ADDICTIONS - the general name for a number of serious diseases characterized by an irresistible urge to use drugs with the development of mental and physical dependence. Types of drug addiction vary by drug. The term “narcotic drug” includes 3 mandatory criteria: medical (the specific effect of the drug on the central nervous system, leading to its repeated use), social (the scale of non-medical consumption of this drug takes on social significance) and legal (official inclusion of the substance in the list of drugs). Abuse of other psychoactive substances refers to substance abuse.
Easily suggestible people, deprived of interests, poorly controlling their desires, people with traits of mental infantilism, as well as pathological traits of character, often become addicted to drugs. The rate of development of drug addiction depends on the chemical structure of the drug, the method of its administration, frequency of administration, dosage and individual characteristics of the body. With different types of addiction, drug intoxication along with differences has a common feature - the emergence of a subjectively pleasant state (euphoria, “high”). The initial stage of drug addiction is the transition from episodic to regular (daily) drug use, sometimes a change in the method of drug administration (from inhaling heroin to intravenous administration), increased endurance to it, and the appearance of addiction to drug intoxication.
Opium addiction (morphinism). Reception of opiates (artisanal preparations of opium, morphine, codeine, promedol, heroin) causes a feeling of pleasant warmth, stroking the skin, a painless “push” in the head, a state of bliss. Then begins a quick change of pleasant ideas against a background of blissful peace with dreamlike fantasies. The predisposing factors for the development of morphinism in recent years are not so much diseases with severe pain as psychopathy and other types of mental instability, pathological curiosity. With the transition of abuse to the stage of the disease, peculiar personality changes (lying, rudeness, selfishness, narrowing of interests in obtaining drugs) and somatic disorders (appetite and digestion disorder, weight loss, sweating, paresthesias, the appearance of eczema, and oppression of sexual function) develop more and more, as well persistent miosis. Acute morphine poisoning is characterized by the appearance of euphoria and arousal at first, which are followed by sharp weakness, dizziness, frequent urination, tachycardia, constricted pupils, increasing drowsiness, which becomes stupid and coma.
Symptoms of withdrawal symptoms during drug deprivation begin to form after 3-4 of its injections. The first signs of withdrawal symptoms occur 6-18 hours after the last dose: yawning, lacrimation and salivation, itching in the nose and nasopharynx, and hyperhidrosis begin. On the 2nd day, there are breaking pains in the joints, cramps of the limbs, anxiety, insomnia, chills, tachycardia , increased blood pressure. Against the background of altered consciousness, psychotic episodes can develop. These phenomena reach their greatest severity on the 2nd – 4th day and then gradually subside over the course of 5–11 days.
Cocaine addiction is now widespread due to the emergence of "crack" - a drug resistant to high temperature cocaine, which can be made in artisanal conditions. With a single use of cocaine, euphoria occurs, a person becomes talkative, overly active, feels a desire for activity. After 2 to 3 hours, weakness, apathy and irritability develop, accompanied by tremors, decreased muscle tone and tachycardia. In case of an overdose, death occurs from paralysis of the respiratory center. Cocaine is usually sniffed, but also swallowed, injected into a vein and smoked. Addiction occurs very quickly, mental dependence is formed after a few tricks, but obvious signs of physical dependence do not appear soon. Cocaine can be considered a criminal drug, because unlike sluggish and passive opium addicts, cocaine is impudent, self-confident and aggressive. Degradation of personality is even deeper than with morphinism. Sleep disorders are persistent. Developing psychotic outbursts are in the nature of delusional ideas of jealousy, persecution or are accompanied by terrifying hallucinations; tactile hallucinosis is characteristic of cocainism (it seems to patients that bugs, worms, bugs, etc., crawl under the skin).
Hash drug addiction - abuse of hemp drugs. Single smoking hashish can cause mild intoxication with a burst of strength and a heightened perception of the environment. Dependence develops slowly, but this type of drug addiction often encourages the use of stronger drugs. With the systematic use and overdoses of the drug, manic psychoses can occur with vivid illusions and hallucinations, which are accompanied by symptoms of hyperesthesia, a distortion of the sense of time and space, derealization and depersonalization. Gradually, a decrease in the circle of interests is planned, memory is disturbed, asthenia develops, patients seek solitude and loneliness. Psychoses can suddenly develop with auditory and visual hallucinations, delusions of persecution and attitude. Hashish almost does not cause physical dependence (mental can be quite strong!), A break in taking the drug is accompanied by mild withdrawal symptoms (sleep disturbances, increased irritability, decreased appetite, sweating, discomfort in the heart).
Treatment . Although modern fairly effective treatment programs (clonidine, tramalic, methadone, etc.) allow you to stop unburdened cases of drug withdrawal even on an outpatient basis, full-fledged complex therapy is possible only for a narcological hospital for 2 months or more (in severe cases, using plasmapheresis) ..
The main tactics of paramedical personnel in the treatment of drug addiction is based on the immutable criterion that the addict is primarily a sick person. The climate in the department from the moment the patient arrives should be purely medical, the patient should immediately establish the boundaries of his possible requirements; any exception to the rules in behavior must meet a decisive "no" staff; fearful and less demanding nurses can quickly become at the mercy of the sick. Thus, a nurse should develop a patient, at the same time merciful and strict attitude towards patients with a sincere interest in their fate.