Chii chakasiyana?
Kune musiyano pakati pemishonga, kushivirira muviri, uye kushivirira kumarwadzo ekurwadziwa. Zvakakosha kuti mumwe nomumwe wedu anonzwisisa kusiyana.
Vanhu vazhinji vane marwadzo asingagumi, kusanganisira mamwe maitiro eArthritis, anorayirwa kurapa marwadzo. Mamiriro avo ehutano anotsanangura kudikanwa kwemishonga yakadaro-ndiyo chikonzero yaive yakarongerwa sechikamu cherongwa hwavo hwekurapa.
Asi, kana iwe ukanyatsocherechedza nyaya, vanhu vanorayirirwa zvakakodzera mishonga yemarwadzo vari kuvhiringidzika nevanovhiringidza. Tinogona kunzwisisa zviri nyore kuti zvakagadzirwa sei. Mushure mezvose, kune chirwere chekushandisa maopioid muUnited States Mishonga inonzi inoderedzwa. Wedzera kune icho chiremera chinopera kubva pakuwedzerwa kwezvinodhaka uye mishonga inopesana nemishonga inokonzera fever pitch.
Chimwe chezvinetso zvataurwa pamusoro apa ndezvokuda kunzwisisika. Asi, ndiko kusakanganwa kwevanhu (semuenzaniso, varwere vasingaperi) avo vanonyatsoda mishonga inorwadza kushanda uye vane humwe hupenyu hwehupenyu. Dambudziko ravo haringagoni kuderedzwa apo kukurumidza kweimwe nyaya kunotaridzirwa. Kuziva uku kwave kwakarasika nokuti vanhu vazhinjiwo havanzwisisi musiyano pakati pezvinodhaka, kunyanya kuzvidzora, uye kushivirira. Hatigoni kuvhara mitsara pakati pezvinhu izvi zvitatu uye tarisira kugadzirisa zvinetso zvine chokuita nekushandisa zvinodhaka uye kushatiswa.
Ndiro danho rekutanga ratinofanira kutora-kunzwisisa izwi.
Chii Chinodhaka?
IAmerican Society of Addiction Medicine (ASAM), American Academy of Pain Medicine (AAPM), uye American Pain Society (APS) vanoona tsanangudzo inotevera yekunyadzisa sezvinoreva kushandiswa kweipioid yekurapa marwadzo:
Chirwere chetachiona chinhu chikuru, chisingaperi, neurobiological, neine genetic, psychosocial, uye zvakatipoteredza zvinokonzera kukura kwayo nekuratidzwa. Iyo inoratidzirwa nemitemo inosanganisira imwechete kana yakawanda pane inotevera: kutadza kushandiswa pakushandiswa kwezvinodhaka, kushandiswa kwemhirizhonga, kupfuurira kushandiswa pasinei nekukuvara, nekuchiva.
Chii Chinonzi Physical Dependence?
IAmerican Society of Addiction Medicine (ASAM), American Academy of Pain Medicine (AAPM), uye American Pain Society (APS) vanoona tsanangudzo inotevera yekuzvidzivirira mumuviri:
Kuzvimiririra kwepanyama kunzvimbo yekugadzirisa inoratidzirwa nechirwere chechirwere chinokonzera kusununguka chirwere chinogona kubudiswa nekudzima kusinganzwisisiki, kuderedzwa kwechirwere ichi, kuderedza ropa romuviri wezvinodhaka, uye / kana kutungamirirwa kweanopikisa.
Chii Chinoshivirira?
IAmerican Society of Addiction Medicine (ASAM), American Academy of Pain Medicine (AAPM), uye American Pain Society (APS) vanoona tsanangudzo inotevera yokushivirira:
Kushivirira ndechekugadziriswa mune izvo zvinoshandiswa kumushonga zvinokonzera kuchinja kunokonzera kuderera (kureva, kuderedza kana kuderera) kweimwe kana zvimwe zvinokonzerwa nemishonga panguva.
Izvozvo zvakati, mishonga inorwadza zvikuru uye mishonga yemishonga inopikisa inobvuma kuti vasingaperi varwere vanorwara vanobata kwenguva refu nemishonga ye opioid kazhinji vanoita kuti vawedzere kuvimba.
Vamwe varwere vachakudzivirira. Asi, kazhinji, boka iri revarwere haritauri mishonga. Icho chaiyo ngozi yekunyadzisa inoonekwa seisingazivikanwi uye isingazivikanwi, asi inogona kunge yakabatana nezvinhu zvakawanda, kusanganisira genetic predisposition.
Dhiyabhorosi pachayo inotakura chirwere chisingaperi. Kuisa pachena kumishonga zvinodhaka chinhu chimwe chete chinokonzerwa nekugadzirwa kwayo. Ichokwadi, kakawanda, kuiswa kune zvinodhaka zvinogona kuita kuti mupiro wemupiro mupiro usakonzera kukanganisa.
Unhu Hwakanaka uye Maitiro
Kutadza kusagadzikana, kushuva, nekugadzirisa kushandiswa kwechirwere, pamwe nekuenderera mberi kwekushandisa kwechirwere pasinei nekushaya kunaka kwepanyama, kwepfungwa, kana zvemagariro kunoonekwa sechimiro chekudhakwa.
Asi, zvinogona kunge zvichinyanya kuoma kupfuura kungoona kuvepo kwezvinhu izvozvo. Izvo zvakafanana zvinogona kunge zvakabatana nokusunungurwa kunorwadza kwakakwana. Chiremba anofanira kunge achikwanisa kushandisa mutongo wavo uye kunzwisisa pakati pekudhakwa uye chimwe chikonzero.
Kune zviito zvakananga zvinoratidza kuvepo kwekudhakwa. Kuzvibata kwakadaro kunosanganisira:
- kwete kuomerera kune zvakatemwa nguva yezvinodhaka
- kutora kanopfuura imwe murasi panguva
- mhinduro dzakadzokororwa dzebiwa kana dzakarasika zvinodhaka
- dhizinesi rekutengesa (kutora mushonga kubva kune vanopfuura chiremba)
- kuzviparadzanisa (kutsvaka nguva yoga)
- kuwedzera kushandisa zvisina kurehwa maitiro ekushandisa pfungwa
- kushandisa mishonga inorwadza ye sedation, kudhakwa, kuwedzera simba, kana kuderedza kushushikana
- kukumbira mamwe maitiro kana nzira dzekutungamira kwechirwere
- kudzivisa kana kusakanganiswa mune zvisingashandisi maawa
Kuita zvinodhaka zvakajeka kunobatanidza nekunogona kuoma, kunyange kuuraya, migumisiro. Kune rumwe rutivi, kuzvidzora kwemuviri kunofungidzirwa kuti inowanzoita mitezo nemuviri kunogara kusingaperi kana kushandiswa kwemimwe mishonga-uye kwete chete marwadzo opioid marwadzo. Semuenzaniso, kuvimba kwepanyama kunogona kuitika ne corticosteroids, antidipressants, beta blockers, uyewo mamwe mishonga isingatarisirwi kudikanwa. Kana mishonga inogona kubatanidzwa nekuzvidzivirira kwepanyama inofanira kurega, mushonga unofanirwa kuiswa kuti urege kudzivirira zviratidzo (semuenzaniso, prednisone tapering).
Kushivirira kunotonyanya kuoma kunzwisisa. Kushivirira kunogona kuitika kune zvinodiwa zvechirwere, asi zvinogonawo kuitika kune zvisingafadzi. Kushivirira kunewo kushanduka, zvichiitika pamitemo yakasiyana yezvipikiso zvakasiyana. Kushandisa maopioid semuenzaniso, kushivirira kune zvinoratidzika zvinowanzoitika zvishoma nezvishoma kudarika kuora mwoyo.
The Bottom Line
Zvinodhaka zvinowanzova chirwere chetsika, kunyange chinogona kuwirirana nekuzvidzivirira mumuviri. Kazhinji, kupindwa muropa kunosanganisira kushandiswa kwechirwere pasinei nemigumisiro yakaipa, kuda chirwere kunyange kana kwete mukurwadziwa mumuviri, uye kuchiishandisa nekuda kwezvikonzero zvimwe kunze kwezvinoratidzwa. Kuvimba kwepanyama kunoratidzwa apo mumwe munhu anokurudzira kuvhiringidza kune chirwere kana kana munhu achizoona zviratidzo zvekudzima kubva pakuvhara mishonga kamwe kamwe. Kushivirira kuripo apo imwe nhamba haina kuunganidza mhinduro imwechete, saka zvichida kuti madhasi akakwirira awane chinangwa chaidiwa. Mune uye pachayo, kuvimba kwepanyama hazvirevi kuti pane kushaya zvinodhaka, asi zvinogona kuenderana nekudhakwa kana kune dambudziko.
Sources:
Tsanangudzo dzine chokuita nekushandiswa kweOpioids kwerapa yekurapa: Consensus Statement yeAmerican Academy of Pain Medicine, American Pain Society, uye American Society of Addiction Medicine. ASAM. 2001.
http://www.asam.org/docs/default-source/public-policy-statements/1opioid-definitions-consensus-2-011.pdf?svvrsn=0
Nheyo dzeDrug Addiction Treatment: Bhuku reKutsvakurudza-Rakagadzirirwa (Chechitatu Gwaro). Kune musiyano pakati pechivimbo chemuviri nekudhakwa here? National Institute on Drug Abuse. December 2012.
https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical- dependence
Kuzvidzivirira Kwepanyama uye Kusagadzikana - Kusiyana Kunokosha. NAABT. Updated 03/12/2016.
http://www.naabt.org/addiction_physical-dependence.cfm/
Zvinodhaka zvekushungurudzwa. IV. Nhanganyaya kumakirasi emishonga. Magazini ye2011: A DEA Relief Guide.
http://www.dea.gov/docs/drugs_of_abuse_2011.pdf