Mental Disorder Due to Heroin

8/16/2019 Mental Disorder Due to Heroin

1/16

ALDILASANI FIRDHAUSAHADI

2015 1040 1011 053

Mental Disorder due to Heroin


2/16

DEFINITIN!ioids are a "lass o# dru$s t%at in"lude &ot% natural ands'nt%eti" su&stan"es(

)T%e natural o!ioids *re#erred to as o!iates+ in"lude o!iu, and,or!%ine(

) Heroin- t%e ,ost a&used o!ioid- is s'nt%esi.ed #ro, o!iu,(

t%er s'nt%eti"s *onl' ,ade in la&oratories+ and "o,,onl'!res"ri&ed #or !ain- su"% as "ou$% su!!ressants- or as anti)diarr%ea a$ents- in"lude "odeine- o/'"odone */'ontin+-,e!eridine *De,erol+- #entan'l *Su&li,a.e+- %'dro,or!%one*Dilaudid+- ,et%adone and !ro!o/'!%ene *Daron+(

Heroin is usuall' ine"ted- eit%er intraenousl' *into a ein+ orsu&"utaneousl' *under t%e sin+- &ut "an &e s,oed or usedintranasall' *i(e(- snorted+( t%er o!ioids are eit%er ine"tedor taen orall'(


3/16

auses T%ere are no "lear)"ut "auses o# dru$ use

ot%er t%an t%e initial "%oi"e to use t%edru$( T%is de"ision to use ,a' &e %i$%l'inuen"ed &' !eer $rou!(

For instan"e- ,an' %eroin users "o,e #ro,#a,ilies in 6%i"% one or ,ore #a,il',e,&ers use al"o%ol or dru$s e/"essiel'or %ae ,ental disorders *su"% asantiso"ial !ersonalit' disorder +- &e%aioral!ro&le,s &e$innin$ in "%ild%ood- lo6 sel#)"on7den"e and anti)aut%oritarian ie6s(


4/16

a %eroin &e%aior s'ndro,e %asso,eti,es &een des"ri&ed( T%is s'ndro,e"onsists o# de!ression *o#ten 6it% an/iet's',!to,s+- i,!ulsieness- #ear o# #ailure-

lo6 sel#)estee,- lo6 #rustration toleran"e-li,ited "o!in$ sills- and relations%i!s&ased !ri,aril' on ,utual dru$ use(


5/16

De,o$ra!%i"sMales are ,ore "o,,onl' a8e"ted &'

o!ioid disorders t%an #e,ales9,ales aret%ree to #our ti,es ,ore liel' to &ede!endent on o!ioids( T%ere is a tenden"'

#or rates o# de!enden"e to de"rease&e$innin$ at 40 'ears o# a$e and usuall'7rst seen in t%e teens and 20s(


6/16

SymptomsOPIOID DEPENDENCE.

T%e DSM-IV-TR s!e"i7es t%at t%ree or ,ore o# t%e #ollo6in$ s',!to,s

,ust o""ur at an' ti,e durin$ a 12),ont% !eriod *and "ause si$ni7"anti,!air,ent or distress+ in order to ,eet dia$nosti" "riteria #or o!ioidde!enden"e;

) Toleran"e; T%e indiidual eit%er %as to use in"reasin$l' %i$%er a,ounts o#t%e dru$ oer ti,e in order to a"%iee t%e sa,e dru$ e8e"t or 7nds t%att%e sa,e a,ount o# t%e dru$ %as ,u"% less o# an e8e"t oer ti,e t%an

&e#ore()


7/16

SymptomsOPIOID ABUSE.

T%e DSM-IV-TR s!e"i7es t%at one or ,ore o# t%e #ollo6in$s',!to,s ,ust o""ur at an' ti,e durin$ a 12),ont% !eriod *and"ause si$ni7"ant i,!air,ent or distress+ in order to ,eetdia$nosti" "riteria #or o!ioid a&use;

) Inter#eren"e 6it% role #ul7ll,ent; T%e indiidual>s use o# o!ioids

re!eatedl' inter#eres 6it% t%e a&ilit' to #ul7ll o&li$ations at 6or-%o,e- or s"%ool(

) Dan$er to sel#; T%e indiidual re!eatedl' uses o!ioids in situationsin 6%i"% it ,a' &e !%'si"all' %a.ardous *6%ile driin$ a "ar- #ore/a,!le+(

) Le$al !ro&le,s; T%e indiidual %as re"urrent o!ioidrelated le$al!ro&le,s *su"% as arrests #or !ossession o# nar"oti"s+(

) So"ial !ro&le,s; T%e indiidual "ontinues to use o!ioids des!itere!eated inter!ersonal or relations%i! !ro&le,s "aused &' or ,ade6orse &' t%e use o# o!ioids(


8/16

SymptomsOPIOID INTOXICATION.

T%e DSM-IV-TR s!e"i7es t%at t%e #ollo6in$ s',!to,s ,ust &e!resent in order to ,eet dia$nosti" "riteria #or o!ioid into/i"ation;

)Use; T%e indiidual re"entl' used an o!ioid(

)%an$es; T%e indiidual e/!erien"es si$ni7"ant &e%aioral or!s'"%olo$i"al "%an$es durin$- or s%ortl' a#ter- use o# an o!ioid(

T%ese "%an$es ,a' in"lude eu!%oria- #ollo6ed &' slo6ed,oe,ents or a$itation- i,!aired ud$,ent- a!at%' *don>t "areattitude+- d's!%ori" ,ood *de!ression- #or e/a,!le+- or i,!aired#un"tionin$ so"iall' or at 6or(

)!ioid)s!e"i7" into/i"ation s'ndro,e; T%e !u!ils in t%e e'es $et

s,aller( In addition- dro6siness or "o,a- slurred s!ee"%- and=ori,!aired ,e,or' or attention durin$- or s%ortl' a#ter- o!ioid useo""ur(

http://www.minddisorders.com/A-Br/Apathy.html


9/16

SymptomsOPIOID WITHDRAWAL.

T%e DSM-IV-TR s!e"i7es t%at t%e #ollo6in$ s',!to,s ,ust &e !resent

in order to ,eet dia$nosti" "riteria #or o!ioid 6it%dra6al;

)A&stinen"e; Eit%er t%e indiidual %as sto!!ed usin$ *or %as redu"ed t%e

a,ount o#+ o!ioids- or an o!ioid anta$onist *i(e(- a dru$- su"% asnalo/one- t%at &lo"s t%e a"tion o# o!ioids+ %as &een ad,inistered(

)!ioid)s!e"i7" 6it%dra6al s'ndro,e; T%ree or ,ore s',!to,sdeelo! a#ter a&stinen"e( T%ese s',!to,s in"lude d's!%ori"*ne$atie+ ,ood- nausea or o,itin$- ,us"le a"%es- runn' nose or

6ater' e'es- dilated !u!ils- $oose&u,!s- or s6eatin$- diarr%ea-

'a6nin$- #eer- and inso,nia(

)I,!air,ent or distress; T%e 6it%dra6al s',!to,s ,ust "ausesi$ni7"ant distress to t%e indiidual or i,!air,ent in #un"tionin$*so"iall'- at 6or- or an' ot%er i,!ortant area+(

)Not due to ot%er disorder; T%e 6it%dra6al s',!to,s "annot &e due toa ,edi"al "ondition or ot%er ,ental disorder(

http://www.minddisorders.com/knowledge/Opioid_antagonist.htmlhttp://www.minddisorders.com/knowledge/Opioid_antagonist.htmlhttp://www.minddisorders.com/knowledge/Opioid_antagonist.htmlhttp://www.minddisorders.com/knowledge/Opioid_antagonist.html


10/16

Dia$nosisDia$nosis o# o!ioid)related disorders are &ased on!atient interie6 and o&serations o# s',!to,s-in"ludin$ si$ns o# 6it%dra6al su"% as dilated !u!ils-6ater' e'es- #re?uent 'a6nin$- and an/iet'- a,on$ot%ers(

) !ioid de!enden"e

De!ression *usuall' eit%er ,aor de!ression orsu&stan"e)indu"ed ,ood disorder+ is t%e ,ost"o,,on disorder( !ioid)de!endent indiiduals

#re?uentl' re!ort sui"idal ideation *t%ou$%ts+ andinso,nia- ot%er su&stan"e use disorders *su"% asal"o%olis,+- an/iet' disorders- antiso"ial !ersonalit'disorder- !ost)trau,ati" stress disorder - and a

%istor' o# "ondu"t disorder are also #airl' "o,,on(


11/16

) !ioid into/i"ation

Into/i"ation on ot%er su&stan"es- su"% asal"o%ol- sedaties- %'!noti"s- andan/iol'ti"s- "an rese,&le into/i"ation ono!ioids( Furt%er,ore- dilated !u!ils "an &eseen(

) !ioid 6it%dra6al T%e restlessness and an/iet' seen in o!ioid

6it%dra6al is also seen in 6it%dra6al #ro,sedaties- %'!noti"s- and an/iol'ti"s(


12/16

Treat,ent o# Opioid dependence

1( Met%adone ,aintenan"e treat,ent( Met%adone is a lon$)a"tin$ o!ioid t%at is $enerall' ad,inistered in anout!atient settin$ *a ,et%adone ,aintenan"e "lini"+( T%e,et%adone !reents t%e indiidual #ro, e/!erien"in$o!ioid 6it%dra6al- redu"es o!ioid "rain$- and ena&les t%e

indiidual to %ae a""ess to ot%er seri"es *su"% asindiidual "ounselin$- ,edi"al seri"es- and HI@)!reentionedu"ation+(

2( !ioid anta$onist treat,ent( An o!ioid anta$onist is a,edi"ation t%at &lo"s t%e e8e"ts o# o!ioids( T%e e8e"ts o#

tain$ an' o!ioids are &lo"ed &' t%e naltre/one *Tre/an+ it6ill !reent t%e indiidual #ro, $ettin$ %i$%(


13/16

3( !ioid a$onist)anta$onist treat,ent(u!renor!%ine *u!rene/+ is an e/a,!le o#an o!ioid a$onist)anta$onist- 6%i"% ,eansit a"ts as &ot% an a$onist *%ain$ so,e

,or!%ine)lie a"tion+ and anta$onist *it&lo"s t%e e8e"ts o# additional o!ioids+(

4( Indiiduali.ed dru$ "ounselin$

5( Sel#)%el! $rou!s

B( Cs'"%ot%era!'


14/16

Treat,ent- Opioid abuse

Most o# t%e treat,ents #or o!ioid de!enden"e 6ould &e a!!ro!riate #oro!ioid a&use e/"e!t ,et%adone and o!ioid anta$onist treat,ent(

- Opioid intoxication

An o!ioid anta$onist- nalo/one *Nar"an+- "an &e ad,inistered toreerse t%e e8e"ts o# a"ute into/i"ation or oerdose on ,ost o!ioids(

- Opioid withdrawal!ioid 6it%dra6al "an &e treated eit%er on an in!atient &asis*deto/i7"ation+ or on an out!atient &asis *,et%adone deto/i7"ation+;

In!atient deto/i7"ation !ro$ra,( T'!i"all'- t%is 6ould &e #ro, t%ree toseen da's( T%e 6it%dra6al "an &e ,edi"all',ana$ed( Clonidine ,a' &e ad,inistered to %el! redu"e so,e

s',!to,s o# 6it%dra6al((


15/16

Cro$nosis!ioid de!enden"e

Re"oerin$ #ro, o!ioid de!enden"e is alon$- di"ult !ro"ess( T'!i"all'- ,ulti!letreat,ent atte,!ts are re?uired(

Rela!sin$- or returnin$ to o!ioids- is notun"o,,on een a#ter ,an' 'ears o#a&stinen"e( rie# !eriods o# a&stinen"e are"o,,on(


16/16

Creention T%e &est sin$le t%in$ an indiidual "an do

to !reent o!ioid)related disorders is neerto use o!ioids su"% as %eroin( !ioids are!o6er#ull' addi"tin$- es!e"iall' i# used

intraenousl'(

Documents

Mental Disorder Due to Heroin