Transcript oral presentation abuse of benzodiazepines among heroin addicts

ORAL PRESENTATION
ABUSE OF BENZODIAZEPINES AMONG HEROIN ADDICTS IN
SKOPJE
B.PAVLOVSKI., T.PANOVSKA, A.CIBISEV, N.POPOVSKI,
D.PETROVSKI, N.VELJANOVSKA, F.LICOSKA
CLINIC OF TOXICOLOGY AND URGENT INTERNAL
MEDICINE.
CLINICAL CENTRE.SKOPJE.R.MACEDONIA
• Since the 1990s abuse of narcotics have
spread greatly in region Skopje.Injecting
heroin use is currently the most common
route of hepatitis C virus transmission in
this increasing subgroup.
NARCOTICS ARE COMING IN ALL COUNTRIES IN
TRANSITION
MARIJUANA
HEROIN
COCAIN
CRACK
SINTETIC NARCOTICS- LSD, ECSTASY
“Pod solncem demokratii rascveta¥t ne tolÝko
gladiolusÝi no i marihuana.”
Sergeí Dovlatov, Russian short-story writer and novelist.
actual trends
100
% 50
0
tot. num
med.int
other
narcotics
100
75
15
10
1.
2.
3.
4.
5.
6.
Therapeutic approaches:
HEROIN OVER DOSES
RESEDATION
MULTIPLE DEPENDENS
ABSTINENTIAL CRISIS
DETOXIFICATION
DISEASES AND COMPLICATIONS
ASSOCIATED WITH DEPENDENCE
THE ROLE OF THE TOXICOLOGISTS
IN THE NATIONAL STRATEGY
TREATMENT
OPIATE
DEPENDENT
PATIENTS
GROUP
PREVENTIVE
EDUCATION
TREATMENT
REHABILITATI
ON
RESOCIALISATI
ON
ALTERNATIVE
MODEL
National strategy treatment of heroin addicts
ABUSE OF FLUNITRAZEPAM IN OPIOID ADDICTS
Ann.Med.Interne(Paris)2000 Apr,
INCREAS IN USE OF TEMAZEPAM BY HEROIN
INJECTORS IN GLASGOW,
USE OF FLUNITRAZEPAM BY MALAYSIAN ADDICTS.
BACKGROUND:
IT WAS A GREAT SCIENTIFIC CHALLENGE TO
INVESTIGATE
BENZODIAZEPINES CO-ABUSE- INCREASING
PROBLEM AMONG HEROIN USERS IN SKOPJE
CONSUMPTION OF BENZODIAZEPINES
A CLEAR TREND TO MULTIPLE DRUGS ABUSE
THE GOALS AND PRIMARY OBJECTIVES OF THIS
STUDY:
TO EXAMINE THE EXTENT OF BENZODIAZEPINES
USE
WHICH OF THEM IS THE MOST OFTEN USED
MATERIAL AND METHODS:
THE STUDY WAS CARRIED OUT ON 92 PATIENTS, CURRENT
HEROIN USERS, AGED 21+- 4 YEARS, DURING THE PERIOD
OF TWO YEARS.
MAINE CARACTERISTICS OF THIS GROUP WERE:
YOUNG PATIENTS, THE YOUNGEST WAS BORN-1985,
EARLY BECAME HEROIN INJECTING DEPENDENT P.
TIME OF H USING: FROM 3 MONTS TO 8 YEARS
H AND BZ WERE DETECTED USING FPIA TECHNIQUE
antiHCV seropositivity was detected using Cobas Core Anti-HCV
EIA.
100
80
60
40
20
0
Total number
Diazepam
Flu
Other
RESULTS:65%(60) PATIENTS S AND U CONC. WERE
RANKED OVER 300NG/ML.
DIAZEPAM WAS RANKED FIRST BY 85%(51)PATIENTS
FLUNITRAZEPAM 12%(7)PATIENTS, 3%(2)OTHER
60
40
20
_
0
diazepam
flunitraz
others
CO-ABUSE WITH BENZODIAZEPINES AT HEROIN
ADDICTS
CONCLUSION 1:
THE MOST COMMON REASON CITED FOR BZ USE WAS TO
ENHANCE THE FEELING OF “HIGH” FROM THE OPIATES
ECONOMIC FACTORS
ATTEMPTS TO AUTOTHERAPY
BZ USE FOR FUN AND PLEASURE
CONCLUSION 2:
DRUG ABUSE BEGAN AFTER A MEDICAL PRESCRIPTION
IN 58% OF CASES. DIAZEPAM WAS TAKEN PER OS, BUT
ALSO I.V. THE MEAN DAILY DOSE WAS 30MG/DAY,
OFTEN ASSOCIATED WITH OTHER DRUGS
CONCLUSION 3:
THE PREVALENCE OF DIAZEPAM USE AND ABUSE AMONG
HEROIN USERS IS VERY HIGH. DIAZEPAM AND
FLUNITRAZEPAM SHOULD BE PRESCRIBED TO HEROIN USERS
WITH CAUTION. A LESS POPULAR AND RARELY USED BZ MAY
BE A BETTER OPTION FOR THIS GROUP.
“I WOULDN’T LIKE TWO DISEASES, ONE
CAUSED BY THE DOCTORS AND THE OTHER
CAUSED BY THE NATURE!”
(Napoleon Bonaparte .)
Clinical pharmacology. Desmond R. Laurence Peter N. Bennett, 1998