Is it Possible to Develop an Addiction to Opioids in Oncology Patients Suffering from Pain?
Je možný vznik lékové závislosti na opioidy u nemocných s bolestíonkologického původu?
Návykovost na opioidy se u nemocných trpících silnou onkologickou bolestí vyvíjí jinak než u toxikomanů. Její možné rozvinutí závisí na zvolenéstrategii jejich aplikace:1. Léčebný režim fixního dávkování opioidů zaručuje nemocnému stálou úlevu v čase. Je zaměřen na preventivní potlačování vznikající bolesti. Jehorealizací se na minimum snižuje možnost vzniku lékové závislosti.2. Strategie analgetické léčby "on demand" je praktickým odrazem přøetrvávající opiofobie lékařů.Opioidy jsou aplikovány v nepravidelných intervalech. Střídá se úleva od bolesti se stavem, kdy je bolest opět pociťována. Četným opakováním tétosituace lze evokovat psychickou závislost a následně i možnost rozvinutí toxikomanického chování iatrogenním způsobem.
Klíčová slova:
onkologická bolest - opioidy - návykovost
Authors:
Z. Toman
Authors‘ workplace:
Odborný léčebný ústav onkologie a pneumologie na Pleši, ředitelka MUDr. Alexandra Aschermannová
Published in:
Anest. intenziv. Med., , 2001, č. 4, s. 195-197
Category:
Overview
An addiction to opioids in oncology patients suffering from severe pain is developing in a different way compared to street-drug addicts. Itsdevelopment is possible according to the regimen of their application:1. Treatment strategy based on a fixed-interval schedule provides the patient with a time-constant pain relief. This strategy preventively suppressesemerging pain. with application of this regimen, drug addiction is suppressed to a minimum.2. Analgetic strategy "on demand" is a practical presentation of opioid-phobia of a physician.Opioids are administered irregularly. Pain relief is repeatedly replaced with pain emergence. Frequent changing of those states can lead to psychicaldependence and subsequently leads to the development of iatrogenically induced drug-addic tion behavior.
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Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2001 Issue 4
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