Review
Opioid Kullanım Bozukluğu arındırma sürecinde ağrının yönetimi: Konfor Kuramı ve Nörobilim temelinde bir yaklaşım
Abstract
Yasadışı opioid kullanımı son yıllarda giderek artmaktadır. Opioid Kullanım Bozukluğunda tedavi, arındırma ve sürdürüm olmak üzere iki aşamadan oluşmaktadır. Arındırma süreci yaklaşık bir hafta süren, yerine koyma tedavisini kapsar. Genellikle arındırma tedavisinin son evresinde kullanılan buprenorfin/nalokson kombinasyonunun azaltılarak kesilmesi ve sürdürüm tedavisinde kullanılacak olan naltrekson hidroklorür ilacına başlanması tercih edilmektedir. Bu geçiş sürecinde ağrı başta olmak üzere ortaya çıkabilen yoksunluk belirtilerinin etkin yönetilememesi, tedavide kalma ile ilişkilidir. Bu kritik süreçte izlem, ek ilaç desteği ve ilaç dışı müdahaleler ile hastanın tedavide kalmasını sağlamakta psikiyatri hemşirelerinin rolü önemlidir. Bu derleme çalışmasında arındırma sürecinde ağrı yönetimine konfor kuramı ve nörobilim temelinde bir yaklaşım getirilmesi amaçlanmıştır.
Supporting Institution
Yoktur.
Project Number
-
Thanks
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References
- CDC. Opioid data analysis and resources. Centers for Disease Control Prevention. Department of Health and Human Service. 03.08.20022,
- Hser Y-I, Evans E, Grella C, Ling W, Anglin D. Long-term course of opioid addiction. Harv Rev Psychiatry. 2015;23(2):76-89.
- Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2021. http://wonder.cdc.gov. . 03.08.2022,
- Brown N. Implementing Harm Reduction Strategies to Reduce Opioid Overdoses. J Nurse Pract. 2021;17(7):870-873.
- Tolomeo S, Steele JD, Ekhtiari H, Baldacchino A. Chronic heroin use disorder and the brain: Current evidence and future implications. Prog Neuropsychopharmacol Biol Psychiatry. 2021;111:110148.
- Huskamp HA, Riedel LE, Barry CL, Busch AB. Coverage of medications that treat opioid use disorder and opioids for pain management in marketplace plans, 2017. Med Care. 2018;56(6):505.
- DSM-5th. Diagnostic and statistical manual of mental disorders. 2013;21(21):591-643.
- Wachholtz A, Foster S, Cheatle M. Psychophysiology of pain and opioid use: implications for managing pain in patients with an opioid use disorder. Drug Alcohol Depend. 2015;146:1-6.
- Laroche F, Rostaing S, Aubrun F, Perrot S. Pain management in heroin and cocaine users. Joint Bone Spine. 2012;79(5):446-450.
- Larson MJ, Paasche‐Orlow M, Cheng DM, Lloyd‐Travaglini C, Saitz R, Samet JH. Persistent pain is associated with substance use after detoxification: a prospective cohort analysis. Addiction. 2007;102(5):752-760.
- Pasero CL, Compton P. Managing Pain in Addicted Patients. Am J Nurs. 1997;97(4):17-18.
- Marie BS, Broglio K. Managing pain in the setting of opioid use disorder. Pain Manag Nurs. 2020;21(1):26-34.
- Compton P, Blacher S. Nursing education in the midst of the opioid crisis. Pain Manag Nurs. 2020;21(1):35-42.
- Jukiewicz DA, Alhofaian A, Thompson Z, Gary FA. Reviewing opioid use, monitoring, and legislature: nursing perspectives. Int J Nurs Sci. 2017;4(4):430-436.
- Siefert ML. Concept analysis of comfort. Blackwell Publishing Ltd.; 2002:16.
- Kolcaba KY. A taxonomic structure for the concept comfort. J Nurs Scholarsh. 1991;23(4):237-240.
- Kolcaba K. Comfort theory and practice: a vision for holistic health care and research. Springer Publishing Company; 2003.
- Kolcaba KY. Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome. ANS Adv Nurs Sci. 1992;15(1):1-10.
- Terzi B, Nurtan K. Konfor kuramı ve analizi. J Nursology. 2017;20(1):67-74.
- Kolcaba K, Tilton C, Drouin C. Comfort theory: A unifying framework to enhance the practice environment. J Nurs Adm. 2006;36(11):538-544.
- Kolcaba KY. A theory of holistic comfort for nursing. J Adv Nurs. 1994;19(6):1178-1184.
- Borsook D. A future without chronic pain: neuroscience and clinical research. Dana Foundation; 2012:
- Christie M. Cellular neuroadaptations to chronic opioids: tolerance, withdrawal and addiction. Br J Pharmacol. 2008;154(2):384-396.
- LeBlanc DM, McGinn MA, Itoga CA, Edwards S. The affective dimension of pain as a risk factor for drug and alcohol addiction. Alcohol. 2015;49(8):803-809.
- Koob GF. Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development. Pharmacol Rev. Jan 2021;73(1):163-201. doi:10.1124/pharmrev.120.000083
- Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry. 2016;3(8):760-773.
- Elif M, Davut O. Opioid Kullanım Bozukluğunda Tedavi ve İzlem. Ankara: Alkol ve Madde Kullanım Bozuklukları Tedavi ve İzlem Klinik Protokolü. T.C. Sağlık Bakanlığı, Sağlık Hizmetleri Genel Müdürlüğü, Araştırma, Geliştirme ve Sağlık Teknolojisi Değerlendirme Dairesi Başkanlığı; 2022. p. 27-37.
- Lee JD, Nunes Jr EV, Novo P, et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X: BOT): a multicentre, open-label, randomised controlled trial. Lancet Psychiatry. 2018;391(10118):309-318.
- Latif ZE, Solli KK, Opheim A, et al. No increased pain among opioid-dependent individuals treated with extended-release naltrexone or buprenorphine-naloxone: A 3-month randomized study and 9-month open-treatment follow-up study. Am J Addict. Feb 2019;28(2):77-85. doi:10.1111/ajad.12859
- Nunes EV, Jr., Scodes JM, Pavlicova M, et al. Sublingual Buprenorphine-Naloxone Compared With Injection Naltrexone for Opioid Use Disorder: Potential Utility of Patient Characteristics in Guiding Choice of Treatment. Am J Psychiatry. Jul 2021;178(7):660-671. doi:10.1176/appi.ajp.2020.20060816
- Kırlı U, Nart O. Opioid kullanım bozukluğu sürdürüm tedavisinde naltrekson implant ile oral buprenorfin-nalokson kullanan hastaların tedaviyi yarıda bırakma risklerinin karşılaştırılması. J Clin Psy. 2021;24(3):342-349.
- Langejan AI, de Kleijn L, Rijkels-Otters H, Chudy SFJ, Chiarotto A, Koes BW. Effectiveness of non-opioid interventions to reduce opioid withdrawal symptoms in patients with chronic pain: a systematic review. Fam Pract. Mar 24 2022;39(2):295-300. doi:10.1093/fampra/cmab159
- MacLean RR, Spinola S, Manhapra A, Sofuoglu M. Systematic review of pain severity and opioid craving in chronic pain and opioid use disorder. Pain Med. 2020;21(2):e146-e163.
- Potter JS, Chakrabarti A, Domier CP, Hillhouse MP, Weiss RD, Ling W. Pain and continued opioid use in individuals receiving buprenorphine–naloxone for opioid detoxification: Secondary analyses from the Clinical Trials Network. J Subst Abuse Treat. 2010;38:S80-S86.
- Amato L, Minozzi S, Davoli M, Vecchi S. Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification. Cochrane Database Syst Rev. 2011;(9)
- Chutuape MA, Jasinski DR, Fingerhood MI, Stitzer ML. One-, three-, and six-month outcomes after brief inpatient opioid detoxification. Am J Drug Alcohol Abuse. 2001;27(1):19-44.
- Streltzer J. Pain management in the opioid-dependent patient. Curr Psychiatry Rep. 2001;3(6):489-496.
- Blondell RD. Ambulatory detoxification of patients with alcohol dependence. Am Fam Physician. 2005;71(3):495-502.
- DiMeola KA, Haynes J, Barone M, et al. A Pilot Investigation of Nonpharmacological Pain Management Intervention Groups in Methadone Maintenance Treatment. J Addict Med. 2022;16(2):229-234.
- Gazzola MG, Beitel M, Cutter CJ, Barry DT. Cognitive behavioral therapy for chronic pain and opioid use disorder. Treatments, Mechanisms, and Adverse Reactions of Anesthetics and Analgesics. Elsevier; 2022:235-246.
- Schainker LM, Voss MW, Yaugher AC. Integrated Care Approach to the Prevention of Opioid Use Disorder. Handbook of Evidence-Based Prevention of Behavioral Disorders in Integrated Care. Springer; 2021:267-292.
- Wachholtz A, Robinson D, Epstein E. Developing a novel treatment for patients with chronic pain and Opioid User Disorder. Subst Abuse Treat Prev Policy. 2022;17(1):1-12.
- Weiss RD, Potter JS, Griffin ML, et al. Reasons for opioid use among patients with dependence on prescription opioids: the role of chronic pain. J Subst Abuse Treat. 2014;47(2):140-145.
- Franken IH, Hendriks VM. Predicting outcome of inpatient detoxification of substance abusers. Psychiatr Serv. 1999;50(6):813-817.
Management of pain in Opioid Use Disorders during detoxification: A psychiatric nursing approach with the context of Comfort Theory and Neuroscience
Abstract
Use of the illicit opioid has been increasing in recent years. Treatment of opioid use disorder consists of two phases: detoxification and maintenance. Detoxification process includes replacement therapy, which takes approximately one week. Generally, in the last phase of detoxification, slowly tapering the buprenorphine/naloxone doses and continuing with the naltrexone is preferred. In this medically managed withdrawal period, ineffective management of withdrawal symptoms -especially pain- related with retention in treatment. The role of psychiatric nurses is important for retention in treatment with follow-up, additional drug support and non-pharmacological interventions. The aim of this review is introduce an approach on the basis of comfort theory and neuroscience to pain management in the detoxification process.
Project Number
-
References
- CDC. Opioid data analysis and resources. Centers for Disease Control Prevention. Department of Health and Human Service. 03.08.20022,
- Hser Y-I, Evans E, Grella C, Ling W, Anglin D. Long-term course of opioid addiction. Harv Rev Psychiatry. 2015;23(2):76-89.
- Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2021. http://wonder.cdc.gov. . 03.08.2022,
- Brown N. Implementing Harm Reduction Strategies to Reduce Opioid Overdoses. J Nurse Pract. 2021;17(7):870-873.
- Tolomeo S, Steele JD, Ekhtiari H, Baldacchino A. Chronic heroin use disorder and the brain: Current evidence and future implications. Prog Neuropsychopharmacol Biol Psychiatry. 2021;111:110148.
- Huskamp HA, Riedel LE, Barry CL, Busch AB. Coverage of medications that treat opioid use disorder and opioids for pain management in marketplace plans, 2017. Med Care. 2018;56(6):505.
- DSM-5th. Diagnostic and statistical manual of mental disorders. 2013;21(21):591-643.
- Wachholtz A, Foster S, Cheatle M. Psychophysiology of pain and opioid use: implications for managing pain in patients with an opioid use disorder. Drug Alcohol Depend. 2015;146:1-6.
- Laroche F, Rostaing S, Aubrun F, Perrot S. Pain management in heroin and cocaine users. Joint Bone Spine. 2012;79(5):446-450.
- Larson MJ, Paasche‐Orlow M, Cheng DM, Lloyd‐Travaglini C, Saitz R, Samet JH. Persistent pain is associated with substance use after detoxification: a prospective cohort analysis. Addiction. 2007;102(5):752-760.
- Pasero CL, Compton P. Managing Pain in Addicted Patients. Am J Nurs. 1997;97(4):17-18.
- Marie BS, Broglio K. Managing pain in the setting of opioid use disorder. Pain Manag Nurs. 2020;21(1):26-34.
- Compton P, Blacher S. Nursing education in the midst of the opioid crisis. Pain Manag Nurs. 2020;21(1):35-42.
- Jukiewicz DA, Alhofaian A, Thompson Z, Gary FA. Reviewing opioid use, monitoring, and legislature: nursing perspectives. Int J Nurs Sci. 2017;4(4):430-436.
- Siefert ML. Concept analysis of comfort. Blackwell Publishing Ltd.; 2002:16.
- Kolcaba KY. A taxonomic structure for the concept comfort. J Nurs Scholarsh. 1991;23(4):237-240.
- Kolcaba K. Comfort theory and practice: a vision for holistic health care and research. Springer Publishing Company; 2003.
- Kolcaba KY. Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome. ANS Adv Nurs Sci. 1992;15(1):1-10.
- Terzi B, Nurtan K. Konfor kuramı ve analizi. J Nursology. 2017;20(1):67-74.
- Kolcaba K, Tilton C, Drouin C. Comfort theory: A unifying framework to enhance the practice environment. J Nurs Adm. 2006;36(11):538-544.
- Kolcaba KY. A theory of holistic comfort for nursing. J Adv Nurs. 1994;19(6):1178-1184.
- Borsook D. A future without chronic pain: neuroscience and clinical research. Dana Foundation; 2012:
- Christie M. Cellular neuroadaptations to chronic opioids: tolerance, withdrawal and addiction. Br J Pharmacol. 2008;154(2):384-396.
- LeBlanc DM, McGinn MA, Itoga CA, Edwards S. The affective dimension of pain as a risk factor for drug and alcohol addiction. Alcohol. 2015;49(8):803-809.
- Koob GF. Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development. Pharmacol Rev. Jan 2021;73(1):163-201. doi:10.1124/pharmrev.120.000083
- Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry. 2016;3(8):760-773.
- Elif M, Davut O. Opioid Kullanım Bozukluğunda Tedavi ve İzlem. Ankara: Alkol ve Madde Kullanım Bozuklukları Tedavi ve İzlem Klinik Protokolü. T.C. Sağlık Bakanlığı, Sağlık Hizmetleri Genel Müdürlüğü, Araştırma, Geliştirme ve Sağlık Teknolojisi Değerlendirme Dairesi Başkanlığı; 2022. p. 27-37.
- Lee JD, Nunes Jr EV, Novo P, et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X: BOT): a multicentre, open-label, randomised controlled trial. Lancet Psychiatry. 2018;391(10118):309-318.
- Latif ZE, Solli KK, Opheim A, et al. No increased pain among opioid-dependent individuals treated with extended-release naltrexone or buprenorphine-naloxone: A 3-month randomized study and 9-month open-treatment follow-up study. Am J Addict. Feb 2019;28(2):77-85. doi:10.1111/ajad.12859
- Nunes EV, Jr., Scodes JM, Pavlicova M, et al. Sublingual Buprenorphine-Naloxone Compared With Injection Naltrexone for Opioid Use Disorder: Potential Utility of Patient Characteristics in Guiding Choice of Treatment. Am J Psychiatry. Jul 2021;178(7):660-671. doi:10.1176/appi.ajp.2020.20060816
- Kırlı U, Nart O. Opioid kullanım bozukluğu sürdürüm tedavisinde naltrekson implant ile oral buprenorfin-nalokson kullanan hastaların tedaviyi yarıda bırakma risklerinin karşılaştırılması. J Clin Psy. 2021;24(3):342-349.
- Langejan AI, de Kleijn L, Rijkels-Otters H, Chudy SFJ, Chiarotto A, Koes BW. Effectiveness of non-opioid interventions to reduce opioid withdrawal symptoms in patients with chronic pain: a systematic review. Fam Pract. Mar 24 2022;39(2):295-300. doi:10.1093/fampra/cmab159
- MacLean RR, Spinola S, Manhapra A, Sofuoglu M. Systematic review of pain severity and opioid craving in chronic pain and opioid use disorder. Pain Med. 2020;21(2):e146-e163.
- Potter JS, Chakrabarti A, Domier CP, Hillhouse MP, Weiss RD, Ling W. Pain and continued opioid use in individuals receiving buprenorphine–naloxone for opioid detoxification: Secondary analyses from the Clinical Trials Network. J Subst Abuse Treat. 2010;38:S80-S86.
- Amato L, Minozzi S, Davoli M, Vecchi S. Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification. Cochrane Database Syst Rev. 2011;(9)
- Chutuape MA, Jasinski DR, Fingerhood MI, Stitzer ML. One-, three-, and six-month outcomes after brief inpatient opioid detoxification. Am J Drug Alcohol Abuse. 2001;27(1):19-44.
- Streltzer J. Pain management in the opioid-dependent patient. Curr Psychiatry Rep. 2001;3(6):489-496.
- Blondell RD. Ambulatory detoxification of patients with alcohol dependence. Am Fam Physician. 2005;71(3):495-502.
- DiMeola KA, Haynes J, Barone M, et al. A Pilot Investigation of Nonpharmacological Pain Management Intervention Groups in Methadone Maintenance Treatment. J Addict Med. 2022;16(2):229-234.
- Gazzola MG, Beitel M, Cutter CJ, Barry DT. Cognitive behavioral therapy for chronic pain and opioid use disorder. Treatments, Mechanisms, and Adverse Reactions of Anesthetics and Analgesics. Elsevier; 2022:235-246.
- Schainker LM, Voss MW, Yaugher AC. Integrated Care Approach to the Prevention of Opioid Use Disorder. Handbook of Evidence-Based Prevention of Behavioral Disorders in Integrated Care. Springer; 2021:267-292.
- Wachholtz A, Robinson D, Epstein E. Developing a novel treatment for patients with chronic pain and Opioid User Disorder. Subst Abuse Treat Prev Policy. 2022;17(1):1-12.
- Weiss RD, Potter JS, Griffin ML, et al. Reasons for opioid use among patients with dependence on prescription opioids: the role of chronic pain. J Subst Abuse Treat. 2014;47(2):140-145.
- Franken IH, Hendriks VM. Predicting outcome of inpatient detoxification of substance abusers. Psychiatr Serv. 1999;50(6):813-817.
There are 44 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Review |
| Authors | |
| Project Number | - |
| Publication Date | February 20, 2023 |
| Submission Date | September 19, 2022 |
| Acceptance Date | November 2, 2022 |
| Published in Issue | Year 2023 Volume: 5 Issue: 1 |
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