Maitiro-Matanho mashanu kune Epioid Epidemic, Chikamu 2 che2

Maererano neU.S. Centers for Disease Control and Prevention (CDC), muna 2016, vanhu 65,000 muUnited States vakafa nekunyanyisa kwezvinodhaka - kupfuura vakaurayiwa muHondo yeVietnam [1] - kuwedzera kweanosvika 19 muzana pane vakafa 54 786 yakanyorwa chete gore rapfuura. [2] Ruzhinji rwekufa kwekuwedzeredza kwakakonzerwa nemaopioid.

Musi waGumiguru 26, 2017, Mutungamiri VaTrump vakatungamira Dhipatimendi reUtano reHurumende neHuman Services kuti vazivise dambudziko reopioid yenyika iri dambudziko rehutano hweveruzhinji pasi pePublic Health Services Act. Zvakakosha sekuzivisa uku, zvakatadza kupa mvumo kune ipi neipi yechimbichimbi mari yemubatanidzwa kana kuisa chero marongero ekongiri. Izvo zvakare zvakapokana nevimbiso yakaitwa neMutungamiri muna Nyamavhuvhu yekuzivisa a emergency yenyika pane maopioid, zita raizodai rakakonzera kugoverwa kwemari yemubatanidzwa. Zvakare, haana kutaura zvishoma nezve kudiwa kwekuwedzera kunodhura kwekupindwa muropa kwekurapa izvo zvakakosha kugadzirisa denda iri.

Usaite chikanganiso: hapana mashiripiti mabara uye hapana nekukurumidza kugadzirisa kudambudziko iri. Zvisinei, pane matanho akakosha anoverengeka anogona kutorwa kudzikisira kukanganisa kwavo kune vanhu, mhuri, uye nharaunda, uye kutibatsira kuti tifambire mberi zvine musoro kugadzirisa mhinduro.

1) Nyanya kukoshesa kurapwa kwehusungwa pamusoro pekusungwa uye kuvharirwa

Pakati pezvinonyanya kukosha kutsigira denda reopioid nderekuti zviri nyore kwazvo kukwirisa pane kuwana rubatsiro. Kudzokorora iyo Inodhura Care Act (ACA, aka Obamacare) yaizongowedzera gaka iri, kubvisa kurapwa kweMedicaid kwakabhadharwa kwemakumi ezviuru zvevanhu vari kunetseka nekudhakwa. Kumwe kuedza kwekudzora mari yeMedicaid kuchave nemhedzisiro imwechete. Panzvimbo pekuenderera mberi kuyedza kuparadza ACA, mari inoita kuti kurapwa kupindwa muropa kuwedzere kunoda kuwedzerwa, uye dzimwe nyika dzinoda kukurudzirwa kutora iyo ACA inowanikwa yeMedicaid yekuwedzera.

Vezvemitemo vemumatunhu makumi matatu vava kutora chikamu muPurisa Inobatsira Kupindwa muropa uye Kudzoreredza Initiative (PARRI), iyo inopa kurapwa kwevashandisi vezvinodhaka vanokumbira rubatsiro kubva kuzviremera zvemitemo. [3] Panzvimbo pekuisa pfungwa pamhosva inokonzeresa kupindwa muropa, kuburikidza nePARRI, vatevedzi vemitemo vanoisa pfungwa pakuwana vanhu rubatsiro rwavanoda, kuedza kunodhura zvishoma uye kunogonesa mibairo yakanaka kupfuura kusungwa (kunowanzo dzokororwa) nekuiswa mutirongo.

2) Tsigira uye wedzera kurapwa-kwakabatsira kurapwa (MAT)

Kuwedzera kwekutsvaga kunoratidza kuti imwe yedzakanakisa nzira yekurapa opioid kupindwa muropa ndeyekutsiva mishonga yekurapa uchishandisa methadone uye buprenorphine. Sechikamu cheimwe nzira inotsvaga kudzikisira kukuvara pane kuomerera pakurega zvachose, kushandiswa kwemishonga iyi kunobatsira kudzikisira kudzokazve pamwe nezvinetso zvine chekuita nezvekupindwa muropa, kusimudzira kugona kwevanhu kuita nekuvakazve hupenyu hwavo. Nehurombo, vashoma chete vezvirongwa zvekurapa zvinodhaka muUS parizvino vane iyi sarudzo.

MAT haina isina kuderera kwayo, zvakadaro. Methadone uye buprenorphine ivo pachavo maopioid ane yavo mukana wekupindwa muropa-kunyangwe zvishoma zvishoma kune buprenorphine, yakasarudzika (zvinopesana izere) opioid agonist. Sezvineiwo, MAT inoshandiswa sebhiriji iro rinobatsira vanhu zvishoma nezvishoma uye zvishoma nezvishoma kubvisa mishonga yekutsiva uye shanduko yekurega. Zvakawanda sezvazvinogona, inofanirwa kuve iri-shoma-nguva pane yehupenyu-hurefu hwekutsiva hutongi.

3) Wedzera kuwanikwa kweiyoxone

Vashandisi veOpioid vanofanirwa kuchengetwa vari vapenyu kwenguva yakareba zvakakwana kuti vatsvage kurapwa. Kunyangwe iko zvino zvapihwa mvumo mune mamwe matunhu uye huwandu huri kuwedzera hwematunhu ekuitakura uye kuibata, vekutanga vanopindura uye nemakamuri echimbichimbi kazhinji vanoshaya zvakakwana zvekushandisa naloxone - mushonga unopesana neopioid overdoses. Naloxone inopesana neopioid-zvichireva kuti inosunga kune maopioid receptors uye inogona kudzosera kumashure maopioid. Iyo inogona chaizvo kudzosa mumwe munhu kuhupenyu, kudzoreredza zvakajairika kufema kune vanhu vane kufema kwakadzora zvakanyanya kana kumira semhedzisiro yekuwedzeredza pane yekunyorerwa opioid kana heroin. Federal nehurumende masangano ehutano anoda kutaurirana mitengo yakaderera uye kuwedzera kuwedzera kuwanika kunexone. Zvakakosha, sepanguva yekunyora uku, CVS inonzi iri kupa naloxone isina mushonga mumatunhu makumi mana nematatu uye Walgreens yakazivisa kuti ichaita iroxone isina kunyorerwa kuwanikwa muzvitoro zvayo zvese.

4) Wedzera zvimwe zvekukuvadzwa zviwanikwa

Hurumende inodawo kushandisa yakawanda kuchinjanisa tsono uye zvirongwa zvakachena zvejekiseni kurwisa zvirwere zvinotapukira zvinopararira nekugovana tsono. Kuwedzera kwekushandisa jekiseni kwezvinodhaka nevanhu vakachinja kubva kumaopioid mufomu yepiritsi kuenda kuheroin kuri kukonzera kuwedzera kunoshamisa kwehutachiona hwehepatitis C. Kubva 2010 kusvika 2015, huwandu hwehutachiona hutsva hwehepatitis C hunotaurwa kuCDC hwapetwa katatu. [4] Hepatitis C parizvino inouraya vanhu vazhinji kupfuura chero chimwe chirwere chinotapuriranwa chakaziviswa kuCDC. Vanoda kusvika zviuru makumi maviri vekuAmerica vakafa nechikonzero chehepatitis C zvine chekuita nezvakakonzerwa muna 2015, ruzhinji rwevanhu vane makore makumi mashanu nemashanu zvichikwira. Hutachiona hutsva hwehepatitis C huri kuwedzera nekukurumidza pakati pevechidiki, huwandu hukuru hwehutachiona hutsva hunoshumwa pakati pemakore makumi maviri kusvika makumi maviri nemapfumbamwe. [5]

5) Dzidzisa uye nekuwedzera zvakanyanya kuwanikwa kweiyo yakazara, multimodal opioid-isina nzira dzekugadzirisa kurwadziwa kusingaperi

Kana zvasvika kumaopioid, kugadzirisa izvo zvinokonzeresa kupindwa muropa kunodawo kugadzirisa chikonzero vanhu vazhinji vakafumurwa kumaopioid pakutanga - kurwadziwa kusingaperi. Izvo zvinokonzeresa zvinokwanisika zveopioid zvakabatana nekushaikwa kweyekutsvagisa-yakavakirwa humbowo hwekushanda kwavo pakurapa kurwadziwa kusingaperi, zvinoda kuti chikamu chemhinduro chiripo mukugadzira mamwe marapirwo ekurwadziwa awanikwe zvakanyanya. Izvi zvinoda paradigm shanduko yehutano hwehutano uye inishuwarenzi kufukidza.

Vanoda kusvika makumi mashanu emamiriyoni vakuru vemuAmerica vane kurwadziwa kwakanyanya kusingaperi kana kurwadziwa kwakanyanya, sekureva kweNational Institutes of Health's National Center yeComplementary uye Yakabatana Hutano (NCCIH). Kubva pane dhata kubva ku2012 National Health Bvunzurudzo Ongororo (NHIS), ongororo yacho inofungidzira kuti mukati memwedzi mitatu yapfuura, vanhu vakuru veUnited States vane mamirioni makumi maviri nemashanu vaive nemarwadzo asingagumi ezuva nezuva, uye mamwe mamirioni makumi maviri nematatu akashumwa kurwadziwa kwakanyanya. [6]

Iko kune opioid-yemahara sarudzo dzekutarisana nekurwadziwa kusingaperi, kusanganisira isiri-opioid mishonga, yakasarudzika kurapa kwemuviri, kutambanudza, uye kurovedza muviri, dzimwe nzira uye dzinowirirana nzira dzemishonga dzakadai sekubaya, chiropractic, masaja, hydrotherapy, yoga, chi kung, tai chi , uye kufungisisa. Muchokwadi, kwenguva yekutanga, iyo American College yeVarapi iri kuraira kurapa kurwadziwa musana nematanho ezvinodhaka senge izvi usati washandisa pamusoro pe-the-counter kana mushonga wekurapa unodzora. Ongororo ichangoburwa yeVatengi Repamiriri yenyika inomiririra ongororo inoratidza vanhu vazhinji vane kurwadziwa musana vakawana dzimwe nzira dzekurapa dzakakosha. Kuongororwa kwevanhu vakuru 3,562 vakawana kuti vangangoita 90 muzana yeavo vakaedza iyo yoga kana tai chi vakashuma kuti nzira idzi dzaibatsira; 84 muzana uye 83 muzana, zvichiteerana, zvakashuma zvakafanana nezve kukwiza uye chiropractic. [7]

Nzira isina opioid yemarwadzo asingagumi inosanganisirawo kudzidza nekudzidzira kupatsanura marwadzo - chiratidzo chinotapuriranwa kuburikidza nehurongwa hwepakati hwetsinga kuti "chimwe chinhu hachina kumira zvakanaka," kubva pakutambura - dudziro kana chirevo chinopihwa chiratidzo chekurwadziwa ichocho - chinowanzo batanidzwa nacho . Kutambura kunoguma nekupindurwa kwepfungwa uye kwepamoyo kusvika pakurwadziwa, uye kunosanganisira kwekutaura-kwemukati nekuzvitenda nezvazvo izvo zvinobva zvaendesa manzwiro.

Idzi nzira dzinoda kuti vanhu vange vachishingairira kutora chikamu mukurwadziwa kwavo kugadzirisa maitiro. Hapana chimwe chazvo chingango bvisa kana "kuuraya" kurwadziwa kusingaperi kwemumwe munhu. Nekudaro, mukubatana uye pamwe nekudzidzira ivo vanogona kuita yakakura misiyano yakanaka mune yekuzviisa pasi pekutambudzika, kugona kuzvidzora, uye hwakazara hupenyu hwehupenyu.

Copyright 2017 Dan Mager, MSW

Munyori we Imwe Gungano Inodikanwa: Maitiro Akadzikama Ekudzoreredza kubva kuAddiction uye Midzi uye Mapapiro: Kunzwisisa Kuva Mubereki Mukudzoreredza (kuuya Chikunguru, 2018)

[2] https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

[3] http://paariusa.org/our-partners/

[4] https://www.cdc.gov/media/releases/2017/p-hepatitis-c-infections-tripled.html

[5] http://www.huffingtonpost.com/entry/with-opioid-crisis-a-surge-in-hepatitis-c_us_59a41ed5e4b0a62d0987b0c4?section=us_huffpost-partners

[6] Richard Nahin, "Zvinofungidzirwa zvePain Kuwanda uye Kushushikana muVakuru: United States, 2012," Iyo Journal of Pain, Nyamavhuvhu 2015 Vhoriyamu 16, Chinyorwa 8, Mapeji 769-780 DOI: http://dx.doi.org /10.1016/j.jpain.2015.05.002

[7] http://www.consumerreports.org/back-pain/new-back-pain-guidelines/?EXTKEY=NH72N00H&utm_source=acxiom&utm_medium=email&utm_campaign=20170227_nsltr_healthalertfeb2017