Izinketho Zonyango Neengonyango
Abantu baye baba ngumlutha we-opioids kangangamakhulu eminyaka, nangona kunjalo, ukusebenzisa i-opioids kuye kwanda ukusuka ngonyaka ka-2000 kunye nophuhliso kunye nokuthengiswa kwamanxeba anamandla atywala kakhulu kwaye ayenomngcipheko omkhulu wokugqithisa. Oku kuye kwaba yingxaki enkulu, kunye neengxaki ze- opioid ezenzeka e-US nakwezinye iindawo zehlabathi.
Umlutha we-opioid ungenye yezilingo ezinzima kakhulu zokusinqoba, kodwa kukho ezinye iindlela zokwenza unyango olukhulu olukhoyo lunokukunceda ekuziphatheni ngokomzimba, kwengqondo kunye noluntu kwimeko enzima.
Nangona i-opioid i-opioid i-painkiller isalathisi ifana kakhulu ne-heroin yokutshabalalisa, kukho ukubaluleka kweentlalo eziza kubangela uhlobo lwonyango oluya kunceda.
Ulwaphulo olususelwa kuTywala
Nangona kukho abantu abaninzi abakholelwa ukuba babambe iqhosha lokunyanga izilingo, inyaniso kukuba yinkathazo eyinkimbinkimbi yexesha elide eqhubekayo kubantu abasengozini. Ngoko unyango olufunekayo luyinkimbinkimbi kwaye luninzi.
Kubalulekile xa sicinga naluphina unyango olusekelwe kubungqina , oko kuthetha ukuba unyango luye lwafundwa kwaye luboniswe ukuba luncedo kubantu abaninzi abanemeko. Zonke iinkqubo ezixutyushwa kule nqaku zinobungqina obufanelekileyo bobunzululwazi bokuxhasa ukuphumelela kwabo, nangona oku akuthethi ukuba basebenzela wonke umntu, ngamaxesha onke, ingakumbi xa esetyenziselwa ukwahlukana nezinye, unyango oluyimfuneko.
Kubalulekile ukuba unyango lube luncedo ukuba loo mntu ufumana unyango olwaneleyo kwiimpawu eziphathekayo, iingqondo zengqondo, kunye nemibandela yenyama, kunye neemeko zentlalo kunye nemiphumo yenkinga.
Ukuba kukho nayiphi na le miba emithathu yokulutha i-opioid ayilungiswanga kakuhle, unyango alukwazi ukuphumelela, kwaye umntu uya kuphinda abuyele, evakalelwa ngakumbi nangokwehluleka kunokuba ayenze ngaphambi kokuba azame ukuyeka. Ngoko ke, ezi zonyango kufuneka zihlanganiswe kwisicwangciso sonyango esibanzi esilandelwayo ngaphambili, ngexesha, nangemva kokuba umntu eshiya i-opioids.
Ukunciphisa Ulwabiwo
Ukunciphisa umonakalo kuyindlela yokunceda abantu abane- opioid yokusebenzisa ingxaki ejolise ekunciphiseni izilima eziphathekayo nezentlalo ezichaphazela abantu abasebenzisa i-heroin, ngamanye amaxesha ezinye i-opioids, kunokuba bakhuthaze umntu ukuba ayeke.
Ukunciphisa utyalo yingxenye ebalulekileyo yonyango kubantu abafaka i-opioids. Iquka izicwangciso ezifana neenkqubo zokutshintshwa kweedaliti, ii-site injection ekhuselekileyo, i-opioid yokuguqulwa kwimizimba (njengeenkqubo zokunakekelwa kwe-methadone), kunye ne-naloxone njengesixhobo sokuguqulwa kwamanzi. Ukunciphisa umonakalo kukhulula ubomi babantu abaza kufa ngenxa yokusuleleka ngegazi njenge-HIV kunye ne-hepatitis, i-blood poisoning, kunye nokugqithisa. Amacandelo okunciphisa amanxeba amaninzi isisinyathelo sokuqala kumntu osebenzisa i-opioids ekuncedeni uncedo, kwaye unokukhokelela kwonyango olongezelelweyo.
Ukunyanga kweengqondo kwi-Opioid Umlutha
Ukunyanga kweengqondo kuye kwaba yinkimbinkimbi kakhulu kwiminyaka embalwa edlulileyo, kwaye kugxininisa kuwo onke amanqanaba okulwa nomlutha we-opioid, ekubeni wenze isigqibo sokutshintsha, ukuyeka okanye ukunciphisa ukusetyenziswa kwe-opioid, ukuyeka ukuziyeka, nokuphepha ukuphindaphinda. Kukho iindlela ezahlukeneyo, ezimele zilungele ukuhlangabezana neemfuno zomntu kunye ne-opioid disorder disorder.
Eminye yonyango eyaziwayo kakhulu yengqondo ichazwe apha ngezantsi.
Ukukhuthazwa kweengxoxo kunye noThuthukisa ukuThuthukisa
Isizathu sokubaluleka kweengqondo kubaluleke kakhulu kwindlela yokwelapha i-opioid. Ukuba umntu akanakuziva ekhuthazwayo ukuyeka i-opioids, banomngcipheko omkhulu wokuphinda abuyele, oko oku kungakhokelela ekubeni mngcipheko wokufa ngokugqithisa. Ngenxa yalesi sizathu, ukuxoxwa ngokunyanisekileyo okanye unyango olushukumisayo olushukumisayo luyisinyathelo esibalulekileyo ekuncedeni abantu abasebenzisa i-opioids ukuba bahlale bekulungele ukuyeka ngaphambi kokuba bazame kwaye baholele kwiinqanaba ezahlukeneyo zenguqu .
Udliwano-mbululo luvame ukufunyaniswa kakuhle ngabantu abasebenzisa i-opioids kuba kuyindlela exhasa kakhulu. Nangona kukho iimbali zeengxaki malunga nokuphandabuzwa kweengxoxo , unyango lubonakala lusebenza.
I-Treatment of Conduct Practicing (CBT)
I-cogntive therapy , okanye i-CBT, yenye yezona zonyango ezibonakaliswe ngongxaki yokusebenzisa i-opioid. Ukongezelela, kusebenza kakhulu ekuphatheni uluhlu lwezinye iingxaki zengqondo, ezifana nokukhathazeka kokukhathazeka, ukuxinezeleka, nokuxhwaleka, okudla ngokubakho ngokugqithisa i-opioid. Ngako oko, i-CBT ihlala yinto efanelekileyo yengonyango yokuqala.
Ababhinqileyo Ukucebisa
Ukucebisa abantu abinileyo okanye izibini zonyango, ngamanye amaxesha kuthiwa unyango lomtshato, luboniswe ukuba luncedo kakhulu ekuphatheni iingxaki zokusetyenziswa kweziyobisi kunye nezilingo, kuquka ukusetyenziswa kwe-opioid disorder. Ukucebisa okubinileyo kunceda bobabini abathandanayo ukuba bahlale ndawonye ngexesha nangemva kokubuyiselwa kwimeko yokusebenzisa i-opioid kunye nalabo abakhetha ukuhlukana. Ngamanye amaxesha izicalulo zengcebiso zingasetyenziselwa kunye nezinye izibonelelo.
Unyango lweNtsapho
Ulwaphulo lweentsapho lunokunceda iintsapho ezininzi apho omnye okanye amalungu entsapho enenkathazo yokuxhatshazwa okanye ukusetyenziswa kweziyobisi, kodwa kusebenza ngokukhethekileyo kubaselula abanenkinga yokusetyenziswa kweziyobisi. Indlela ehamba phambili igxininisa kwiintsholongwane zentsapho ngokupheleleyo njengoko zifuna ukunakekelwa ngonyango, kwaye umntu okanye abantu abaneengxaki zokusetyenziswa kweziyobisi bathathwa njengesifo sesifo seentsapho jikelele, kunokuba kungenxa yeengxaki.
Ulwaphulo lwezentsapho luza kunceda xa amaqabane okanye abantwana bechaphazelekayo nokuziphatha komntu onomlutha we-opioids. Ukuva malunga namava abo kunokunceda ukukhuthaza umntu onomlutha wokutshintsha ukuziphatha kwakhe ukuze kuphuculwe ubomi balabo abathandayo. Intsapho inokufumana iindlela zokuxhasa umntu oyeka i-opioids, kwaye uyazi ngakumbi iindlela abanokuba nazo ngokungabonakali ukuba neengxaki ezenzeke kwixesha elidlulileyo.
Ulwaphulo lwezentlalo luyaziwa kakhulu, kwaye lunokufumaneka njengenxalenye yenkqubo yonyango epheleleyo, kunye ne-inshurensi, kunye nokufumaneka ngasese.
Hypnotherapy
I-Hypnotherapy luhlobo lonyango lwengqondo olusebenzisa iziganeko zengqondo kunye nesiphakamiso sonyango ukunceda abantu abanezidakamizwa ukuba bacinge ngokuphathelele utshintsho. I-Hypnotherapy isebenzisa i-hypnosis ukubanceda abantu bafikelele ezi ngongoma zengqondo ngendlela efanelekileyo nefanelekileyo. Akunjenge-stnosis yesiteji, esisebenzisa amavolontiya okanye amaqhinga angabonakaliyo engqondweni ukuze athabathe abaphulaphuli.
Abanye abantu bafumana i-hypnosis ukuba iphumelele ekunqabuleni izithintelo zabo zengqondo ekutshintshiseni, kwaye ifumene i-hypnotherapy ukuxhobisa, kunye nokuphumla, kubancede bazive baninzi ukulawula isimo sabo sengqondo ngaphandle kweziyobisi. Nangona kunjalo, nangona i-hypnotherapy iyaziwa kakuhle, yinto ephikisanayo kunye nexesha eliqhelekileyo elingaqondakaliyo. Ukuba uthatha isigqibo sokuzama i-hypnotherapy, qiniseka ukuba usebenzisa umgqirha ofanelekileyo. Iimfuneko zeemqinisekiso zihluka ngolawulo kwaye kufuneka ulindele ukuhlawula i-$ 100-200 ngeyure. Mhlawumbi ufuna iiseshoni ezininzi ze-hypnotherapy ukukuxhasa ngenkxaso yakho.
Neurotherapy
I-neurotherapy yonyango oluqhelekileyo oluqhelekileyo lwezobisi, kodwa lusetyenziswa kakhulu, ngakumbi kubantu abangaphenduli kakuhle ukuthetha unyango. Kwafunyaniswa ngexesha lovavanyo lwezilwanyana apho ingqondo ingaqeqeshwa ukuba ivelise iingqondo ezihlukeneyo ezinxulumene namazwe angokwengqondo ephilileyo, nokuba kukho iipatheni zengqondo ezichaphazelekayo kwiimeko ezahlukahlukeneyo zengqondo, kubandakanywa umlutha.
I-neurotherapy ibandakanya ukuba i-sensors ye-elektroniki inamathele ngesikhumba sakho kunye ne-gel eqhubayo, kwaye ukhululeke ngelixa ikhomputer ikunika ingxelo kwingqondo yakho yengqondo. Le ngxelo ingaba ngendlela ye-movie, ebonakala ilula njengokuba ubuchopho bakho buvelisa iifom ezinqwenelekayo kwaye bumnyama njengoko kuvelisa iifrikansi ezinxulumene nobungozi bokuxhatshazwa. Ngaphandle koko, ividiyo ingaba nombala owandisa okanye wehla ngokunyaniseka njengengxelo. Iimvumi okanye izandi zomsindo zingasetyenziselwa ukunikezela ngengxelo, ephakamileyo okanye ephazamisekile ngokuxhomekeke kwimeko yakho yengqondo, ekuvumela ukuba ubuyisele ingqondo yakho njengoko ukhulula amehlo akho avaliwe. Ukuba umculo okhethiweyo uyamnceda kwaye uyamnandi, oku kungabonwaba kakhulu, okuvumela abantu abanomlingo ukuba bafumane amandla abo okufikelela kumazwe angcolileyo ngengqondo ngaphandle kweziyobisi.
Akunabasebenzi abaninzi abanokwazi ukubonelela ngeenkonzo ze-neurotherapy, njengoko kungaziwa kwizakhono zempilo, kwaye kufuneka ukuba uqeqesho olubanzi kunye nezixhobo ezixabisekileyo ukubonelela ngenkonzo. Kodwa abo bazinikezelayo, kunjalo, bahlala bezinikezele kakhulu, kwaye baqonde ukukwazi ukunceda abantu abangazange baphendule kakuhle kwezinye iyeza. Ukuba ucinga nge-neurotherapy, qiniseka ukuba ukhetha ugqirha oqinisekisiwe ne-Biofeedback Certification International Alliance (BCIA), kwaye ulindele ukuhlawula i-$ 100-200 ngeyure, kwiiseshoni eziliqela.
Isisombululo seshumi elinambini
Ukuququzelela isishumi elinambini isicwangciso esakhiwe kwisiseko sokuthi ukubandakanyeka kwiqela elixhasayo njengamaNarcotics Anonymous okanye Utywala abangabonakaliyo kunokunceda abantu ukuba bafeze kwaye bahlale beqhekeza. Nangona kukho ubungqina bokuba le ndlela iphumelele kunyango lokusetyenziswa kakubi kotywala kunye nokuxhomekeka, ubungqina bokusebenza ngempumelelo kubantu abaxhomekeke kwi-opioid akukacaci. Ukongezelela, njengoko amaqela ayengekho unyango olusesikweni, ngamanye amaxesha abantu abahlukumezayo bangasebenzisa amathuba abathathi-nxaxheba, kwaye banokusebenzisa amaqela ukujongana neziyobisi.
Abathathi-nxaxheba abaninzi kula maqela banenzuzo kubahlobo obutsha kunye nezinto ezinokuthi zingabangelwa yimibutho yenkxaso efana ne-NA okanye i-AA. Iintlanganiso zikhululekile kwaye ziyafumaneka jikelele kwihlabathi. Ezi nkqubo zincike ekuvunyelweni kwesifo sengxaki yokusebenzisa izidakamizwa, ukuzinikela kumandla aphezulu, kunye nobudlelwane phakathi koontanga abangenayo.
Ulawulo oluPhezulu
Ngamanye amaxesha ukulawulwa kwexesha elifanelekileyo kusetyenziswa xa abantu abaneengxaki zokusetyenziswa kweziyobisi banelungelo lokunyangwa ngumqeshi okanye kwinkqubo yenkundla. Kwindlela yokulawulwa kwemigqaliselo, ukungaphumeleli ukuthobela iziphumo zonyango ekulahlekelweni komsebenzi, ukuvalelwa entolongweni kunye nokulahleka kwedumela. Ukulawulwa kwezinto ezingapheliyo kunokubambisana nezikhuthazo ezintle okanye ezikhuthazayo, apho abathathi-nxaxheba bangayifumana imali okanye iifowuni zokuthobela inkqubo.
Unyango lwezoNyango lwe-Opioid
Kukho iindlela ezininzi ezikhethiweyo zokukhetha kuzo ukuba ukhetha unyango lwezonyango.
Buprenorphine
Umgca wokuqala wonyango usetyenziso lwe-pharmacological okanye unyango olusisiseko nge-buprenorphine, imithi yecalinge ekhusela i-opioid receptors kwingqondo ukukhusela iimpawu zokuhoxisa i- opioid, ngaphandle kokubangela inani elifanayo le-sedation okanye i-euphoria ehlangene ne-opioid agonists.
Ukwelashwa kwe-Buprenorphine kulondolozwa kwiklinikhi. Izigulane ezigcinwe kwi-buprenorphine okanye i-methadone aziguquleli kwesinye isiyobisi sokusetyenziswa gadalala: zizonke ziyeza kunyango oluchanekileyo olumiselwe ngumgqirha ofanelekileyo.
Oogqirha badinga ilayisenisi okanye i-DEA waiver ukuba imisele i-buprenorphine okanye i-Suboxone (buprenorphine kunye ne-naloxone, ukuphazamisa ukujova). Abantu abasebenzisa ezi zonyango bahlala bekwazi ukulungisa ubudlelwane, babambe imisebenzi, kwaye basengozini encinane yobundlobongela besitalato, ubundlobongela kunye ne-HIV. Bafezekisa ukuzinza okubangela ukuba uthathe inxaxheba epheleleyo kwiingenelo zokuziphatha kunye nezinye iindlela zonyango lwengqondo.
IMethadone
I-Methadone yi-opioid eyenziwe yinto eguqula intlungu yesimiso seentlanzi, kodwa ngokunciphisa ukunyamezela nokudityaniswa kunye ne-heroin kunye neziyobisi ze-opioid. Oku kuthetha ukuba abantu abanomlutha kwi-opioids, njenge heroin, banokuzinzileyo kwi-methadone, bavumele ukuba babeke ubomi babo ngokufanelekileyo, kwaye bajoyine unyango ukuze baphathe izizathu ezibangela ukuxhatshazwa kwabo. Isebenza ngonyango lokurhoxiswa kwi-opioid kwaye isetyenziswe kunyango oluxhaswa ngamachiza enomsoco opioid. Ngokuqhelekileyo unikezwa ngomlomo, kodwa inokunikezwa nge-injection, kwifom ye-liquide, okanye njenge-tablet okanye i-tablet. Ngokuqhelekileyo ihanjiswa kwinkqubo evunyiweyo kaRhulumente.
Naltrexone
I-Naltrexone yonyango olongezelelweyo lonyango olusetyenziswa rhoqo kangako ukuxhomekeka kwe-opioid. Ikhusela ngokupheleleyo i-opioid receptors kwaye ngenxa yoko, ngamanye amaxesha abantu abasebenzisa i-opioids abayithandi umphumo, ngokuqhelekileyo basebenzisa kuphela xa iinjongo zabo zokuyeka ziphezulu kakhulu. I-injection yexesha elide, iVivitrol, yindlela yokwenza i-naltrexone eyanciphisa ukuthotyelwa, efuna iilenki zenyanga.
Ukukhetha iNgcali
Ukuba unengxaki yokusebenzisa i-opioid disorder, ukuthunyelwa kwinkcazo yempilo yengqondo okanye ingcali yonyango kunokunceda ukugqiba amanyathelo alandelayo. Amathuba akho okuphumelela axhomekeka kakhulu kwi-motivation yakho yokutshintsha.
Iingcali zonyango zonyango zivunywa ngokusemthethweni kwamanye amanqanaba, kodwa imithetho yelizwe iyahluka ngokumalunga neziqinisekiso aba bantu kufuneka babambelele kwilayisenisi. Kweminye imimandla kunye namazwe, kukho imfuneko emincinci kwimfundo noqeqesho kwiimeko zokusebenzisa izidakamizwa, kwaye akukho nokuba ngumqathango wokuqeqeshwa ekucebisi okufanelekileyo. Kukho inani lewebhu elinemithombo yokukunceda ukuba ufumane iinkonzo zonyango, kubandakanywa iiwebhusayithi ezigcinwe yiarhente karhulumente njengeSAMSHA.
Kubalulekile ukufumana ochwepheshe bezonyango abaqeqeshwe ekugqithiseni. Eli qela lingabandakanya oogqirha abaqinisekisa nge-American Board ye-Addiction Medicine, okanye abo baqeqesha iminyaka kwiindawo zokuhlala ngengqondo kunye nokuqonda kakuhle kwesi sifo, nangona inani elincinci lonyango loogqirha, ikakhulukazi abo basebenza kuluntu kunye namazinga aphezulu okusetyenziswa kwezifo ze-opioid, abanolwazi kakhulu kwaye banokwazi ukunyangwa kwe-opioid disorder disorder.
Kwakhona kubalulekile ukufumana uqeqesho oluzimeleyo olungayi kuxhamla ngokwezimali kwiingcebiso zabo kwinkqubo ethile okanye iqela leenkqubo. Ku luncedo ukubonisana nochwepheshe onolwazi olubanzi kuzo zonke iinketho zokonyango, kungekhona umnini wesibonelelo sonyango.
Uvavanyo olusisigxina ngumqeqeshi oqeqeshwe ekuvavanyeni kweengxaki zokusetyenziswa kweemveliso kufuneka zibandakanye ukuhlolisiswa kweendlela zakho zokusetyenziswa, ubuninzi besetyenzisiweyo, ubunzima, iingxaki zomthetho okanye ezinxulumene nomsebenzi, kunye nedatha encedisayo engabandakanya imfuza, imbali yentsapho, ukuxhatshazwa, izakhono zokuhlangabezana kunye neenkqubo zokuxhasa.
Abanye abaqeqeshi bexilongo bacela ukuthetha namalungu entsapho okanye abahlobo abasondeleyo, ukuze bafumane umbono obaluleke ngakumbi kwipateni yokusetyenziswa kwesigulane. Kukho izinto ezininzi ezinokukhokela uqeqesho lwezempilo ukuze ufumane isicwangciso sonyango esingcono kakhulu. Kubalulekile ukucwangcisa isicwangciso kwiinkolelo zomntu kunye nesayensi yesayensi.
ILizwi
Nangona ingaba isinyathelo esinzima ukufuna unyango lwe-opioid disorder disorder, kwaye ngamanye amaxesha ungathatha unyango oluninzi kwaye uphinde ubuyele kwakhona ukuba ungabikho nto, akukho nto ungayikuzisola ngazo. Kukho amabali amaninzi aphefumlelayo abantu abunqobile i-opioid disorder disorder, kwaye baye baxabisa ngokutsha ubomi ngenxa yoko.
> Imithombo
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> UDehghani-Arani F, uRostami R, uNalali H. Neurofeedback uqeqesho lwe-opiate umlutha: Ukuphucula impilo yengqondo nokuthanda. I-Applied Psychophysiology ne-Biofeedback ; 38 (2): 133-141. 2013.
> Manganiello A. Uphononongo olulinganisiweyo lwe-hypnotherapy kunye neengqondo zonyango ekwenzeni unyango lwe-methadone. I-American Journal ye-Clinical Hypnosis ; 26 (4): 273-279. 1984.
> Moore B, Fiellin D, uSchottenfeld R, et al. Ulwaphulo lokuziphatha olunokwenzululwazi luphucula iziphumo zonyango lwabasebenzisi be-opioid kwiprogram yokunakekelwa kokunakekelwa kwe-buprenorphine. Umbhalo weNyango yokuSebenzisa unyango ; 71: 54-57. 2016.
> Ukuqaliswa kwonyango echazwe kwisifundo ngokuthelekisa ukukhululwa kwe-naltrexone, buprenorphine. Uhlaziyo lwe-Psychopharmacology ye-Brown University ; 29 (3): 1-6. 2018.