ʻO kahi ʻelima ʻanuʻu kokoke i ka Opioid Epidemic, ʻĀpana 2 o 2

Wahi a ka US Centres for Disease Control and Prevention (CDC), i ka makahiki 2016, ua make he 65,000 mau kānaka ma United States i ka make ʻana o ka lāʻau i ʻoi aku ka nui o ka make ma ke Kaua Vietnam [1] - kahi piʻi o aneane 19 pākēneka ma mua o ka make ʻana o 54,786. hoʻopaʻa ʻia i ka makahiki i hala iho nei. [2] ʻO ka hapa nui o kēia mau make make nui i loaʻa mai nā opioids.

Ma ʻOkakopa 26, 2017, ua kauoha ʻo Pelekikena Trump i ka US Department of Health and Human Services e haʻi i ka pilikia opioid a ka lāhui i kahi pilikia olakino lehulehu ma lalo o ke kānāwai Health Services Law. ʻOiai he mea nui e like me kēia hoʻolaha, ua hāʻule ʻo ia i ka ʻae ʻana i nā kālā pekelala kūloko a i ʻole ke waiho ʻana i nā hoʻolālā paʻa. Ua kue ia i ka hoʻohiki a ka Pelekikena i hana ai i ʻAukake e hoʻolaha a pilikia kūloko ma nā opioids, kahi inoa i hoʻokumu ʻia i ka hoʻokaʻawale ʻia o ke kālā pekelala. Eia kekahi, ua haʻi iki ʻo ia i ka pono no ka hoʻonui nui ʻana o ka loaʻa ʻana o ka lāʻau make i mea nui e hoʻoponopono ai i ka maʻi ahulau.

Mai kuhihewa: ʻaʻohe pōkā hoʻokalakupua a ʻaʻole hoʻoponopono wikiwiki i kēia pilikia. Eia nō naʻe, nui a hewahewa nā ala i hiki ke lawe ʻia e hōʻemi i ka hōʻino ʻia o kēlā me kēia, ʻohana, a me nā kaiāulu, a kōkua iā mākou e holomua i nā hopena.

1) Hoʻouna mua i ka mālama ʻana i ka mea hōʻalo ma mua o ka hopu a me ka paʻa ʻana i ka hale

Ma waena o nā pilikia nui e kākoʻo ana i ka maʻi ahulau opioid ʻoi aku ka maʻalahi o ke kiʻekiʻe ma mua o ka loaʻa ʻana o ke kōkua. Ke hoʻonui nei i ke Kānāwai mālama kūpono (ACA, a.k.a. Obamacare) e hoʻonui ai i kēia āpau, e hoʻopau ana i ka mālama kālā ʻana a Medicaid no nā ʻumi tausani mau kānaka e hakakā nei me ka ʻāpiki. ʻO nā hana ʻē aʻe e hōʻemi i ke kālā Medicaid e loaʻa ka hopena like. Ma mua o ka hoʻomau ʻana i ka hoʻāʻo ʻana e luku i ka ACA, pono e hoʻonui ʻia ke kālā e hana ai i ka mālama ʻana i ka mea hōʻalo, a ʻoi aku ka nui o nā mokuʻāina e pono e hōʻeuʻeu i ka hoʻonui ʻia ʻana o ka Medicaid o ka ACA.

Ke komo nei nā keʻena mālama kānāwai ma nā mokuʻāina he 30 i kēia manawa i ka Polokalamu Kōkua Hoʻohui Hoʻohui a Hoʻōla Hou (PARRI), kahi e hāʻawi nei i ka lāʻau no nā mea hoʻohana lāʻau e noi ana i ke kōkua mai nā luna hoʻomalu kānāwai. [3] Ma kahi o ka nānā ʻana i ka hewa i hopena ʻia mai ka hoʻāo, ma o PARRI, ke kiaʻi nei ka luna kānāwai i ka loaʻa ʻana o ke kōkua i ka poʻe e pono ai, kahi hana e emi ai ke kumukūʻai a mālama i nā hopena maikaʻi aʻe ma mua o ka hopu ʻia ʻana (pinepine pinepine ʻia) a me ka paʻahao.

2) Kākoʻo a hoʻonui i ka lāʻau lapaʻau kōkua ʻia (MAT)

Hōʻike ka hoʻonui ʻana i ka noiʻi i kekahi o nā ʻano hana e pono ai ka mālama ʻana i ka ʻōpili opioid ma o ka hana ʻana i nā lāʻau lapaʻau me ka methadone a me ka buprenorphine. Ma ke ʻano he ʻaoʻao e ʻimi ana e hōʻemi i ka pōʻino ma mua o ka koi ʻana i ka abstinence piha, kōkua ka hoʻohana ʻana i kēia mau lāʻau i ka hoʻoliʻiliʻi hou a me nā pilikia olakino e pili ana i ka hoʻāʻo ʻana, e hoʻonui ana i ka hiki i nā poʻe ke hana a kūkulu hou i ko lākou ola. Minamina, ʻo kahi hapa wale nō o nā papahana lapaʻau hōʻalo ma ka US i kēia manawa ke koho.

ʻAʻole ʻo MAT i waho o kāna mau downsides, eia nō naʻe. ʻO Methadone a me buprenorphine he opioids lāua ʻelua me kā lāua pono iho no ka hoʻōla - ʻoi aku ka liʻiliʻi no ka buprenorphine, kahi ʻāpana (i kū ʻole i ka piha) opioid agonist. Ma ke kūpono, hoʻohana ʻia ʻo MAT ma ke alahaka e kōkua i ka poʻe me ka lohi a me ka holomua e hoʻopau i nā meds pani a hoʻololi i ka abstinence. E like me ka hiki, pono e kaupalena ʻia ka manawa ma mua o ke ola aupuni lohi.

3) Hoʻonui i ka loaʻa o naloxone

Pono e mālama ʻia nā mea hoʻohana Opioid i ka manawa lōʻihi e ʻimi i ka lāʻau. ʻOiai ʻae ʻia i kēia manawa i kekahi mau mokuʻāina a me ka nui o nā kaona e lawe a lawelawe iā ia, nele pinepine nā mea pane a me nā keʻena pilikia i nā lako o ka naloxone — ka lāʻau e pale ai i ka overdosis opioid. ʻO Naloxone kahi antagonist opioid-ʻo ia hoʻi ka mea e paʻa ai i nā mea loaʻa opioid a hiki ke hoʻohuli i nā hopena o nā opioid. Hiki iā ia ke hoʻōla maoli i kekahi i ke ola, hoʻihoʻi i ka hanu maʻamau no nā poʻe nona ka hanu i lohi a kū hoʻi ma ke ʻano he overdosing i nā opioids a i ʻole heroin. Pono nā keʻena olakino pekelala a me ka mokuʻāina e kūkākūkā i nā kumukūʻai haʻahaʻa a hoʻonui hou i ke komo i ka naloxone. ʻO ka mea nui, e like me ka manawa o kēia kākau ʻana, CVS ke hāʻawi nei i ka naloxone me ka ʻole o kauka i 43 mau mokuʻāina a ua hoʻolaha ʻo Walgreens e loaʻa ia i nā naloxone manuahi ʻole ka lāʻau lapaʻau ma kāna mau hale kūʻai āpau.

4) Hoʻonui i nā kumuwaiwai hōʻemi ʻino ʻē aʻe

Pono ke aupuni e hoʻolilo kālā hou aku no ka kuapo kuʻikuʻi a hoʻomaʻemaʻe i nā polokalamu ʻohe e hakakā ai i nā maʻi lele e hoʻolaha ʻia ana e nā nila. ʻO ka piʻi ʻana o ka lāʻau lapaʻau injection e ka poʻe i neʻe mai ka opioids i ke ʻano pill i heroin e hoʻonui nei i kahi piʻi nui o nā maʻi hepatitis C. Mai ka 2010 a i ka 2015, ua aneane pākolu ka nui o nā maʻi virus hepatitis C hou i hōʻike ʻia i ka CDC. [4] Pepehi ʻo Hepatitis C i kēia manawa i nā poʻe he nui aku ma mua o nā maʻi infectious ʻē aʻe i hōʻike ʻia iā CDC. Ma kahi kokoke i 20,000 mau ʻAmelika i make mai nā kumu pili i ka maʻi hepatitis C i ka makahiki 2015, ka hapanui o nā kānaka he 55 a ʻoi paha makahiki. Ke piʻi wikiwiki nei nā maʻi virus hepatitis C hou i waena o ka poʻe ʻōpio, me ka helu nui loa o nā maʻi hou i hōʻike ʻia ma waena o 20 a 29 mau makahiki. [5]

5) E aʻo a hoʻonui i ka loaʻa ʻana o ka laulima, nā opioid manuahi multimodal e pili ana i ka ʻeha mau ʻana

I ka wā e pili ana i nā opioids, ke kamaʻilio ʻana i nā kumu kumu o ka hoʻowalewale e koi pū i ka haʻi ʻana i ke kumu i hōʻike ʻia nā poʻe he nui i nā opioids i ka wā mua - ʻeha mau. ʻO ka hiki ke hoʻopili ʻia o nā opioids me ka ʻole o ka hōʻike noiʻi e pili ana i kā lākou pono i ka mālama ʻana i ka ʻeha mau, pono ʻia kahi ʻāpana o ka hopena i ka hana ʻana i nā lāʻau ʻeha ʻē aʻe. Pono kēia i kahi hoʻololi paradigm no nā lawelawe olakino a me ka ʻinikua uhi.

Ma kahi o 50 miliona mau mākua ʻAmelika i ʻeha nui a i ʻole ʻeha nui, e like me ka National Institutes of Health's National Center for Complementary and Integrative Health (NCCIH). Ma muli o ka ʻikepili mai ka 2012 National Health Interview Survey (NHIS), ua hoʻohālikelike ka noiʻi ma loko o ʻekolu mau mahina i hala iho nei, ua loaʻa he 25 miliona mau mākua ʻAmelika i ka ʻeha mau o kēlā me kēia lā, a he 23 miliona mau mea i hōʻike ʻeha loa. [6]

Aia kekahi mau koho opioid-ʻole no ka hana ʻana me ka ʻeha mau, e like me nā lāʻau non-opioid, hoʻōla kino, hoʻomālō, a me nā hoʻoikaika kino, nā ʻano a me nā lāʻau lapaʻau kōkua like e like me ka acupuncture, chiropractic, massage, hydrotherapy, yoga, chi kung, tai chi , a me ka noʻonoʻo ʻana. ʻO ka ʻoiaʻiʻo, no ka manawa mua, ke aʻoaʻo aku nei ke Kulanui ʻAmelika o ʻAmelika i ka mālama ʻana i ka ʻehaʻeha me nā hana nondrug e like me kēia ma mua o ka ʻimi ʻana i nā mea hōʻemi ʻeha a ʻoi paha. ʻO kahi loiloi hope loa a nā mea kūʻai aku e hōʻike ana i ka lāhui e hōʻike ana i nā poʻe he nui me ka ʻeha o ke kua i ʻike ʻia he pono kūpono ʻē aʻe. ʻO ka nānā ʻana o 3,562 mākua i ʻike he ʻaneʻane 90 pākēneka o ka poʻe i hoʻāʻo i ka yoga a i ʻole tai chi i hōʻike mai he kōkua kēia mau ʻano hana; 84 pakeneka a me 83 pakeneka, i hōʻike ʻia i ka mea like e pili ana i ka lomilomi a me ka chiropractic. [7]

ʻO ke ala manuahi ʻole opioid i ka ʻeha mau pū kekahi me ke aʻo ʻana a me ka hoʻomaʻamaʻa ʻana i ka hoʻokaʻawale ʻana i ka ʻeha — ka hōʻailona i hoʻoili ʻia ma o ka ʻōnaehana mānoanoa "he hewa kekahi mea," mai ka ʻehaʻeha ʻana - ka wehewehe a me ke ʻano i hāʻawi ʻia i kēlā hōʻailona ʻeha - pili pinepine ʻia iā ia. . ʻO nā hopena ka hopena ma muli o ka noʻonoʻo a me ka noʻonoʻo i ka ʻeha, a me nā kamaʻilio kūloko a me nā manaʻo e pili ana iā ia a laila e hoʻohuli i nā hopena o ka naʻau.

Koi ʻia kēia mau hana i ka poʻe e komo i ka hana i loko o kā lākou hana hoʻōla ʻeha. ʻAʻole paha kekahi o lākou e hoʻopau a "pepehi" paha i ka ʻeha mau o kekahi. Eia nō naʻe, i ka hui pū ʻana a me ka hoʻomaʻamaʻa hiki iā lākou ke hana i nā ʻokoʻa maikaʻi nui i ka ʻike kumuhana o ka ʻeha, ka hiki ke hoʻoponopono iā ia iho, a me ke ʻano holoʻokoʻa o ke ola.

Kuleana kope 2017 Dan Mager, MSW

Ka mea kākau o Koi ʻia kahi ʻaha nui: kahi ala kaulike i ke ola ʻana mai ka hoʻāla ʻana a Nā mole a me nā ʻēheu: Parenting Mindful in Recovery (e hiki mai ana Iulai, 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, "Kuhi o ka prevalence ʻeha a me ke koʻikoʻi i nā mākua: United States, 2012," The Journal of Pain, ʻAukake 2015 Volume 16, Helu 8, ʻAoʻao 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