Ingabe bazolimaza i-fibromyalgia nezinye iziguli ezibuhlungu ezingapheli?
Sibhekene nesifo esibuhlungu esingapheli eMelika. Kwaphela amashumi eminyaka, abantu ababhekene nobuhlungu obungapheli be- fibromyalgia noma ezinye izimo ezibuhlungu baye bazibuza, "Kuyini lapho isakhiwo sezokwelapha sizokhokha khona ngempela?" Manje zikhona, kodwa ungase ungathandi umphumela.
I-CDC iyala odokotela ukuthi bangayiphatha kanjani ubuhlungu obungapheli, futhi leli gumbi lesisekelo lezincomo yilokhu: ama-painkillers ama-opioid awavunyelwe ukusetshenziswa kwesikhathi eside.
Zinezizathu ezinhle zaleso sincomo, kodwa lokho akusho ukuthi ngeke kubangele ukuhlupheka okwengeziwe kubantu asebevele behlupheka kakhulu kunokwanele.
Imithi ethize esikhuluma ngayo lapha ihlanganisa:
- I-oxycodone
- I-Hydrocodone
- I-Codeine
- Morphine
- Fentanyl
- I-Methadone
Igama elithi "opioid" lisho izinguqulo zokwenziwa kwezidakamizwa ze-opiate. Zivame ukubizwa ngokuthi izidakamizwa.
I-Crux ye-Opioid Issue
Enhliziyweni yenkinga ukuthi sibhekene nokuhlukunyezwa kwe-painkiller nokufa ngokweqile. Eqinisweni, ukweqa ngokweqile izidakamizwa manje kuyimbangela ehamba phambili yokufa ngengozi e-US, futhi i-opioids iyisizathu esikhulu salokho.
Ngokusho kwe-American Society of Addiction Medicine:
- Abantu abangaphezu kuka-47,000 bafa ngokudakwa kwezidakamizwa ngo-2014;
- Cishe abangu-19 000 kulabo abafelwayo babangelwa ngenxa yokuphulukisa izidakamizwa;
- Abangu-11 000 ngaphezulu babizwa ngokuthi i-heroin (ngaphezulu ngalokhu ngezansi);
- Ukushona kwama-opioid okungahlosiwe kuye kwaphindwe kane kusukela ngo-1999;
- Njengoba ukudayiswa kwe-opioid ngokomthetho kuye kwanda, ukwelashwa ngokweqile nokudlula ngokweqile ukufa ngenxa yama-opioids kuye kwafana nabo.
Kungani ubheka ukufa kwe-heroin eceleni kwalawo mithi ebuhlungu? I-Heroin i-opioid nayo, futhi ekuhlolweni, cishe amaphesenti angu-94 e-heroin abayiluthayo athi baqala ukugqilaza izidakamizwa zesiguli bese beshintshela ku-heroin ngoba kungabizi futhi kulula ukuyithola.
Ukusetshenziswa kwe-heroin nokushona ngokweqile kuye kwaphakama ngesilinganiso esifanayo nomuthi wokulutha opioid nokufa.
Uma ubhekene nalezi zinombolo, ukwanda kwemigomo ye-opioid ngokuzumayo kusabisa. Yinkinga yomphakathi kanye nenkinga yokuphoqelela umthetho okufanele iqondiswe.
Yingakho i-CDC ibheka indlela i-opioids enqunywe ngayo futhi ifuna ezinye izindlela.
Ubuhlungu Bangapheli Nokuswela Ukwanele
Okwamanje, sinabantu abaningi abanobuhlungu obuhlala njalo. I-National Institutes of Health (NIH) ngo-2015 yathi "indlela ephikisana ngayo-eyodwa-ehambisanayo yonke" yayingenele futhi isetshenziselwa ukusetshenziswa okungaphezulu kwezidakamizwa ezingekho izidakamizwa ezisekelwe ebufakazini, ezizimele, futhi zibandakanya izinhlobo eziningi zokwelashwa.
Ngesikhathi esifanayo, i-NIH ikhulume obala ukuthi umphakathi wezokwelapha ungazijwayele ngokwelashwa okungewona okwelashwa, okwenza kube lula ukuthembela kuma-opioids.
Abantu abaningi abaphila nobuhlungu obungapheli bangakufakazela iqiniso lamazwi kaNIH. Lokhu kungenxa yokuthi ukwelashwa kwabo kuhilela kuphela ama-painkillers futhi akwanele. Kungaba njalo ngoba bahlolisise ezinye izinketho futhi bathola ukukhululeka okungaphezulu kunamaphilisi kuphela. Kodwa-ke, ngisho nalabo abaye bathola ezinye izindlela zokwelapha eziphumelelayo, ama-opioid avame ukuqhubeka nokudlala indima emgomeni wabo.
Ukwengeza, abantu abanezimo ezingaqondakali ezifana ne-fibromyalgia bavame ukuthola ukuthi odokotela babo abakwazi ukunikeza isiqondiso esifanele kulokho okumele kwenziwe ngaphandle kokuthatha imithi , futhi leyo mithi ivame ukufaka ama-opioids.
I-Trend Away esuka ku-Opioids
Ngenxa yokuthi ama-opioids asiza abantu abaningi ukusebenza kangcono, umphakathi obuhlungu ongapheli usabele ngesaba nokuthukuthela njengoba uhulumeni kanye nokuphoqelelwa komthetho bazama ukuwasebenzisa kabi ukusebenzisa i-opioid.
Lapho odokotela beqala ukuphenywa futhi abanye balahlekelwa amalayisensi abo, abanye odokotela baba nesaba kakhulu ukubeka i-opioids. Ubani ongabeka icala? Akekho ofuna ukuthi ukuphila kwabo kusongelwe.
Khona-ke, ngo-2014, i-Drug Enforcement Administration yahambisa i-hydrocodone ohlwini lokulawulwa kwezidakamizwa, kusukela kuSheduli III kuya kuSheduli II, eyenza iziguli zifinyelele ngezingodo ezintsha ukuze zithole imiyalelo egcwele, kuhlanganise nokuthola umuthi omusha odokotela njalo, futhi badinga ukuthatha isisindo somzimba endaweni ekhemisi esikhundleni sokuthi udokotela uyithumele ngefeksi.
Lokhu kwakha ubunzima obengeziwe, ikakhulukazi kubantu okufanele bahambe ngendlela ende eya ehhovisi likadokotela wabo kanye / noma ekhemisi.
Iziguli ezibuhlungu kanye nabameli bacele uhulumeni nokuphoqelelwa komthetho ukuthola izindlela zokulwa nale nkinga ngaphandle kokulahla abantu bemithi abathembele kuyo. Noma kunjalo, lokho akubonakali ukuthi yilokho abakutholayo.
Ngesikhathi esifanayo, ukuhlupheka okungapheli kuyinkinga enkulu edinga ukuqondiswa kahle. Ngokwe- National Pain Report:
- Izigidi ezingamaMelika ezingu-100 zihlushwa ubuhlungu obungapheli,
- Ubuhlungu bubiza i-US cishe ngo-R6 600 billion ngonyaka,
- Abantu abaningi banokuhlupheka okungapheli kunokwesifo sikashukela, isifo senhliziyo noma umdlavuza.
Izincomo ze-CDC
Entwasahlobo ka-2016, i-CDC yashicilela isiqondiso sayo sokubhala ama-opioids for Pain Chronicle. Ichaza izinkinga ze-opioids ezibangela, zibeka izinketho zokwelapha ezingekho izidakamizwa nezingekho opioid, nobufakazi (noma kunalokho, ukuntuleka kwayo) ukuthi ukusetshenziswa kwe-opioid kuphumelela ebuhlungu obungapheli.
Isiqondiso sikhipha amaphoyinti angu-12 odokotela okumele balandele uma bebeka opioids ngobuhlungu obungapheliyo. Ihlanganisa indlela yokunquma ukuthi i-opioids ifanelekile yini isiguli ngasinye, ukuthi ungayifaka kanjani inzuzo ngokubhekelana nomngcipheko, okumele kuxoxwe ngayo nesiguli, indlela yokulondoloza ukwelashwa kwe-opioid ngokuphepha, nendlela yokubuka ukulutha nokulondeka ngendlela efanele.
Uma ucabangela izingozi - kokubili kumuntu nomphakathi - la maphuzu angu-12 anengqondo futhi anesibopho. Uma udokotela efunda lonke, umbiko omude kakhulu, uzobona ukuthi yiziphi izinhlobo zokwelapha ezisekelwe ebufakazini, okufaka:
- Ukwelapha ngokomzimba
- Ukwelashwa kokuziphatha kwengqondo
- Sebenzisa imithi yokwelapha
- I-steroid injection.
Uma kuziwa emithini engekho opioid, i-CDC ikhuluma:
- Izidakamizwa eziphikisayo ezifana ne-ibuprofen
- Anticonvulsants ezifana ne-pregabalin ne-gabapentin
- Ama-antidepressants.
Phezu kwalokho, isincomo se-CDC sinengqondo. Kungani kunika izidakamizwa eziyingozi kubantu abaningi uma kungabasizi okuningi futhi kubangela inkinga enkulu yempilo yomphakathi?
Ukukhathazeka
Odokotela kufanele bafinyelele ubuhlungu ngendlela engavamile, ephelele. Kodwa-ke, kuze kube yilapho umphakathi wezokwelapha ufundiswa kangcono ngezindlela ezingezona izidakamizwa, lokhu akunakwenzeka ngendlela enenjongo.
Umbiko ogcwele we-CDC ubude kakhulu. Uma udokotela ebukela amaphuzu angu-12 ekugcineni, ngeke abone noma yiziphi ezinye izincomo. Abanye bangabona umugqa wokuqala- "Ukwelapha okungenayo i-Nonpharmacologic kanye ne-nonopioid pharmacologic therapy okukhethwa ukuba ubuhlungu obungapheli," - bese uma lapho.
Lokhu kuzwakala njengezinsolo ezinzima zodokotela. Akuhlosiwe ngaleyo ndlela. Odokotela bamatasa futhi bangase bangabi nesikhathi sokuhamba ngezinhlahlandlela ngekhefu elihle. Ngaphezu kwalokho, kuyilapho abanye odokotela bezimangalisayo, ezinye ziphakathi, kanti ezinye ziyizihlukumeza. Iziguli ezibuhlungu, futhi ikakhulukazi lezo ezimweni ezingaqondakali ezifana ne-fibromyalgia, ngokuvamile zizwa izinto ezinjengalezi, "Asinayo izidakamizwa ezisebenza kahle kulokho, ngakho-ke kufanele ufunde ukuhlala nayo."
Ezinye izimpendulo
Abaguli bezinhlungu nabameli baye bacela imithethonqubo ehlakaniphile exazulula izinkinga ezinomthelela omncane kulabo abasebenzisa lezi zidakamizwa ngokusemthethweni. Ngesinye isikhathi, baphikisana, kufanele ulalele isiguli.
Isibonelo, ocwaningweni, odokotela bangase bangacabangi ukuthi inani lokuthuthuka elibalulekile uma umuntu ezwa ubuhlungu, ukuthi ukuthuthukiswa okuncane kungukuhlukana phakathi kokukhiqiza okuthile nokuhlala embhedeni usuku lonke, noma phakathi kokukwenza ngosuku lomsebenzi ukuhamba nokukhubazeka.
Ingxabano evamile ukuthi inombolo encane kakhulu yeziguli ezibuhlungu iba umlutha we-opioids, ngesifundo esisodwa esibonisa ukuthi kwenzeka kuphela kuma-3 amaphesenti. Uma uqeda labo abanomlando wokusebenzisa kabi izidakamizwa noma ukulutha umlutha, izinga liwela ngaphansi kwamaphesenti angu-0.2.
Ukwengeza, banxusa kakhulu ukugxila ezindleleni ezingekho emthethweni lapho abathengisi abaningi abalahla noma abadakamizwa bethola ama-opioid abo, njengalawa:
- Ukweba noma ukudala amapayipi amakhompiyutha
- Ukuthengwa kwe-intanethi okungekho emthethweni
- Ukweba kuma-pharmacy, izibhedlela noma izikhungo zezokwelapha
- Ukuzenza abasebenzi bezokwelapha nokubiza ekufakweni kabusha.
Inkinga ye-opioid yinkinga eyinkimbinkimbi futhi ephuthumayo. Mhlawumbe ngolunye usuku inkinga izokwehliswa ngokwanele ukuthi iziguli ezibuhlungu ngeke zizwe sengathi zibhekiswe ngokungalungile futhi zilahlekelwa ukufinyelela kwimithi abayidingayo.
Okwamanje, ukhokha iziguli ezibuhlungu ukuba zifundiswe ngalezi zinkinga-kanye nezinhlahlandlela-ngakho singaqinisekisa ukuthi odokotela bethu bawasebenzisa ngokunembile futhi hhayi ukuwahumusha ngokuthi "ungawunikeli igunya loku-opioids".
Kufanele futhi siqaphele izinkinga ze-opioids ezingadala emphakathini, kubantu abaseduze nathi, nakithi. Ukuze uthole olunye ulwazi, bheka:
- Ukuthatha ama-Painkillers Ngokuphepha
- Ama-ophiates for Fibromyalgia & Chronic Patigue Syndrome
Imithombo
I-American Society of Addiction Medicine. Umlutha we-Opioid: 2016 Amaqiniso & Amanani. Wonke Amalungelo Agodliwe. Kufinyelelwe: ngo-Ephreli 2016.
U-Dowell D, et al. Izincomo nemibiko. 2016 Mashi 18. 65 (1); 1-49. Umhlahlandlela we-CDC wokubeka i-opioids ngobuhlungu obungapheli - i-United States, ngo-2016.
Isikhungo sePolisi ehloswe ngezinkinga. Ukukhwabanisa kwezidakamizwa nokusetshenziswa kabi, Isiqondiso No. 24, Edition 2. Julie Wartell, uNancy G. La Vigne. Wonke Amalungelo Agodliwe. Kufinyelelwe: ngo-Ephreli 2016.
Fishbain DA, et al. Imithi yobuhlungu. 2008 Meyi-Jun; 9 (4): 444-59. Yimaphi amaphesenti weziguli ezingapheli ezibuhlungu ezingenabuhlungu ezivezwe olwazini olungapheli lwe-opioid le-analgesic ukuthuthukisa ukuhlukunyezwa / ukulutha umuthi kanye / noma izimo ezihlobene nezidakamizwa ezihlobene nezidakamizwa? Ukubuyekezwa okusekelwe ebufakazini obuhlelekile.
Isikhungo seNational on Abuse Abuse. Ukuphuza Ukuphuza Ama-Opioids: I-Heroin kanye Nemithi Yokudakwa Kwezidakamizwa. Nora D. Volkow, MD. Wonke Amalungelo Agodliwe. Kufinyelelwe: ngo-Ephreli 2016.
Umbiko Wezinhlungu Zesizwe. Abagulayo Abangapheli Abagulayo Banokuthile Okushoyo Mayelana "Ne-Opioid Epidemic." Wonke Amalungelo Agodliwe. Kufinyelelwe: ngo-Ephreli 2016.