Indlela yamanyathelo amahlanu kwi-Opioid Epidemic, Icandelo 2 le-2

Ngokwe-US Centers for Disease Control and Prevention (CDC), ngo-2016, ngabantu abayi-65,000 e-United States ababhubha ngenxa yokusetyenziswa gwenxa kweziyobisi — abangaphezulu kunabo babulawa kwiMfazwe yaseVietnam [1] - ukwanda malunga neepesenti ezili-19 ngaphezulu kwabantu abangama-54 786 ababhubhileyo ibhalwe nje kunyaka ongaphambili. [2] Uninzi lwaba bantu babhubhe kakhulu ngenxa ye-opioids.

Ngo-Okthobha i-26, i-2017, uMongameli uTrump wayalela iSebe lezeMpilo laseMelika kunye neenkonzo zoLuntu ukuba babhengeze ingxaki yesifo se-opioid kwisimo sexesha likaxakeka kwezempilo phantsi koMthetho weeNkonzo zeMpilo kaRhulumente. Kubalulekile njengoko esi sibhengezo sibalulekile, isilele ekugunyaziseni nayiphi na imali engxamisekileyo yomanyano okanye ukubeka naziphi na iindlela zekhonkrithi. Ikwaphikisana nesithembiso esenziwe nguMongameli ngo-Agasti sokumemezela imeko kaxakeka yesizwe kwiiopioids, isikhundla esasiza kuthintela ulwabiwo lwenkxaso mali. Ngapha koko, khange athethe kangako ngesidingo sokwandiswa kweendleko zokufumaneka kunyango olubalulekileyo ekujonganeni nobhubhane.

Sukuyenza impazamo: akukho mbumbulu zemilingo kwaye akukho zilungiso zikhawulezayo kule ngxaki. Nangona kunjalo, kukho amanyathelo abalulekileyo anokuthathwa ukunciphisa umonakalo wawo kubantu, kwiintsapho, nakuluntu, kwaye usincede senze inkqubela phambili ebonakalayo kwizisombululo.

1) Beka phambili unyango lweziyobisi ngaphezulu kokubanjwa kunye nokuvalelwa

Phakathi kwezona ngxaki zibalulekileyo ezixhasa ubhubhane we-opioid kukuba kulula kakhulu ukunyuka kunokuba ufumane uncedo. Ukutshitshiswa koMthetho woKhathalelo ongenakufikeleleka (i-ACA, aka Obamacare) kuya kukhulisa lo msantsa, kupheliswe unyango oluxhaswa ngemali yiMedicaid kumashumi amawaka abantu abalwa neziyobisi. Eminye imizamo yokunciphisa inkxaso-mali yeMedicaid iya kuba nefuthe elifanayo. Endaweni yokuqhubeka nokuzama ukutshabalalisa i-ACA, inkxaso-mali eyenza ukuba unyango lweziyobisi zifikeleleke ngakumbi kufuneka zonyuswe, kwaye amazwe amaninzi kufuneka akhuthaze ukwamkelwa kwe-ACA yolwandiso lweMedicaid.

I-arhente zokunyanzeliswa komthetho kumazwe angama-30 ngoku zithatha inxaxheba kwiPolisa eliNcedisa ukuLungisa kunye nokuBuyisa kwakhona (i-PARRI), enikezela ngonyango kubasebenzisi beziyobisi abafuna uncedo kumagunya ezomthetho. [3] Endaweni yokugxila kulwaphulo-mthetho olubangelwa likhoboka, nge-PARRI, unyanzeliso lomthetho lujolise ekufumaneni abantu abaludingayo, inzame ebiza imali encinci kunye nokuthintela iziphumo ezilungileyo kunokubanjwa (okuphindaphindiweyo) nokuvalelwa.

2) Ukuxhasa nokwandisa unyango oluncediswa ngamayeza (MAT)

Ukonyusa uphando kucebisa ukuba enye yezona ndlela zisebenzayo zokunyanga i-opioid yeziyobisi kukusebenzisa amayeza endaweni yoko usebenzisa i-methadone kunye ne-buprenorphine. Njengengxenye yendlela efuna ukunciphisa ingozi kunokunyanzela ukuyeka ngokupheleleyo, ukusetyenziswa kwala mayeza kunceda ukunciphisa ukubuyela umva kunye neengxaki zonyango ezinxulumene neziyobisi, ukuphucula amandla abantu okusebenza nokwakha ubomi babo kwakhona. Ngelishwa, bambalwa kuphela kwiinkqubo zonyango lweziyobisi eMelika okwangoku abanokhetho.

IMAT ayikho ngaphandle kwecala layo, nangona kunjalo. IMethadone kunye ne-buprenorphine zombini zii-opioid ezinokubakho kweziyobisi-nangona zincinci kangako kwi-buprenorphine, inxenye (ngokuchasene ne-opioid agonist epheleleyo. Ngokufanelekileyo, i-MAT isetyenziswa njengebhulorho enceda abantu ngokuthe ngcembe kwaye ngokuthe ngcembe bathabathe amanyathelo okutshintsha kunye notshintsho lokuyeka. Ngangoko kunokwenzeka, kufanele ukuba ibe lixesha elinomda kunolawulo lobomi obude.

3) Yandisa ukufumaneka kwe-naloxone

Abasebenzisi be-Opioid kufuneka bagcinwe bephila ixesha elide ngokwaneleyo ukuze bafumane unyango. Nangona ngoku kugunyazisiwe kwamanye amazwe kunye nenani elikhulayo loomasipala ukuba bayiphathe kwaye bayilawule, abaphenduli bokuqala kunye namagumbi kaxakeka bahlala bengenazo izibonelelo ezaneleyo ze-naloxone-iyeza elichasene ne-opioid overdoses. I-Naloxone yi-opioid antagonist-ethetha ukuba ibophelela kwii-opioid receptors kwaye inokuguqula iziphumo zeopioids. Ingabuyisa umntu ngokoqobo ebomini, ibuyisele ukuphefumla okuqhelekileyo kubantu abaphefumla kancinci okanye bema ngenxa yokonyusa i-opioids okanye i-heroin. Iiarhente zempilo zikarhulumente kunye nezikarhulumente kufuneka zithethathethane namaxabiso asezantsi kwaye zongeze ukufikelela kwi-naloxone. Ngokubalulekileyo, ngelixesha lokubhalwa, iCVS kuthiwa inika i-naloxone ngaphandle kommiselo kumazwe angama-43 kwaye iWalgreens ibhengeze ukuba iyakwenza i-naloxone engenamayeza ifumaneke kuzo zonke iivenkile zayo.

4) Yandisa ezinye izixhobo zokunciphisa umonakalo

Urhulumente kufuneka achithe imali eninzi kunaniselwano ngeenaliti kunye neenkqubo zesirinji ezicocekileyo ukulwa nezifo ezosulelayo ezisasazeka ngokwabelana ngenaliti. Ukunyuka kwenaliti yokusetyenziswa kweziyobisi ngabantu abasuke kwiipioid kwifom yeepilisi baya kwiheroin kuthintela ukwanda okukhulu kosulelo lwe-hepatitis C. Ukusukela ngo-2010 ukuya ku-2015, inani losulelo olutsha lwe-hepatitis C oluchazwe kwi-CDC phantse liphindaphindwe kathathu. [4] I-Hepatitis C okwangoku ibulala abantu abaninzi kunaso nasiphi na esinye isifo esosulelayo esixelwe kwi-CDC. Phantse ama-20 000 aseMelika asweleke kwizizathu ezinxulumene ne-hepatitis C ngo-2015, uninzi lwabantu abaneminyaka engama-55 nangaphezulu. Usulelo olutsha lwe-hepatitis C lusanda ngokukhawuleza kubantu abancinci, kunye nelona nani likhulu losulelo olutsha oluxeliweyo phakathi kweminyaka engama-20 ukuya kwengama-29 ubudala. [5]

I-5) Fundisa kwaye wandise ngokubonakalayo ukufumaneka kweendlela ezihlangeneyo ze-opioid zokujongana nentlungu engapheliyo

Xa kuziwa kwii-opioid, ukulungisa iingxaki ezingunobangela kuya kufuna ukujongana nesizathu sokuba abantu abaninzi babonakaliswe kwii-opioids kwindawo yokuqala-iintlungu ezingapheliyo. Amandla okulutha e-opioids ngokudibanisa nokusilela kobungqina obusekwe kuphando bokusebenza kwabo kunyango lweentlungu ezingapheliyo, kufuna ukuba inxenye yesisombululo ilele ekwenzeni ezinye iindlela zonyango ukuba zifikeleleke ngakumbi. Oku kuyakufuna utshintsho lweparadigm kwiinkonzo zononophelo lwempilo kunye neinshurensi.

Phantse izigidi ezingama-50 zabantu abadala baseMelika baneentlungu ezingapheliyo okanye iintlungu ezinzima, ngokweZiko leSizwe leZiko lezeMpilo lezeMpilo eliDibeneyo kunye neNtlanganisela (NCCIH). Ngokusekelwe kwidatha evela kwi-2012 National Health Interview Survey (i-NHIS), isifundo siqikelela ukuba kwisithuba seenyanga ezintathu ezidlulileyo, abantu abadala abangama-25 ezigidi base-US babeneentlungu ezingapheliyo zemihla ngemihla, kwaye izigidi ezingama-23 ezingaphezulu zabika iintlungu ezinzima. [6]

Kukho iindlela ze-opioid-free zokujongana nentlungu engapheliyo, kubandakanya amayeza angenayo i-opioid, unyango olukhethekileyo lomzimba, ukuzolula, kunye nokuzilolonga umzimba, iindlela ezizezinye kunye nezincedisayo zamayeza ezinje nge-acupuncture, chiropractic, massage, hydrotherapy, yoga, chi kung, tai chi , nokucamngca. Ngapha koko, okwesihlandlo sokuqala, iAmerican College of Physicians icebisa ukunyanga iintlungu zangasemva ngamanyathelo okungasebenzisi iziyobisi ngaphambi kokuya kwi-counter-counter okanye kwiipilisi zokuthomalalisa iintlungu. Uphononongo lwamva nje lwabathengi lubonisa abantu abaninzi abaneentlungu zangasemva ezifumene ezinye iindlela zonyango eziluncedo. Uphando lwabantu abadala abangama-3,562 lwafumanisa ukuba phantse iipesenti ezingama-90 zabo bazama i-yoga okanye i-tai chi baxela ukuba ezi ndlela ziluncedo; Iipesenti ezingama-84 kunye neepesenti ezingama-83, ngokwahlukeneyo, zichaze okufanayo malunga nokuthanjiswa kunye ne-chiropractic. [7]

Indlela engenasifo se-opioid kwiintlungu ezingapheliyo ikwabandakanya ukufunda kunye nokuziqhelanisa nokwahlula iintlungu-umqondiso ohanjiswe ngenkqubo ye-nervous system ukuba "kukho into engalunganga," ukusuka ekubandezelekeni-ukutolikwa okanye intsingiselo enikwe kuloo mqondiso wentlungu-ihlala iqhotyoshelwe kuyo . Ukubandezeleka kubangelwa kukuphendula ngokwasemphefumlweni nangokweemvakalelo kwintlungu, kwaye kubandakanya intetho yakho yangaphakathi yokuthetha kunye neenkolelo malunga nayo eziqhuba ukushukunyiswa ngokweemvakalelo.

Ezi ndlela zifuna ukuba abantu babe ngabathathi-nxaxheba abakhutheleyo kwinkqubo yokubuyisa iintlungu. Akukho namnye kubo onokuthi asuse okanye "abulale" umntu iintlungu ezingapheliyo. Nangona kunjalo, ngokudibeneyo kunye nokuziqhelanisa banokwenza umahluko obonakalayo kumava aphantsi kwentlungu, ukukwazi ukuzilawula, kunye nomgangatho wobomi.

Ilungelo lokushicilela 2017 uDan Mager, MSW

Umbhali we Ezinye zeNdibano ziyafuneka: Indlela elungeleleneyo yokuBuya kwakhona kwiAddiction kwaye Iingcambu kunye neeWings: Ukukhulisa abantwana ngengqondo ekubuyiseleni (iza ngoJulayi, 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] URichard Nahin, "Uqikelelo lwePain Prevalence and Severity in Adult: United States, 2012," Ijenali yeNtlungu, Agasti 2015 uMqulu 16, Ikhupha 8, iphepha 769-780 INGXELO: 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