{"id":8050,"date":"2020-02-04T14:18:10","date_gmt":"2020-02-04T19:18:10","guid":{"rendered":"http:\/\/localhost:10028\/uncategorized\/benzodiazepines-overlooked-part-of-the-opioid-epidemic\/"},"modified":"2020-02-04T14:18:10","modified_gmt":"2020-02-04T19:18:10","slug":"benzodiazepinler-opioid-salgininin-gozden-kacan-kismi","status":"publish","type":"post","link":"https:\/\/napolilaw.lemonadestand.org\/tr\/article\/benzodiazepinler-opioid-salgininin-gozden-kacan-kismi\/","title":{"rendered":"Benzodiazepinler: Opioid Salg\u0131n\u0131n\u0131n G\u00f6zden Ka\u00e7an K\u0131sm\u0131"},"content":{"rendered":"

\u0130ki y\u0131ll\u0131k bir s\u00fcre boyunca, doktorlar neredeyse yazd\u0131 altm\u0131\u015f alt\u0131 milyon re\u00e7ete<\/a><\/u> diazepam, alprazolam, lorazepam ve di\u011fer "benzolar" i\u00e7in.<\/p>\n

Bu ila\u00e7lar olduk\u00e7a ba\u011f\u0131ml\u0131l\u0131k yapar ve son derece zararl\u0131 yan etkileri vard\u0131r.<\/p>\n

Doktorlar genellikle kayg\u0131 veya uykusuzluk i\u00e7in benzo re\u00e7ete eder. Bu ila\u00e7lar olduk\u00e7a ba\u011f\u0131ml\u0131l\u0131k yapar.<\/p>\n

Ek olarak, ya\u015fl\u0131 yeti\u015fkinler aras\u0131nda benzodiazepinler d\u00fc\u015fme riskini \u00f6nemli \u00f6l\u00e7\u00fcde art\u0131r\u0131r.<\/p>\n

Einstein T\u0131p Fak\u00fcltesi'nden Dr. Joanna Starrels, benzos alan ya\u015fl\u0131 yeti\u015fkinlerin "endi\u015fe verici" say\u0131s\u0131ndan endi\u015fe duyuyordu.<\/p>\n

"Ya\u015fl\u0131lar, a\u015f\u0131r\u0131 doza ek olarak y\u00fcksek d\u00fc\u015fme, kafa kar\u0131\u015f\u0131kl\u0131\u011f\u0131, bili\u015fsel bozukluk riskiyle kar\u015f\u0131 kar\u015f\u0131yad\u0131r" dedi.<\/p>\n

"Ya\u015fl\u0131 hastalara opioidlerle birlikte benzodiazepinler re\u00e7ete edildi\u011finde bu riskler daha da art\u0131yor.<\/p>\n

Amerikan Geriatri Derne\u011fi gibi toplumlar\u0131n onlara kar\u015f\u0131 uyar\u0131da bulunmalar\u0131n\u0131n nedeni budur.<\/p>\n

Benzodiazepinler, opioid ba\u011f\u0131ml\u0131l\u0131\u011f\u0131n\u0131n ve opioid doz a\u015f\u0131mlar\u0131n\u0131n yakla\u015f\u0131k \u00fc\u00e7te birinden sorumludur.<\/p>\n

Opioid Salg\u0131n\u0131n\u0131 Ne Ba\u015flatt\u0131?<\/strong><\/h2>\n

Baz\u0131lar\u0131na g\u00f6re, 1980 tarihli bir say\u0131daki a\u015fa\u011f\u0131daki 100 kelimelik mektup, New England T\u0131p Dergisi<\/em> ak\u0131m\u0131 tetiklemi\u015f olabilir opioid krizi<\/a><\/u>:<\/p>\n

Yak\u0131n zamanda ard\u0131\u015f\u0131k olarak izlenen 39.946 hastanede yatan t\u0131bbi hastada narkotik ba\u011f\u0131ml\u0131l\u0131\u011f\u0131 insidans\u0131n\u0131 belirlemek i\u00e7in mevcut dosyalar\u0131m\u0131z\u0131 inceledik. En az bir narkotik m\u00fcstahzar alan 11.882 hasta olmas\u0131na ra\u011fmen, ba\u011f\u0131ml\u0131l\u0131k \u00f6yk\u00fcs\u00fc olmayan hastalarda makul \u00f6l\u00e7\u00fcde iyi belgelenmi\u015f ba\u011f\u0131ml\u0131l\u0131k vakas\u0131 sadece d\u00f6rt vaka vard\u0131. Ba\u011f\u0131ml\u0131l\u0131k yaln\u0131zca bir \u00f6rnekte \u00f6nemli kabul edildi. \u0130lgili ila\u00e7lar iki hastada meperidin, birinde Percodan ve birinde hidromorfondu. Narkotik ila\u00e7lar\u0131n hastanelerde yayg\u0131n olarak kullan\u0131lmas\u0131na ra\u011fmen, ba\u011f\u0131ml\u0131l\u0131k \u00f6yk\u00fcs\u00fc olmayan t\u0131bbi hastalarda ba\u011f\u0131ml\u0131l\u0131k geli\u015fiminin nadir oldu\u011fu sonucuna var\u0131ld\u0131.<\/p><\/blockquote>\n

Sonraki otuz yedi y\u0131l boyunca, ara\u015ft\u0131rmac\u0131lar bu mektuba birden fazla at\u0131fta bulundular. alt\u0131 y\u00fcz kez<\/a><\/u>.<\/p>\n

Bu t\u00fcr mektuplar i\u00e7in ortalama al\u0131nt\u0131 say\u0131s\u0131 on bir kat\u0131yd\u0131.<\/p>\n

Bu mektubun ortaya \u00e7\u0131kmas\u0131ndan birka\u00e7 y\u0131l sonra, G\u0131da ve \u0130la\u00e7 \u0130daresi yasalla\u015ft\u0131rd\u0131. do\u011frudan pazarlama<\/a><\/u> Hem t\u00fcketiciler hem de hekimler i\u00e7in.<\/p>\n

Televizyon reklamlar\u0131 hemen ard\u0131ndan re\u00e7eteli ila\u00e7lar\u0131n yararlar\u0131n\u0131 dile getirdi ve tehlikelerini g\u00f6z ard\u0131 etti.<\/p>\n

E\u015fzamanl\u0131 olarak eczane sat\u0131\u015f temsilcileri doktorlara \u00fccretsiz numune ve di\u011fer malzemeleri da\u011f\u0131tt\u0131.<\/p>\n

Bu kombinasyon muhtemelen opioid salg\u0131n\u0131n\u0131 ba\u015flatt\u0131. 2017'de bu salg\u0131n 45.000'den fazla can ald\u0131 ve yakla\u015f\u0131k iki milyon ba\u011f\u0131ml\u0131 yaratt\u0131.<\/p>\n

Sorumlu kim?<\/strong><\/h2>\n

B\u00fcy\u00fck \u00f6l\u00e7ekli trajedilerin genellikle birka\u00e7 farkl\u0131 nedeni vard\u0131r ve devam eden opioid salg\u0131n\u0131 da bir istisna de\u011fildir.<\/p>\n

\u0130la\u00e7 \u00fcreticileri, en g\u00fc\u00e7l\u00fc re\u00e7eteli a\u011fr\u0131 kesicileri kimin yaratabilece\u011fini g\u00f6rmek i\u00e7in bir t\u00fcr silahlanma yar\u0131\u015f\u0131na girdiler.<\/p>\n

Sonu\u00e7, morfin veya eroinden daha g\u00fc\u00e7l\u00fc ve daha fazla ba\u011f\u0131ml\u0131l\u0131k yapan Fentanil gibi bir ila\u00e7t\u0131.<\/p>\n

Ayr\u0131ca baz\u0131 \u00fcreticiler satt\u0131klar\u0131 ila\u00e7la ilgili olumsuz bilgileri g\u00f6md\u00fcler.<\/p>\n

Ayr\u0131ca uyu\u015fturucular\u0131, opioid ba\u011f\u0131ml\u0131l\u0131\u011f\u0131na kar\u015f\u0131 \u00f6zellikle savunmas\u0131z olan d\u00fc\u015f\u00fck gelirli ve di\u011fer sosyoekonomik gruplara da pazarlad\u0131lar.<\/p>\n

Bu \u00fcreticiler milyonlarca dolar kazand\u0131. \u0130la\u00e7 nakliye \u015firketleri bu arada milyarlarca dolar kazand\u0131.<\/p>\n

Federal Kontroll\u00fc Maddeler Yasas\u0131 uyar\u0131nca, nakliye \u015firketleri ila\u00e7 i\u00e7erikleri, ama\u00e7lar\u0131 vb. ile ilgili sorular sormal\u0131d\u0131r.<\/p>\n

Ancak \u00e7o\u011fu zaman, bu nakliye \u015firketleri sadece kutular\u0131 paketledi ve kamyonlar\u0131 s\u00fcrd\u00fc. Riske att\u0131klar\u0131 hastalar\u0131 umursam\u0131yorlard\u0131.<\/p>\n

Doktorlar\u0131n sorumlu olmas\u0131 da m\u00fcmk\u00fcnd\u00fcr. New York'un bir\u00e7ok yerinde s\u00f6zde hap fabrikalar\u0131 t\u00fcredi. Bu kliniklerdeki doktorlar, hastan\u0131n t\u0131bbi ge\u00e7mi\u015fini kapsaml\u0131 bir \u015fekilde kontrol etmeden opioid re\u00e7eteleri yazd\u0131.<\/p>\n

Ek olarak, baz\u0131 doktorlar, yetkin olmad\u0131klar\u0131 halde opioid re\u00e7eteleri yazm\u0131\u015flard\u0131r.<\/p>\n

\u00d6rne\u011fin, di\u015f hekimleri, g\u00f6r\u00fcn\u00fc\u015fte k\u00f6k kanal\u0131 ve di\u011fer olduk\u00e7a orta dereceli, k\u0131sa s\u00fcreli a\u011fr\u0131lar i\u00e7in \u00e7ok miktarda opioid re\u00e7ete ettiler.<\/p>\n

Dava A\u00e7abilir miyim?<\/strong><\/h2>\n

T\u0131pk\u0131 opioid krizinin birden \u00e7ok nedeni oldu\u011fu gibi, birden \u00e7ok kurban\u0131 da var. T\u00fcm bu kurbanlar\u0131n genellikle yasal se\u00e7enekleri vard\u0131r.<\/p>\n

Yaralanan ma\u011fdurlar veya aileleri kusurlu \u00fcr\u00fcn iddias\u0131nda bulunabilir. Bu \u00fcr\u00fcn hatas\u0131 a\u015fa\u011f\u0131dakilerden biri olabilir:<\/p>\n