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Opioid dependence: mechanisms of development of withdrawal syndrome and its treatment
Hosenseidlová, Pavla ; Novotný, Jiří (advisor) ; Ujčíková, Hana (referee)
This work deals with opioids, opioid-induced withdrawal syndrome, and its treatment. Opioids are the most commonly used analgesics in medicine, and so far, there hasn't been a better alternative for them in most health cases. However, with long-term use, dependence can develop relatively quickly, and they have a high potential for abuse. When opioid use is discontinued, withdrawal syndrome occurs, and its symptoms resemble those of the flu, including muscle and joint pain, feeling cold and having a runny nose, nausea and vomiting, diarrhea, and tachycardia. These symptoms can be very intense and are often accompanied by psychological manifestations such as anxiety and depression. The treatment of opioid withdrawal syndrome is based on alleviating both physical and psychological symptoms. Most commonly, treatment involves using opioid agonists or antagonists with accompanying therapy for psychological manifestations. It is also important to include psychotherapy in the treatment process because the addiction in many cases stems from unresolved psychological or socio-economic issues.
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Pharmacotherapy in the treatment of opioid addiction
Bodinková, Jolana ; Novotný, Jiří (advisor) ; Kašík, Petr (referee)
Opiate addiction represents a difficult problem, both medically and socially. With millions of affected people, either by such kinds of addiction or its side effects, across the globe, the condition requires its resolution to be effective, which can be provided by opioid pharmacotherapy, either methadone-, buprenorphine- or naloxone-based. In regard to increasing numbers of not only cases but also deaths, related to drug overdose, opiate addiction treatments still remain underused in medical settings. This thesis summarizes pharmacotherapy practices used during opioid use disorder treatments. Its main part predominantly focuses on the description of therapeutical procedures, their advantages, and deficiencies. Keywords: opioid abuse, pharmacotherapy, methadone, buprenorphine, naloxone
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Life on Subutex
LEDINSKÁ, Hana
The Diploma Thesis deals with the Subutex addiction and its effects on the lives of the Subutex users. The main goal of the thesis is to find out how Subutex affects everyday lives of its users from social, health and also other perspectives. There are two main research questions. Firstly, the question is what poses a main problem for the Subutex users in connection with their addiction and secondly, what limitations they face when it comes to their everyday lives. The theoretical part of the thesis includes definition of addiction, describes its phases, causes and other factors connected with it. Further, there is a short overview of currently most commonly used drugs including Subutex. The chapter "Effects of drug addiction" sums up the most common direct effects of drug addiction on social and health wellbeing of the users. The following chapter talks about social work and the importance of case management when dealing with drug addicts, and also the importance of coordination of all phases of rehabilitation. The final pages of the theoretical part mention different ways and kinds of treatments of drug addiction, mainly the substitution treatment. The empirical part of the thesis is focused on research, research questions, methods, and of course, its results. The research was based on semi-structured interviews with 10 interviewees, whose background is also described in more detail. All of the interviewees are clients of "Kontaktní centrum Písek" and all of them are active users of Subutex. The ways of how they get the substance were not considered as a limitation in the research. The results of the research led to several conclusions. Firstly, the main problem the Subutex users have to face is the low living standard as a result of their low economic status and the high price of Subutex. The users also often face comorbidity and their health is rather poor. They most often suffer from hepatitis C gained through needle usage. Further, the interviewees mention negative effects of Subutex usage on their social life and relationships, and also social stigmatisation leading often to social exclusion and worsened mental health. All these aspects negatively impact the quality of life of the Subutex users and hinder their better integration back into society. The thesis as well as its results can be beneficial as a complementary study material or as a source of information for novice workers at social services focusing on drug addiction.
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Bio-psycho-social-spiritual model in the buprenorphine substitutional treatment
Hanus, Richard ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
This thesis is focused on the application of holistic, bio-psycho-social-spiritual model of dependence to concrete therapeutic method, namely to the substitution treatment of persons dependent on opiate addictive substances with synthetic opioid buprenorphine. The aim is to describe the essence of BPSS model of addiction, with the specifics of opiate addiction, and the treatment system based on it. Also, to show substitution therapy as one of the most effective methods that improves quality of a dependent person's life. Further, to confirm the need for a holistic perception of substitution treatment when ersatz drug use itself is not a real chance for dependent persons, unless such treatment is accompanied by psychosocial and spiritual therapeutic approach. Another objective is to map the risk that, in practice, the substitution therapy initiation in a holistic range brings in the context of contemporary reality. The work will consider approach bases to opiate addicts, especially the optics of lifelong abstinence versus controlled use, leading to better quality of dependent person's life. Theoretic base of the thesis is the theory of bio-psycho-social-spiritual model of dependence and the possibility of its application to the chosen concrete curative therapeutic approach - substitution treatment...
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The drop-in centre Drug-OUT Club from Usti nad Labem substitution programme clients' quality of life
Šulcová, Ilona ; Janíková, Barbara (advisor) ; Matoušek, Petr (referee)
The thesis focuses on one of the possible methods of the opioid addiction treatment, on the substitution therapy. It also describes specific form of substitution therapy in Ústí nad Labem, part of the particular low-threshold facility for drug users. The paper also briefly discusses opioid addiction and the options of its substitutional therapy in Ústí nad Labem (e.g. methadone therapy, buprenorfine therapy). The aim of this thesis is to evaluate life quality of substitutional therapy's clients in the low-threshold facility in Ústí nad Labem and compare those results with life quality of clients who are using buprenorfine obtained on the black market. Another goal is to use these findings to improve and expand services for this target group. The theoretical part briefly describes the opioid addiction and possible methods of its treatment, mainly substitutional therapy. The research evaluates the life quality of clients who are using buprenorfine and identifies problematic parts of their lives. Data were collected using WHOQOL - BREF questionnaire - anonymous questionnaire of World Health Organization. Sociodemographic and anamnestic data of clients of substitutional therapy were involved. The sample of the clients of substitutional therapy was compared with the control group which consists of...
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The drop-in centre Drug-OUT Club from Usti nad Labem substitution programme clients' quality of life
Šulcová, Ilona ; Janíková, Barbara (advisor) ; Matoušek, Petr (referee)
The thesis focuses on one of the possible methods of the opioid addiction treatment, on the substitution therapy. It also describes specific form of substitution therapy in Ústí nad Labem, part of the particular low-threshold facility for drug users. The paper also briefly discusses opioid addiction and the options of its substitutional therapy in Ústí nad Labem (e.g. methadone therapy, buprenorfine therapy). The aim of this thesis is to evaluate life quality of substitutional therapy's clients in the low-threshold facility in Ústí nad Labem and compare those results with life quality of clients who are using buprenorfine obtained on the black market. Another goal is to use these findings to improve and expand services for this target group. The theoretical part briefly describes the opioid addiction and possible methods of its treatment, mainly substitutional therapy. The research evaluates the life quality of clients who are using buprenorfine and identifies problematic parts of their lives. Data were collected using WHOQOL - BREF questionnaire - anonymous questionnaire of World Health Organization. Sociodemographic and anamnestic data of clients of substitutional therapy were involved. The sample of the clients of substitutional therapy was compared with the control group which consists of...
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The attitudes of medical doctors and other key professionals regarding opioid substitution therapy in Kazakhstan
Čečeleva, Olga ; Zábranský, Tomáš (advisor) ; Mravčík, Viktor (referee)
Background A number of studies across countries have proven that the methadone maintenance program, if efficiently started and implemented, is really effective tool both for treatment of opioid dependence and harm reduction. The expansion of methadone substitution programmes in Kazakhstan may have a positive influence upon the health and social climate inside the country. The main target of this research is to survey the attitudes of medical doctors regarding opioid substitution treatment in Kazakhstan. Methods The study was composed of two surveys. Questionnaires were distributed (administered by electronic mail) to 17 centres for drug addiction treatment all over Kazakhstan. 19 medical doctors not yet providing opioid substitution treatment and 6 medical doctors enrolled in opioid substitution treatment responded to the questionnaire. Two therapists also participated this research and their responses are mentioned as well. Quantitative data were supplemented and enhanced by use of qualitative data obtained by analysis of original documents and by interviews with two key informants. Attitudes were measured using both multiple and single choice question types and a 5 point Likert scale. Findings Individual viewpoints of the first group of participants varied, but not largely. The fraction of the...
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Bio-psycho-social-spiritual model in the buprenorphine substitutional treatment
Hanus, Richard ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
This thesis is focused on the application of holistic, bio-psycho-social-spiritual model of dependence to concrete therapeutic method, namely to the substitution treatment of persons dependent on opiate addictive substances with synthetic opioid buprenorphine. The aim is to describe the essence of BPSS model of addiction, with the specifics of opiate addiction, and the treatment system based on it. Also, to show substitution therapy as one of the most effective methods that improves quality of a dependent person's life. Further, to confirm the need for a holistic perception of substitution treatment when ersatz drug use itself is not a real chance for dependent persons, unless such treatment is accompanied by psychosocial and spiritual therapeutic approach. Another objective is to map the risk that, in practice, the substitution therapy initiation in a holistic range brings in the context of contemporary reality. The work will consider approach bases to opiate addicts, especially the optics of lifelong abstinence versus controlled use, leading to better quality of dependent person's life. Theoretic base of the thesis is the theory of bio-psycho-social-spiritual model of dependence and the possibility of its application to the chosen concrete curative therapeutic approach - substitution treatment...
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The Importance of Substitution Programmes in Drug Addiction Therapy System
MÁLKOVÁ, Gabriela
The title of my thesis is: The Importance of Substitution Programmes in Drug Addiction Therapy System. Substitution therapy has its unique place especially in the treatment of opioid addictions. It helps individuals with stabilization and improvement of their social, somatic and mental state and it is important for the society, when public spending on the care and repression are reduced thanks to substitution treatment. In this bachelors thesis I deal with the issue of the effects of substitution therapy on the lives of people who use it for a long time. First, in the theoretical part, I define the issues concerning the addiction on non-alcohol drugs and then I deal with substitution therapy, its history, its current situation, its forms, types and components that substitution therapy includes. Attention in this section is paid to the effectiveness in terms of individual as well as social; therefore, I focus also on the disadvantages and difficulties that are associated with substitution therapy. As the objective of the thesis I chose to discover the importance of substitution programmes in drug addiction treatment. To achieve this objective, I defined two subobjectives, namely: Mapping the subjective evaluation of mental, somatic and social satisfaction of persons included in a substitution programme, and the comparison of mental, somatic and social situation prior and after inclusion of the client in a substitution programme. Given these objectives, I established three research questions that ask about the effects of substitution treatment on the social, somatic and mental aspects of the respondents. The research was conducted in a qualitative form, by the method of interviewing and the technique of semi-structured interviews. The research results have confirmed the improvements or stabilization of social, somatic and mental aspects of persons included in long-term substitution programmes. As the core finding I consider the fact that there is some abuse of substitution therapy, in which case its effectiveness in these three levels is less visible than in persons observing substitution therapy in the prescribed manner. The results of my thesis can serve for the needs for further research, to inform the general public and professionals, and they also have a practical use when working with clients in substitution treatment.
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