Vachakuvadza fibromyalgia & vamwe varwere vasingaperi?
Tiri kutarisana nechirwere chisingagumi muAmerica. Kwemazana makumi emakore, vanhu vanotambura nekurwadziwa kusingaperi kubva kune fibromyalgia kana mamwe mamiriro ezvinhu anorwadza vakashamisika, "Nguva ipi yekurapa ichazobhadhara chaizvo kwatiri?" Iye zvino ivo, asi iwe unogona kunge usingafariri mhinduro.
ICDC inokurudzira vanachiremba nezvekurapa marwadzo asingagumi, uye ibwe rekona rekukurudzira ndeizvi: opioid painkillers haafaniri kutarisirwa kwenguva refu.
Vane zvikonzero zvakanaka zvekukurudzira ikoko, asi izvi hazvirevi kuti hazvizokonzeri kutambura kwakawedzerwa kune vanhu vari kutotambura zvinopfuura zvakakwana.
Mishonga chaiyo yatinotaura pamusoro apa inosanganisira:
- Oxycodone
- Hydrocodone
- Codeine
- Morphine
- Fentanyl
- Methadone
Izwi rokuti "opioid" rinoreva kushandiswa kweshanduro yeapiate zvinodhaka. Izvo zvinowanzonziwo se narcotics.
The Crux of the Opioid Issue
Pamwoyo wechinetso ndechokuti isu tiri kutarisana nehosha yepamusoro peinkiller kushandiswa uye kudarika kwekufa. Kutaura zvazviri, kuwedzeresa kwezvinodhaka ikozvino ndiyo inokonzera kukanganisa kufa muUnited States, uye opioid ndiyo chikonzero chikuru cheizvozvo.
Maererano neAmerican Society of Addiction Medicine:
- Vanopfuura 47 000 vanhu vakafa nemafuta ekuderedza zvinodhaka muna 2014;
- Inenge 19 000 yeavo vafa ndivo vaikonzerwa nemishonga yepamusoro yepamusoro;
- Inenge 11 000 yakawanda yainzi inonzi heroin (yakawanda pane iri pasi apa);
- Kufa kwekungoita maopioid kwakapetwa kane kubva muna 1999;
- Sezvo mutemo wepaopioid yekutengesa wanyanya kuwedzera, kupindwa muropa kwehutachiwana uye kuperevedza kwevakafa nekuda kweipioid vakafananidza ivo.
Sei uchiona kufa kweheroin pamwe chete neavo marwadzo ekurwadziwa? Heroin is opioid zvakare, uye muongororo, vazhinji vanokwana 94 kubva muzana ye heroin vanopindwa muropa vanoti vanotanga kuve vakapindwa muropa nechirwere chepaintericers ndokushandura ku heroin nokuti inodhura uye iri nyore kuwana.
Kushandiswa kweHerinomi uye kudarika kwekufa kwepamusoro kwakakwira kune imwe yepamusoro kune mishonga yeapioid kuwedzerwa uye rufu.
Paunotarisana nenhamba idzodzo, kupararira kwezvinyorwa zveopioid zvinoshamisa kamwe kamwe. Ihu hutano hwevanhu vose uye dambudziko rekuteerera mitemo rinofanira kutariswa.
Ndicho chikonzero CDC iri kutarisa kuti maopioid anotsanangurwa sei uye anotarisa dzimwe nzira.
Dambudziko Risingagumi Nokusakwanira Kurapa
Panguva iyi, tine vanhu vakawanda vanorarama nekurwadziwa nguva dzose. Sangano reNational Institutes of Health (NIH) muna 2015 rakati "nzira imwechete yepiritsi-yakafanana-yose" yakanga isingakwanisi uye yakasimudzira kushandiswa kwemishonga isiri yemishonga yakange iri uchapupu-yakagadzirirwa, yakasarudzwa, uye yakabatanidza marudzi akawanda emishonga.
Panguva imwecheteyo, iyo NIH yakataura pachena kuti mishonga yezvokurapa yakazara haina kujairika zvakakwana nemishonga isiri yemishonga, iyo inoita kuti zvive nyore kuvimba nemaopioid.
Vanhu vazhinji vanorarama nemarwadzo asingagumi vanogona kupupurira chokwadi chemashoko eNIH. Izvozvo zvingave nokuti kurapwa kwavo kunongobatanidza painkillers uye hakuna kukwana. Inogonawo kuva nokuti vakatsvaga mamwe maitiro uye vakawana hupfumi hwakawanda kupfuura nemapiritsi chete. Zvisinei, kunyange pakati pevaya vakawana mamwe maitiro anobatsira, maopioid anowanzoita basa muhurumende yavo.
Uyezve, vanhu vane maitiro asinganzwisisiki se fibromyalgia vanowanzoona kuti vanachiremba vavo havagoni kupa nhungamiro yakakwana pane zvingaita kunze kwekutora mishonga , uye iyo mishonga inowanzosanganisira opioids.
The Trend Away from Opioids
Nemhaka yokuti opioids inobatsira vanhu vazhinji vachiita zvakanaka, mharaunda isingaperi inorwadza yakaita nekutya uye kutsamwa sezvo hurumende uye kushanda kwemitemo kwakaedza kukanganisa kushandiswa kweapioid zvisina kunaka.
Apo vanachiremba vakarwa vakatanga kuongororwa uye vamwe vakarasikirwa nemakambisi avo, vamwe vanachiremba vakatya zvikuru kuisa maopioids. Ndiani angazvipa mhosva? Hapana anoda kuti mararamiro avo atyisidzike.
Zvadaro, muna 2014, Drug Enforcement Administration yakashandura hydrocodone kune yakarongedzwa zvinhu, kubva paHorodhe III kusvika kuHatori II, iyo yakaita kuti varwere vauye nepakati pezvitsva kuti vawane zvinyorwa zvizere, kusanganisira kuwana mushonga mutsva kubva kuna chiremba nguva dzose, uye achida kutora mishonga yemuviri mu pharmacy panzvimbo yekuita kuti chiremba anyore.
Izvi zvakagadzira matambudziko akawanda, kunyanya kune vanhu vanofanira kutyaira rwendo rurefu kuhofisi yechiremba uye / kana pharmacy.
Varwere vehurombo nevatsigiri vakadana hurumende uye kushandiswa kwemitemo kuti vawane nzira dzokurwisa dambudziko pasina kudzivisa vanhu vemishonga yavavanotarisira. Zvisinei, izvozvo hazvioneki kuti ndizvo zvavari kuwana.
Panguva imwe chete, kurwadziwa kusingaperi ndeye nyaya huru inoda kunyatsotaridzirwa. Maererano neNational Pain Report:
- Mamiriyoni zana evaAmerica vanotambura nekurwadziwa kusingaperi,
- Marwadzo anotengesa US nezve $ 600 mabhiriyoni pagore,
- Vanhu vakawanda vane kurwadziwa kusingaperi kune vane chirwere cheshuga, chirwere chemwoyo kana kenza.
Mazano eCDC
Muchirimo cha20166, CDC yakabudisa mutungamiri wayo wekutsanangura maOpioids for Chronic Pain. Iyo inonyanya kutaura nezvematambudziko anokonzerwa neopioid, inoisa zvirongwa zvisiri zvemishonga uye zvisina opioid, uye uchapupu (kana kuti pane, kushayikwa kwayo) kuti kushandiswa kweopioid kunoshanda kuburikidza nekurwadziwa kusingaperi.
Nhungamiro inobudisa nharo 12 kuvanachiremba kutevera pavanoronga opioid yekutambudzika kusingaperi. Inosanganisira nzira yekuziva kana maopioid akafanirwa nemurwere mumwe nomumwe, kuti aenzanise sei rubatsiro nemusungo, iyo inofanira kukurukurwa nemurwere, nzira yekuchengetedza kuchengetedza opioid zvakachengeteka, uye kuti ungatarisa sei kusagadzirisa uye nzira yekurapa zvakakodzera.
Paunofunga nezvezvipingamupinyi - zvose kune mumwe nomumwe uye kumarudzi - aya gumi nemaviri anonzwisisa uye ane mutoro. Kana chiremba achiverenga yose, iyo yakareba, mushumo, iye achaona kuti ndeapi humwe humwe uchapupu-hwakarongwa hunoonekwa, kusanganisira:
- Physical therapy
- Kuchengetedza maitiro therapy
- Dzidzira kurapa
- Steroid injections.
Apo zvinosvika kune vasiri-opioid mishonga, CDC inotaura nezve:
- Anti-inflammatory drugs like ibuprofen
- Anticonvulsants vakaita sa pregabalin uye gabapentin
- Antidepressants.
Pamusoro penyika, mazano eCDC anonzwisisika. Sei uchipa mishonga ine ngozi kuvanhu vazhinji kana zvisingabatsiri izvo zvakawanda uye zviri kukonzera dambudziko guru rehutano hwevanhu?
Kunetseka
Vanachiremba vanofanira kunge vava kushungurudzika mune imwe nzira yakasiyana, yakazara. Zvisinei, kusvikira chikwata chezvechiremba chichidzidziswa zviri nani nezvenzira dzisiri dzemishonga, izvi hazvigone kuitika nenzira ipi zvayo inobatsira.
Mharidzo yakazara yeCDC ndeyekare zvikuru. Kana chiremba akatarisa kupfupikiswa kwemashoko gumi nemagumo ekupedzisira, havazooni chero humwe humwe mazano. Vamwe vanogona kuona mutsara wokutanga- "Nonpharmacologic therapy uye nonopioid pharmacologic therapy inoshandiswa mukurwadziwa kusingaperi," - uye mira ipapo.
Izvi zvinonzwika sechinyorwa chinonyunyisa chechiremba. Hazvirevi saizvozvo. Vanachiremba vakabatikana uye vangave vasina nguva yekufamba nemitemo nekodhi yakanaka-toothed. Kunyanya, apo vamwe vanachiremba vanoyevedza, vamwe vane mamiriro mashoma, uye vamwe vanonyadzisa. Varwere vane marwadzo, uye kunyanya avo vane maitiro asinganzwisisiki se fibromyalgia, kazhinji vanonzwa zvinhu zvakadai, "Hatina zvinodhaka zvinoshanda zvakanaka izvo, saka iwe unofanira kungodzidza kurarama nazvo."
Zvimwe Pfungwa
Varwere vane marwadzo nevatsigiri vave vakadana kwenguva refu mitemo ine njere inogadzirisa zvinetso zvisingabatsiri kune avo vanoshandisa zvinodhaka izvi zvakakodzera. Pane imwe nguva, vanopopotedzana, iwe unofanira kuteerera murwere.
Somuenzaniso, mune chidzidzo, vanachiremba vangasafunga nezvekuwedzera kwekuwedzerwa kunokosha kune munhu ari kurwadziwa, kuti kuwedzera kuduku ndiko musiyano pakati pekuve uchibudirira uye uchigara mubhedha zuva rese, kana pakati pekuita kuburikidza nezuva rebasa uye kuenderera mberi nekuremara.
Nharo imwe chete ndeyokuti nhamba shomanana yevarwere vanorwadziwa inova mishonga yeopioid, pamwe nekuongorora kumwe kunoratidza kuti inongoitika chete munenge 3 muzana. Kana iwe ukabvisa avo vane nhoroondo yekushandisa zvinodhaka kana kusvuta, chirwere chinowira pasi pe 0.2%.
Uyezve, vanokurudzira zvikuru kutarisa nzira dzisiri pamutemo umo vatengesi vakawanda kana vanoita zvinodhaka vanowana opioid dzavo, zvakadai se:
- Kubata kana kusika fake mishonga yepamutemo
- Kutengeswa kwepaIndaneti zvisina kukodzera
- Kubata kubva kumaprota, zvipatara kana zvipatara
- Kuzvienzanisa nevashandi vezvechiremba uye kudana muzvinyorwa.
Nyaya ye opioid inonetsa uye inokurudzira zvakakosha nyaya. Zvichida rimwe zuva dambudziko richaderedzwa zvakakwana zvokuti varwere vanorwadziwa havazonzwi sokunge vari kusaruramisirwa uye vachirasikirwa nekuwana mishonga yavanoda.
Panguva ino, inobhadhara varwere kurwadziwa kuti vadzidziswe pamatambudziko-uye nemitemo-saka tinokwanisa kuve nechokwadi kuti vanachiremba vedu vari kuvashandisa nenzira yakarurama uye kwete kuvashandura se "musatongorongedza opioids" gwaro.
Tinofanirawo kunge tichiziva matambudziko eopioids anogona kuumba munzanga, kune vanhu vari pedyo nesu, uye kwatiri, pamwe chete. Kuti uwane mamwe mashoko, ona:
- Kutora Painkillers Zvakachengeteka
- Opiates for Fibromyalgia & Chronic Fatigue Syndrome
Sources
American Society of Addiction Medicine. Opioid Addiction: 2016 Facts & Figures. Kodzero dzose dzakachengetedzwa. Yakasvika: April 2016.
Dowell D, et al. Mazano uye nhoroondo. 2016 March 18. 65 (1); 1-49. CDC mutungamiri wekutsanangura opioid yekutambudzika kusingaperi - United States, 2016.
Chirongwa cheDambudziko-Rakagadziriswa Policing. Chirongwa Chekushandisa Mishonga Inonyadzisira uye Zvakashata, Tungamira Nha. 24, 2nd Edition. Julie Wartell, Nancy G. La Vigne. Kodzero dzose dzakachengetedzwa. Yakasvika: April 2016.
Fishbain DA, et al. Pain medicine. 2008 May-Jun; 9 (4): 444-59. Ndeapi mazana evarwere vasingaremi varwere vanorwara vanoratidzirwa kune asingagumi anpioid analgesic therapy inoshandiswa pakushandurwa / kukanganisa uye / kana kuzvipira kwehutano hwemishonga? Hwaro hwakarongeka-hwakarongwa.
National Institute on Drug Abuse. America's Addiction to Opioids: Heroin uye Prescription Drug Abuse. Nora D. Volkow, MD. Kodzero dzose dzakachengetedzwa. Yakasvika: April 2016.
National Pain Report. Vanorwara Vasingaperi Vanoshuva Chinhu Chakanotaura Nezve "Opioid Epidemic." Kodzero dzose dzakachengetedzwa. Yakasvika: April 2016.