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ORAL PRESENTATION ABUSE OF BENZODIAZEPINES AMONG HEROIN ADDICTS IN SKOPJE B.PAVLOVSKI., T.PANOVSKA, A.CIBISEV, N.POPOVSKI, D.PETROVSKI, N.VELJANOVSKA,

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Presentation on theme: "ORAL PRESENTATION ABUSE OF BENZODIAZEPINES AMONG HEROIN ADDICTS IN SKOPJE B.PAVLOVSKI., T.PANOVSKA, A.CIBISEV, N.POPOVSKI, D.PETROVSKI, N.VELJANOVSKA,"— Presentation transcript:

1 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

2 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.

3 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.short-story

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5 Therapeutic approaches: 1.HEROIN OVER DOSES 2.RESEDATION 3.MULTIPLE DEPENDENS 4.ABSTINENTIAL CRISIS 5.DETOXIFICATION 6.DISEASES AND COMPLICATIONS ASSOCIATED WITH DEPENDENCE

6 PREVENTIVE EDUCATION TREATMENT REHABILITATI ON RESOCIALISATI ON ALTERNATIVE MODEL OPIATE DEPENDENT PATIENTS GROUP National strategy treatment of heroin addicts THE ROLE OF THE TOXICOLOGISTS IN THE NATIONAL STRATEGY TREATMENT

7 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.

8 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

9 THE GOALS AND PRIMARY OBJECTIVES OF THIS STUDY:  TO EXAMINE THE EXTENT OF BENZODIAZEPINES USE  WHICH OF THEM IS THE MOST OFTEN USED

10 MATERIAL AND METHODS: THE STUDY WAS CARRIED OUT ON 92 PATIENTS, CURRENT HEROIN USERS, AGED 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.

11 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

12 CO-ABUSE WITH BENZODIAZEPINES AT HEROIN ADDICTS

13 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

14 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

15 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.

16 “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


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