Kodi amavulaza fibromyalgia ndi odwala ena osamva?
Tikukumana ndi vuto lalikulu lakumva ku America. Kwa zaka zambiri, anthu omwe akudwala ululu wa fibromyalgia kapena zinthu zina zopweteka kwambiri adadzifunsa kuti, "Kodi azachipatala atiperekere liti kwenikweni?" Tsopano iwo ali, koma inu simungakonde zotsatira.
CDC ikulangiza madokotala momwe angachiritse kupweteka kwanthawi yaitali, ndipo mwala wapangodya wa malangizi ndi awa: opioid painkillers sakuvomerezedwa kuti agwiritse ntchito nthawi yayitali.
Ali ndi zifukwa zomveka zowonjezera, koma izi sizikutanthauza kuti sizingayambitse mavuto ena mwa anthu omwe akuvutika kale kuposa kale.
Mankhwala omwe timayankhula pano ndi awa:
- Oxycodone
- Hydrocodone
- Codeine
- Morphine
- Fentanyl
- Methadone
Mawu oti "opioid" amatanthauza mankhwala opiate. Iwo amatchulidwanso kawirikawiri ngati mankhwala osokoneza bongo.
Nkhani Yachiwawa ya Opioid
Pamtima wa vutoli ndikuti tikukumana ndi mliri wa matenda opweteka komanso kuwonongeka kwa owonjezera. Ndipotu, kuwonjezera pa mankhwala osokoneza bongo tsopano ndi chifukwa chachikulu cha imfa mwadzidzidzi ku US, ndipo opioids ndi chifukwa chachikulu cha izo.
Malingana ndi American Society of Addiction Medicine:
- Anthu oposa 47,000 anafa chifukwa cha mankhwala osokoneza bongo mu 2014;
- Pafupifupi anthu okwana 19,000 amamwalira chifukwa cha mankhwala osokoneza bongo;
- Pafupi anthu ena 11,000 adatchedwa heroin (zambiri pamunsimu);
- Kufa kwa opioid popanda cholinga mwadzidzidzi kwakhala katatu kuyambira 1999;
- Ngati malonda a opioid ovomerezeka awonjezeka, mankhwala osokoneza bongo ndi kuwonjezereka kwa imfa chifukwa cha opioids afanana nawo.
Bwanji kuyang'ana pa imfa ya heroin limodzi ndi mankhwala opweteka? Heroin ndi opioid nayenso, ndipo mufukufuku, pafupifupi 94 peresenti ya heroin akudandaula amanena kuti poyamba adayamba kumwa mankhwala osokoneza bongo ndipo amasintha kupita ku heroin chifukwa ndi zotchipa komanso zosavuta kupeza.
Kugonjetsedwa kwa heroin komanso kuwonjezera pa chiwerengero cha anthu oposa zaka makumi asanu ndi limodzi (100) akufera pamtundu wofanana ndi mankhwala osokoneza bongo opioid ndi imfa.
Poyang'anizana ndi manambala amenewo, kuchuluka kwa malamulo a opioid kukudzidzimutsa mwadzidzidzi. Ndi umoyo waumphawi komanso vuto la malamulo lomwe liyenera kuthandizidwa.
Ndicho chifukwa chake CDC ikuyang'ana momwe opioid imayankhira ndikuyang'ana njira zina.
Kupweteka Kwambiri ndi Chithandizo Chokwanira
Pakalipano, tili ndi anthu ambiri omwe amakhala ndi ululu wopitirira. Bungwe la National Institutes of Health (NIH) mu 2015 linati njira ya "mapiritsi-yokwanira-onse" inali yoperewera ndipo inagwiritsidwa ntchito kwambiri chifukwa cha mankhwala osagwiritsa ntchito mankhwala omwe anali okhudzana ndi umboni, ogwiritsidwa ntchito pawokha, ndipo amagwiritsa ntchito mitundu yambiri ya chithandizo.
Pa nthawi yomweyi, a NIH adanena poyera kuti chipatala chonse sichidziwika bwino ndi mankhwala osachiritsika, zomwe zimapangitsa kuti zikhale zosavuta kudalira opioids.
Anthu ambiri omwe ali ndi ululu wosatha amatsimikizira kuti mawu a NIH ndi oona. Izi zikhoza kukhala chifukwa chakuti mankhwala awo amangophatikizapo kupweteka komanso osakwanira. Zingakhalenso chifukwa chakuti afufuza njira zina ndikupeza mpumulo wambiri kusiyana ndi mapiritsi okha. Komabe, ngakhale pakati pa omwe apeza njira zina zothandizira, ma opioid nthawi zambiri amapitiliza kugwira ntchito mu regimen yawo.
Kuonjezerapo, anthu omwe sadziwa zambiri monga fibromyalgia amapeza kuti madokotala awo sangathe kuwatsogolera pazomwe angachite kupatula kumwa mankhwala , ndipo mankhwalawa amakhala opioids.
Njira Yopita ku Opioids
Chifukwa chakuti opioids imathandiza anthu ambiri kugwira bwino ntchito, anthu ovutika kwambiri amachititsa mantha ndi kukwiya pamene boma ndi malamulo akuyesera kuthetsa kugwiritsa ntchito molakwa opioid.
Madokotala atayamba kufufuzidwa ndipo ena adataya malayisensi awo, madokotala ena adachita mantha kwambiri kuti alembe opioids. Ndani angawatsutse? Palibe amene akufuna kuti moyo wawo uopsezedwe.
Kenaka, mu 2014, Drug Enforcement Administration inachititsa kuti hydrocodone ikhale ndi ndondomeko yoyendetsera katundu, kuyambira pa ndondomeko III mpaka pa ndondomeko yachiwiri, yomwe idapangitsa odwala kudumpha kudumphira atsopano kuti adziwe mankhwala, kuphatikizapo kupeza mankhwala atsopano kwa dokotala nthawi zonse, ndi akuyenera kutenga mankhwala oyenera ku pharmacy mmalo mwa kukhala ndi dokotala fakitale.
Izi zinayambitsa mavuto ena, makamaka kwa anthu omwe amayendetsa galimoto kwa nthawi yaitali ku ofesi yawo ndi / kapena mankhwala.
Odwala opweteka ndi oyang'anira akuyitanitsa boma ndi malamulo kuti apeze njira zothetsera vuto popanda kuletsa anthu a mankhwala omwe amadalira. Komabe, izo sizikuwoneka kuti si zomwe iwo akupeza.
Pa nthawi yomweyi, kupweteka kwanthawi yaitali ndi nkhani yaikulu yomwe imayenera kuyankhulidwa bwino. Malinga ndi National Reporting Report:
- Anthu mamiliyoni 100 a ku America akuvutika ndi ululu wosatha,
- Mavuto amawononga US $ 600 biliyoni pachaka,
- Anthu ambiri amakhala ndi ululu wosatha kusiyana ndi matenda a shuga, matenda a mtima kapena khansara.
Ma CDC's Recommendations
Kumayambiriro kwa chaka cha 2016, CDC inafotokoza malangizo ake olembera opioids for Chronic Pain. Zimatchula mavuto omwe amachititsa opioids, kuyambitsa njira zosagwiritsira ntchito mankhwala osokoneza bongo komanso zosagwiritsidwa ntchito ndi opioid, komanso umboni (kapena kuti, kusowa kwawo) kuti ntchito ya opioid imatha kupweteka kosatha.
Chitsogozochi chimapereka mfundo 12 kuti madokotala azitsatira pamene akulemba opioids kuti azivutika kwambiri. Zimaphatikizapo momwe angadziwire ngati opioids ndi yoyenera kwa wodwalayo, momwe angaganizire zopindulitsa ndi masewera, zomwe muyenera kuzikambirana ndi wodwalayo, momwe angasamalire bwino opioid mankhwala, ndi momwe angayang'anire mankhwala osokoneza bongo komanso momwe angachitire moyenera.
Poganizira zoopsa - kwa munthu aliyense komanso kwa anthu - mfundo 12zi ndi zanzeru komanso zowona. Ngati dokotala akuwerenga lonse, lipoti lalitali kwambiri, iye adzawona mtundu wotani wa zochitika zokhudzana ndi chithandizo, zomwe zikuphatikizapo:
- Kuchiza thupi
- Njira yothetsera chidziwitso
- Chitani mankhwala
- Steroid jekeseni.
Malinga ndi mankhwala osakhala opioid, CDC imatchula:
- Mankhwala otsutsa-kutupa monga ibuprofen
- Anticonvulsants monga pregabalin ndi gabapentin
- Kudetsa nkhaŵa.
Pamwamba, malangizo a CDC ndi othandiza. Nchifukwa chiyani amapereka mankhwala owopsa kwa anthu ambiri pamene sakuwathandiza kwambiri ndipo akubweretsa vuto lalikulu la thanzi la anthu?
Zodetsa nkhaŵa
Madokotala ayenera kukhala akukumana ndi ululu m'njira yodziwika bwino, yowonjezera. Komabe, mpaka dera lachipatala liphunzitsidwe bwino za njira zopanda mankhwala, izi sizingakhoze kuchitika mwa njira iliyonse yopindulitsa.
Mauthenga onse a CDC ndi otalika kwambiri. Ngati dokotala akuyang'ana ndemanga 12 mwachidule pamapeto pake, sangawone zotsatira zina. Ena amatha kuona mzere woyamba- "Nonpharmacologic therapy ndi mankhwala osagwirizana ndi mankhwala osagwiritsidwa ntchito osopioid amakonda kupweteka kosalekeza," - ndipo imani pamenepo.
Izi zikuwoneka ngati chitsutso chotsutsa cha madokotala. Izo sizinakonzedwe mwanjira imeneyo. Madokotala ali otanganidwa ndipo sangakhale ndi nthawi yopitilira muzitsogozo ndi chisa chabwino cha toothed. Komanso, ngakhale madokotala ena ali odabwitsa, ena amakhala osasinthasintha, ndipo ena ndi ovuta kwambiri. Odwala ululu, makamaka omwe ali ndi matenda osokonezeka monga fibromyalgia, nthawi zambiri amamva zinthu monga, "Ife tiribe mankhwala omwe amagwira ntchito bwino kwambiri, choncho mumangophunzira kuti muzikhala nawo."
Zochitika zina
Odwala opweteka ndi owalimbikitsa akhala akuyitanitsa malamulo othandiza kuti athetse mavuto omwe akugwiritsira ntchito mankhwalawa moyenera. Nthawi zina amatsutsana, muyenera kumvetsera wodwalayo.
Mwachitsanzo, mu kafukufuku, madokotala sangaganizire kuchuluka kwa kusintha kwake kofunika kwambiri kwa munthu yemwe ali ndi ululu, kuchepa kwakung'ono ndiko kusiyana pakati pa kukhala ndi phindu linalake ndikugona pabedi tsiku lonse, kapena pakati pa kupanga tsiku la ntchito ndi kukhala ndi chilema.
Nthano yowonjezereka ndi yakuti odwala ochepa kwambiri amayamba kumwa mankhwala opioid, ndi kafukufuku umodzi wosonyeza kuti zimangokhala pafupifupi 3 peresenti. Mukachotsa anthu omwe ali ndi mbiri ya kugwiritsa ntchito mankhwala osokoneza bongo kapena mankhwala osokoneza bongo, mlingo umakhala pansi pa 0,2 peresenti.
Kuonjezerapo, iwo amalimbikitsa kwambiri kuganizira njira zoletsedwa zomwe amalonda ambiri omwe amamwa mankhwala kapena mankhwala osokoneza bongo amapeza opioids awo, monga:
- Kubera kapena kupanga zolembera zamankhwala zabodza
- Kugula kwa intaneti kosaloleka
- Kuba kuchokera ku pharmacies, kuchipatala kapena kuchipatala
- Kusonyeza antchito azachipatala ndi kuyitana mu refills.
Nkhani ya opioid ndi nkhani yovuta komanso yofunika kwambiri. Mwinamwake tsiku lina vuto lidzachepetsedwa mwakuti odwala opweteka sadzamva ngati akuwongolera mopanda chilungamo komanso kutaya mwayi wa mankhwala omwe akufunikira.
Padakali pano, zimapereka odwala ovutika kuti aphunzire pazovuta-ndi zitsogozo-kuti tiwone kuti madokotala athu akuwagwiritsa ntchito molondola komanso osatanthauzira monga "osapereka udindo wa opioids".
Tiyeneranso kuzindikira mavuto omwe opioids angapangitse pakati pa anthu, ndi anthu omwe ali pafupi kwambiri ndi ife, komanso kwa ife. Kuti mudziwe zambiri, onani:
- Kutenga Painkillers Mwabata
- Opiates for Fibromyalgia & Chronic Fatigue Syndrome
Zotsatira
American Society of Addiction Medicine. Opioid Addiction: 2016 Zolemba ndi Ziwerengero. Maumwini onse ndi otetezedwa. Kupezeka: April 2016.
Dowell D, et al. Malangizo ndi malipoti. 2016 March 18. 65 (1); 1-49. CDC malangizo othandizira opioids kuti azivutika kwambiri - United States, 2016.
Malo Othandiza Polimbana ndi Mavuto. Kugwiritsa ntchito mankhwala osokoneza bongo komanso kugwiritsa ntchito molakwika, Guide No. 24, Edition 2. Julie Wartell, Nancy G. La Vigne. Maumwini onse ndi otetezedwa. Kupezeka: April 2016.
Fishbain DA, et al. Mankhwala owawa. 2008 May-Jun; 9 (4): 444-59. Kodi ndi chiwerengero chotani cha odwala osapweteka omwe sachiritsidwa omwe amatha kukhala ndi mankhwala osokoneza bongo opioid akuyendetsa / kugwiritsa ntchito mankhwala osokoneza bongo komanso / kapena makhalidwe okhudzana ndi mankhwala osokoneza bongo? Ndemanga yowonetsera umboni.
National Institute on Drug Abuse. America's Addiction to Opioids: Heroin ndi Prescription Kugwiritsa Ntchito Mankhwala Osokoneza Bongo. Nora D. Volkow, MD. Maumwini onse ndi otetezedwa. Kupezeka: April 2016.
Lipoti la Nthenda Yadziko lonse. Odwala Osautsa Amakhala ndi Chomwe Anganene Ponena za "Mliri wa Opioid." Maumwini onse ndi otetezedwa. Kupezeka: April 2016.