Relapses and remissions, withdrawal syndrome and withdrawal syndrome with opiate addiction

Opioid addiction is one of the most common types of addiction. It often develops even among the socially-advantaged strata of the population, destroying destinies, provoking HIV infection, hepatitis B and other serious illnesses.

Diagnosis of opium addiction

Now the main way to diagnose opium addiction is to collect an anamnesis. However, due to its inaccuracy and subjectivity, this method needs to be confirmed by several types of research:

  • laboratory;
  • instrumental;
  • clinical.

In the laboratory, chromatography is primarily carried out, within which the biological environments of the organism are studied. Thus, urine analysis for toxicology allows to determine whether a person has taken opiates within the last 48 hours.

The accuracy of the chromatographic study is 90%, but it is impossible to establish the dependence of the drug on it. In addition, this method requires large time, material and labor costs.

If after half an hour of the body's reaction is not observed, the person is administered another 0.4 mg intravenously or up to 0.8 mg intramuscularly.

The following signs indicate a positive reaction:

  • dilated pupils;
  • behavior disorder;
  • withdrawal syndrome;
  • drowsiness;
  • is a dystrophic affect.

The most modern method of diagnosing opium addiction is electroondontodiagnostics, which is performed by the EOM-3 apparatus. The purpose of the study was to determine the degree of electroexcitability of intact teeth.

The presence of dependence on opioids is indicated by disorders of the nerves and receptors of the pulp. As a rule, the threshold of excitability from electrocution among drug addicts is 10-15 times lower than normal.

Apparatus for electroondontiagnosis EOM-3

Clinical picture of withdrawal syndrome

Abstinence syndrome in opium addiction is a withdrawal syndrome, which is accompanied by three groups of disorders:

  • Mental.
  • Neurological.
  • Somatovegetative.

The severity of the withdrawal syndrome is determined by the specific drug to which the dependence was formed. It can be morphine, opium, heroin, methadone and many other types of opiates.

In addition, the severity of abstinence is affected by factors such as the duration of the intake of substances and their dosage, the presence of complications, the reactivity of the body.

The rate of development of withdrawal symptoms for opiate addiction may also be different. For example, addicted to methadone administered intravenously, withdrawal symptoms occur later than those who took acetylated opium poppy preparations.

Regardless of the particular substance to which the dependence has been formed, the abstinence syndrome in opiate addiction occurs in several stages.

Initially, there are symptoms of mental dependence - a state of dissatisfaction, tension.

Simultaneously there are signs of somatovegetative disorders:

  • dilated pupils;
  • goosefoot;
  • tension;
  • yawning;Runny nose and sneezing;
  • lack of appetite;
  • problems with sleeping.

The second phase of withdrawal occurs 30-36 hours after drug withdrawal, accompanied by an increase in some of the symptoms of the first phase, and the appearance of new ones: the alternation of chills and fever;

  • drowsiness;
  • general weakness;
  • piloerection;
  • muscle and joint pain.
  • With the transition to the third phase, all the previous symptoms increase dramatically, especially pain in the muscles. A person can not find a comfortable position: he constantly turns in bed, gets up and again lies down. He develops depression, there is a sense of hopelessness.

    On the third day, the fourth phase of withdrawal occurs, lasting 5-10 days.

    This period is characterized by dyspeptic phenomena:

    • abdominal pain;
    • vomiting;
    • diarrhea;
    • false urge to defecate.

    Also during abstinence blood coagulability increases, tachycardia, hypertension, slightly increases body temperature. Sometimes drug addicts who injected intravenous opioids suffer from severe itching in the veins.

    In addition, every addict during the withdrawal syndrome has an irresistible desire to take opiate to ease his condition.

    Heroin addicts experience the most severe pain in the muscles, but they completely pass through 4-5 days during the treatment.

    Patients often find out about chronic pathologies only during the period of abstinence. Gastrointestinal disturbances cause vomiting and pain in the intestines and stomach, with pulmonary dysfunction, dyspnea appears.

    Heart failure often causes death of a patient during an abstinence syndrome.

    Treatment

    The primary task in the treatment of opiate addiction is to eliminate the withdrawal syndrome.

    For this, 4 drugs are used:

    • Clopheline.
    • Tiapride.
    • Tramal.
    • Heminearrin.

    Clopheline promptly stops somatovegetative disorders, tiaprid relieves pain syndrome and psychopathic disorders. Tramal suppresses pain syndrome. Geminearin restores the functional of the catecholamine system.

    At the next stage of treatment, it is necessary to suppress cravings for drugs. Weakening the attraction to drugs help neuroleptics like nuleptil and propazin. However, their action is terminated immediately after discontinuation.

    Recently, for the treatment of opioid dependence, xenon, a non-toxic and effective drug, is increasingly being used. In the beginning, he struggles with the consequences of chronic intoxication of the body. This period lasts from 5 to 8 days.

    Xenon is then used as part of anti-relapse therapy, which coincides with the early post-stroke period. Treatment lasts 10-15 days.

    After 30-60 seconds after inhalations with xenon, the patient's pulse is normalized, and 45-60 seconds after the end of the procedure, pain in the legs disappears and relaxation sets in, anxiety is eliminated.

    In addition, after the use of xenon, most patients lose the irresistible desire to take opiate.

    In the case when a person has a desire to get rid of addiction, he is prescribed psychotherapy - group and family.

    The purpose of such studies is to create a person's strong disgust for drugs through the formation of a negative reflex. For this, during drug intoxication, the patient is administered intravenously with corazole, which causes panic fear.

    Remissions and relapses

    Within a few months after the onset of remission, the patient often develops a false withdrawal syndrome, which often provokes relapses.

    This condition can last for a year, accompanied by the characteristic signs:

    • insomnia;
    • mild autonomic disorders;
    • strengthening of craving for drugs;
    • lack of appetite;
    • mood swings.

    It is very difficult to achieve a stable remission, so after the treatment it is important to continue to monitor the doctor and undergo maintenance therapy.

    The first case of the patient is hospitalized, regardless of whether there is an abstinence syndrome, acute or chronic intoxication, psychosis.

    Then treatment begins, which includes 3 important steps:

    • Detoxification and restorative therapy.
    • Intensive treatment for addiction.
    • Antiretroviral therapy.

    The primary task is to completely block the patient's access to opiates, and this process can be slow, fast or sudden.

    A healthy patient with pronounced psychopathic traits sharply deprives the drug. If the body is weakened, the refusal of the drug will be carried out gradually.

    After 3-4 weeks, the second stage of therapy begins. During this period, psychotherapeutic methods of treatment, including hypnosis, are used. It is aimed at developing a negative reflex on the drug.

    The final stage of treatment is the longest. It lasts about 5 years, and its main goal is to avoid relapses. At this stage, psychotherapeutic treatment continues, stimulating and restorative therapy is conducted.

    • Share