhulwini). |
| Izigulane ezamkela uRevia okanye iVivitrol zabika ngokunciphisa ukusela kotywala. |
| Ukongeza iRevia okanye iVivitrol okanye ukucebisa ngokukhethekileyo kotywala kwiprogram yezokwelapha phantse kabili ithuba lokuba wenze kakuhle. |
Ukungenelela kokuziphatha
Ukungenelela kokuziphatha okudibeneyo (CBI) - okubandakanya ukucebisa iingcebiso ezihlangeneyo -unyango wokuziphatha , ukuphucula ukukhuthazwa, kunye neendlela zokuphucula ukubandakanya iqela lokuncedisa iqela -libonise iziphumo ezintle kwizifundo.
Amachiza awanika izigulane inzuzo
Ngokutsho kophando, imishanguzo ibonakala iyinxalenye ebalulekileyo yoludibaniso lokuphumelela kokusetyenziswa kotywala. Kwaye, kusetyenziswa njengendlela yokuphatha utywala.
Uthotho olunamandla kunaloo ndlebe kukuba abo bafumana nayiphi na imishanguzo benza ngcono kakhulu kunabo abazange bafumane iipilisi kuzo zonke, "utsho uProfesa Barbara Mason, i-Scripps Research Institute, kunye nomlobi wesifundo. "Oku kufuneka kube yi-call-up call." Ngaphantsi kwepesenti enye yalabo bafuna ukuncedwa ukuxhomekeka kotywala ofumana imithi ethile, amayeza ayasetyenziswa. Ukuxiliswa kotywala kunokunceda izigulane zifumane ithuba lokuphucula, ngokukodwa kwiindawo ezisemhlabeni. "U
Indlela yeSinclair
Ngomnyaka ka-2001, uDavid Sinclair, Ph.D., umphandi waseFinland wathi i-80% yezinga lokuphilisa ngokuxhomekeka kotywala xa izidakamizwa zokusetyenziswa kotywala zikaRevia okanye iVivitrol zichongwe ngokweSinclair yakhe. Uphando lukaDkt. Sinclair lupapashwe kwiphephancwadi ephononongwa ngontanga noTywala noTywala kunye ne-Journal of Clinical Psychopharmacology. I-Sinclair Indlela yenkqubo yokwenza unyango olusezantsi eFinland, le ndlela isetyenziswa e-UK, kodwa le ndlela ayifumaneki e-United States.
Ngendlela ye-Sinclair, abantu bathatha kuphela uRevia okanye i-Vivitrol ngaphambi kokusela kwaye kungenjalo. U-Revia kunye neVivitrol abafani nezinye iziyobisi ezinxamnye neziyobisi ezibangelwa ukugula okukhulu kunye neengqondo zengqondo xa kuthathwa ngotywala. Ukutshintsha kwendlela yokuziphatha kuvela kuphela ngexesha. Ngendlela ye-Sinclair, iRevia okanye iVivitrol ithathwa iyure enye ngaphambi kokusela utywala. Ekupheleni kweenyanga ezine ukuya kweyinyanga zonyango ngeNkqubo ye-Sinclair, iipesenti ezingama-80 zabantu ababesetyenziselwa utywala basebenzisa ngokunyanisekileyo okanye beshiya ngokupheleleyo.
Indlela esebenza ngayo xa abantu bevame ukusela utywala, i-endorphins ikhutshwe kwingqondo, kwaye oku kuqinisa ukuziphatha kotywala. U-Revia kunye neVivitrol vimba i-endorphins enokuva. Kunjengeenkwenkwezi zikaPavlov xa zithethwa ngokutya xa intsimbi yayisisigxina, ezi zizinja zaye zahlanjululwa ukuba zenze umsindo wentsimbi yodwa. Nangona kunjalo, xa le ntaka zaqhubeka zihanjiswa ngeentsimbi zokulila kunye nokutya, ukunyuka kwamisa.
Kukholelwa ukuba isizathu esona sikhulu seSinclair asizange sibanjwe e-US sibini. E-US, iiprogram ze-12 zinyathelo zilawula izicwangciso zonyango ezibekwe oogqirha, ukuba, kwaye oogqirha abathandi ukuba i-Sinclair Method ikhuthaza abantu abaneengxaki zokuxhomekeka kotywala ukuba baqhubeke bephuza.
> Imithombo:
Anton, RF, et al. "Ukudibanisa i-Pharmacotherapies kunye neNkqubo yokuLungiswa koTywala." ISIFUNDO SOKUQALA: I-Trial Control Control ". Umbhalo we-American Medical Association. Meyi 2006
> ISiko leSizwe malunga nokuTywala noTywala. Uphuhliso lwezoNyango lwezoTywala, uphando lwezoLimo kunye neMpilo , uMqulu 33, iNombolo 4. 2011.
> I-Sinclair, ii-JD izidakamizwa zokunciphisa utywala kotywala. Ama-Annal of Medicine 22 : 357-362, 1990.
> Sinclair, JD. Ubu bungqina malunga nokusetyenziswa kweNaltrexone kunye neendlela ezahlukileyo zokusebenzisa kwiCreatment of Alcoholism. Utywala kunye noTywala. 36 (1): 2-10. 2001.
> Heinälä P, Alho H, Kiianmaa K, Lönnqvist J, Kuoppasalmi K, Sinclair JD.Usetyenziso lweNaltrexone ngaphandle kokuphambaniswa kwangaphambili kwiNyango yoTywala: Uyi-Double Factory-Blind, i-Placebo-Controlled Trial. J Clin Psychopharmacol. 2001 Juni; 21 (3): 287-92.