Ngaba baya kulimaza i-fibromyalgia kunye nezinye izigulane ezibuhlungu ezingapheliyo?
Sibhekene nesifo esibuhlungu esingapheliyo eMelika. Kwiminyaka emininzi, abantu abaneentlungu ezingapheliyo ezivela kwi- fibromyalgia okanye ezinye iimeko ezibuhlungu bazibuza ukuba, "Luphi ixesha lotyando lwezonyango oluza kubakhokela ngqalelo?" Ngoku kunjalo, kodwa ungasithandi umphumo.
I-CDC icetyisa oogqirha malunga nendlela yokuphatha intlungu engapheliyo, kwaye ilitye lembombo le ngcebiso yilo: i-opioid painkillers ayinyanzeliswa ukusetyenziswa kwexesha elide.
Zinezizathu ezifanelekileyo zeso siphakamiso, kodwa oko akuthethi ukuba akuyi kubangela ukubandezeleka okungakumbi kubantu abasele behlupheke ngaphezu koko.
Izidakamizwa ezithile esithetha ngazo ziquka:
- IOxycodone
- Hydrocodone
- ICodeine
- Morphine
- Fentanyl
- IMethadone
Igama elithi "opioid" libhekiselele kwiinguqulelo zokwenziwa kwamachiza opiate. Zihlala zibizwa ngokuba zizidakamizwa.
I-Crux ye-Opioid Issue
Kwintliziyo yengxaki kukuba sibhekane neengxaki zokuxhaphazwa kwe-painkiller kunye nokufa ngokweqile. Enyanisweni, ukugqithiswa kweziyobisi ngoku kungoku kubangela ukufa kwengozi eMelika, kwaye i-opioids yeso sizathu esikhulu.
Ngokutsho kweMerika Society of Addiction Medicine:
- Abantu abangaphezu kwama-47,000 bafa ngokugqithisa izidakamizwa ngo-2014;
- Phantse ama-19,000 abo bafa babangelwa ngenxa yokugulisa izidakamizwa;
- Phantse i-11,000 ngaphezulu yabelwe yi-heroin (ngaphezulu kule izantsi apha);
- Ukufa kwe-opioid ngokungenziyo kuye kwaphindwe kane ukususela ngo-1999;
- Njengoko ukuthengiswa kwe-opioid esemthethweni kuye kwanda, unyango lweziyobisi kunye nokufa ngokweqile ngenxa ye-opioids ziye zafana nazo.
Kutheni ukhangele ukufa kwe-heroin kunye nezo zonyango? I-Heroin i-opioid nayo, kwaye kuphando, amaninzi angama-94 ekhulwini lama-heroin addicts athi aqala ukuba ngumlutha wee-painkillers zonyango aze aguqule kwi-heroin ngenxa yokuba engabizi kwaye kulula ukuyifumana.
Ukusetyenziswa kweHeroin kunye nokufa ngokweqile kwenyuka kwinqanaba elifanayo kwi-opioid umlutha kunye nokufa.
Xa ubhekene nala manani, ukusabalala kwemimiselo ye-opioid kuphazamiseka ngokukhawuleza. Yinkqubo karhulumente impilo kunye neengxaki zokunyanzeliswa komthetho ekufuneka ziqwalaselwe.
Yingakho ii-CDC zijonge ukuba i-opioids imiselwe njani kwaye ifuna ezinye iindlela.
Ubuhlungu obungapheliyo kunye noNyango olungapheliyo
Okwangoku, sinabantu abaninzi abanobuhlungu obuqhubekayo. I-Institutes of Health (NIH) ngo-2015 yathi "indlela enye yepilisi-fits-all" yayingenelisekanga kwaye iqhutyelwa ukusetyenziswa kakubi kwezilonyango ezingezizo iziyobisi ezisekelwe kubungqina, ngokuzimeleyo, kwaye zibandakanya iintlobo ezininzi zonyango.
Ngexesha elifanayo, i-NIH ibonise esidlangalaleni ukuba uluntu lwasekuhlaleni aluqhelani ngokwaneleyo kunye nononyango lwezonyango, okwenza kube lula ukuthembela kwi-opioids.
Abantu abaninzi abahlala bebuhlungu obungapheliyo banokufakazela inyaniso yeengxelo ze-NIH. Oku kunokuba kuba unyango lwabo luquka kuphela i-painkillers kwaye alinelanga. Kungakho nokuba baye bahlola ezinye iinketho baza bafumana ukukhululeka kunokuba neepilisi zodwa. Nangona kunjalo, phakathi kwalabo bafumene amanye unyango olululo, i-opioids ihlala idlala indima kwi-regimen yayo.
Ukongezelela, abantu abaneemeko ezingaqondakaliyo ezifana ne-fibromyalgia bafumana ukuba oogqirha abanako ukubanceda ukuba benze ntoni ngaphandle kokuthatha amayeza , kwaye loo mayeza aquka i-opioids.
Indlela yokuhamba esuka kwiiOpioids
Ngenxa yokuba i-opioids inceda abantu abaninzi baqhuba bhetele, uluntu olungapheliyo luye lwasabela ngoloyiko nangomsindo njengoko urhulumente kunye nokunyanzeliswa komthetho bazama ukuphazamisa ukusetyenziswa kakubi kwe-opioid.
Xa oogqirha baqala ukuphandwa kwaye abanye balahlekelwa iilayisensi zabo, abanye oogqirha babesaba kakhulu ukunika i-opioids. Ngubani o no kubeka ityala? Akukho mntu ufuna ukuba ukuphila kwabo kusongelwe.
Emva koko, ngo-2014, uLawulo lwezoLawulo lweMithi loLawulo lwaMachiza lwasusa i-hydrocodone kwisihlomelo sezinto ezilawulwayo, ukusuka kwiShedyuli III ukuya kwiShedyuli II, eyenza izigulane zixhamle kwiipoksi ezintsha ukuze zifumane imiyalelo egcweleyo, kuquka ukufumana umyalelo omtsha kumgqirha rhoqo, kwaye efuna ukuthatha isigqirha somzimba kwikhemisi esikhundleni sokuba ugqirha wefeksi.
Oku kwadala ubunzima obongezelelweyo, ngakumbi kubantu abafanele baqhube i-ofisi yabo ugqirha kunye / okanye ikhemisi.
Izigulane zezinhlungu kunye nabacebisi baye bacela urhulumente kunye nokuthotyelwa komthetho ukufumana iindlela zokulwa neengxaki ngaphandle kokunciphisa abantu beyeza. Nangona kunjalo, oko akubonakali ukuba yiyiphi into abayifumanayo.
Ngexesha elifanayo, intlungu engapheliyo ngumcimbi omkhulu omele ulungiswe ngokufanelekileyo. Ngokubhekiselele kwingxelo yeSizwe soPhando:
- Izigidi ezingama-100 zaseMerika zineengxaki ezingapheliyo,
- Ubuhlungu bubiza i-US malunga ne-$ 600 yezigidi ngonyaka,
- Abantu abaninzi banentlungu engapheliyo kune-diabetes, isifo senhliziyo okanye umhlaza.
Iziphakamiso zeCDC
Ngentwasahlobo ka-2016, i-CDC yashicilele isiKhokelo sayo sokuLawulwa kwama-Opioids for Pain Chronic. Ichaza iinkcukacha zeengxaki ze-opioids ezibangelwayo, zibeka izikhetho zonyango ezingezizo iziyobisi kunye nezingekhozo opioid, kunye nobungqina (mhlawumbi, ukungabikho kwayo) ukuba ukusetyenziswa kwe-opioid kusebenza ngokubandezeleka okungapheliyo.
Isikhokelo sibonisa iingongoma ezili-12 zoogqirha ukuba zilandele xa zichaza ii-opioids zentlungu engapheliyo. Iquka indlela yokuchonga ukuba i-opioids ifanelekile kwisigulane ngasinye, indlela yokuphonononga inzuzo kunye nomngcipheko, okumele kuxoxwe ngayo nesigulane, indlela yokugcina unyango lwe-opioid ngokuphepha, nendlela yokujonga umlutha kunye nendlela yokuphatha ngayo ngokufanelekileyo.
Xa kuqwalaselwa ingozi - kokubili kumntu kunye noluntu - ezi zi-12 iingongoma zinengqondo kwaye zixanduva. Ukuba ugqirha ufunde lonke, ingxelo ede kakhulu, uya kubona ukuba zeziphi izicwangciso zonyango olusisiseko, oluquka:
- Ulungiso lwenyama
- Ulwaphulo lokuziphatha
- Ukusebenzisa unyango
- Injini ze Steroid.
Xa kuziwa kwiziyobisi ezingekho i-opioid, i-CDC ichaza:
- Izidakamizwa ezichasayo ezifana ne-ibuprofen
- Anticonvulsants ezifana ne-pregabalin kunye ne-gabapentin
- Ukuxhatshazwa.
Phezulu, isiluleko se-CDC sinengqiqo. Kutheni ukunikezela izidakamizwa ezinobungozi kubantu abaninzi xa kungabancedi kakhulu kwaye kubangela ingxaki enkulu yempilo yoluntu?
Ixhalaba
Oogqirha kufuneka babe neentlungu ezibangelwa ngabanye, ngendlela epheleleyo. Nangona kunjalo, kude kube yilapho uphuhliso lwezonyango lungcono malunga nezindlela ezingezizo iziyobisi, oku akunakwenzeka nakwephi na indlela enentsingiselo.
Ingxelo epheleleyo yeCDC ide kakhulu. Ukuba ugqirha ubhekisele kwiingongoma ezili-12 ekupheleni, abayi kubona nayiphi na enye ingcebiso. Abanye bangabona umgca wokuqala- "Ulwaphulo lwe-Nonpharmacologic kunye ne-nonopioid unyango lwe-pharmacologic lukhethwa ukuba lubuhlungu obungapheliyo," - kwaye ume apho.
Oku kufana nokunyanzeliswa ngonyaba oogqirha. Akujoliswe ngaloo ndlela. Oogqirha baxakeke kwaye abanakho ixesha lokuhamba nezikhokelo kunye nekhefu elihle. Ngakumbi, ngelixa abanye oogqirha babamangalisa, ezinye zidibeneyo, kwaye ezinye zizingcipheko. Izigulane ezibuhlungu, kwaye ngokukodwa abo baneemeko ezingaqondakaliyo ezifana ne-fibromyalgia, bavame ukuva izinto ezinjengalezi, "Asinayo iziyobisi ezisebenza kakuhle kuloo nto, ngoko ke kufuneka ufunde ukuhlala nayo."
Ezinye iziPhumo
Izigulane zezinhlungu kunye nabacebisi baye babiza ixesha elide imimiselo eqondileyo ejongene neengxaki ezinempembelelo encinci kulabo basebenzise la mayeza ngokusemthethweni. Ngexesha elithile, bathi, kufuneka uphulaphule isigulane.
Ngokomzekelo, kwiphononongo, oogqirha abanako ukujonga ubungakanani bentsebenzo ebalulekileyo ngexesha lomntu onentlungu, ukuba ukuphuculwa okuncinci kukuthe umahluko phakathi kokuvelisa kwaye uhlale embhedeni yonke imini, okanye phakathi kokuwenza ngosuku lomsebenzi kunye kufuneka uhambe ngokukhubazeka.
Ingxoxo eqhelekileyo kukuba inani elincinci leentlungu ziba zizilwelwe kwi-opioids, kunye nophando olubonisa ukuba kwenzeka kuphela malunga neepesenti ezingama-3. Xa uchitha abo banembali yokusetyenziswa kakubi kweziyobisi okanye umlutha, izinga liwela ngaphantsi kweepesenti ezingama -2.
Ukongezelela, banxusa ngakumbi ukugxila kwiindlela ezingekho mthethweni apho abathengisi abaninzi abanomlutha okanye iziyobisi bafumana i-opioid yabo, njengale:
- Ukweba okanye ukudala ipayipi yemithi yokukhohlisa
- Ukuthengwa kwe-intanethi engekho mthethweni
- Ukweba kwii-pharmacy, izibhedlele okanye amaziko ezonyango
- Ukuzenza abasebenzi bezonyango kunye nokubiza kwii-refills.
Umcimbi we-opioid yinkxalabo enzima kwaye ingxamisekileyo. Mhlawumbi ngelinye ilanga ingxaki iya kuncitshiswa ngokwaneleyo ukuba izigulane zentlungu aziyi kuva ngathi zijoliswe ngokungalunganga kwaye zilahlekelwe ukufikelela kwimichiza abayidingayo.
Okwangoku, ihlawulela izigulane ezibuhlungu ukuba zifundiswe ngemibandela-kunye nezikhokelo-ngoko sinokuqinisekisa ukuba oogqirha bethu basebenzise ngokuchanekileyo kwaye bengayibaguquli njengokuba "musa ukumisela i-opioids".
Sifanele siqaphele iingxaki ze-opioids ezingadala kuluntu, kubantu abasondeleyo kuthi, nakuthi nathi. Ngolwazi olungakumbi, bonani:
- Ukuthatha iiPairyillers ngokukhuselekileyo
- Iimfumba zeFibromyalgia & Syndrome yoKhathazeka okungapheliyo
Imithombo
I-American Society of Addiction Medicine. Umlutha we-Opioid: 2016 Iinkcukacha kunye namanani. Onke Amalungelo Agciniwe. Kufumaneka: Ngo-Apreli 2016.
Dowell D, et al. Iingcebiso kunye neengxelo. 2016 Matshi 18. 65 (1); 1-49. Isikhokelo se-CDC sokumisela i-opioids yeentlungu ezingapheliyo-e-United States, ngo-2016.
Iziko lePolisi-Oriented Policing. Ukukhwabanisa kweMithi yokuChengisa iMithi kunye nokusetyenziswa kakubi, Isikhokelo esinguNombolo 24, u-2 weNguqulelo. Julie Wartell, uNancy G. La Vigne. Onke Amalungelo Agciniwe. Kufumaneka: Ngo-Apreli 2016.
Fishbain DA, et al. Iimpawu zobuhlungu. 2008 Meyi-Juni; 9 (4): 444-59. Yiyiphi ipesenti yezigulana ezingapheliyo ezibuhlungu ezingabonakaliyo kwi-opioid ye-analgesic therapy ekuhlakuleleni ukusetyenziswa kakubi / umlutha kunye / okanye iimpawu ezinxulumene neziyobisi ezinobungozi? Uhlaziyo olusekelwe kwisiseko.
Isizwe seSizwe sokuLawulwa kweziyobisi. I-America's Addiction to Opioids: IHeroin kunye neMigomo yokuLawula kakubi iziyobisi. Nora D. Volkow, MD. Onke Amalungelo Agciniwe. Kufumaneka: Ngo-Apreli 2016.
Ingxelo yesiBanga seSizwe. Abagulayo Abangapheliyo Abangapheliyo Bakho Into Eyithethayo Ngayo "I-Opioid Epidemic." Onke Amalungelo Agciniwe. Kufumaneka: Ngo-Apreli 2016.