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Opiatabstinens

Sist revidert:
Sist revidert av:


Definisjon:
Opiatabstinens er symptomene som melder seg når vedvarende overstimulering av opiatreseptorer i hjernen reduseres eller opphører
Forekomst:
I Norge er det ca. 10.000 sprøytemisbrukere
Symptomer:
Abstinenssymptomer er rhinoré, tåreflod, magesmerter, diaré, brekninger, leggkramper, gåsehud, gjesping
Funn:
Tilstanden er ofte preget av angst og uro, ev. utvidete pupiller
Diagnostikk:
Blodprøver tas for å kartlegge den medisinske tilstanden
Behandling:
Abstinensbehandling med buprenorfin eller metadon
  • Nasjonal kompetansetjeneste for tverrfaglig spesialisert rusbehandling (TSB) - nettside 
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  2. Kosten TR, Baxter LE. Effective management of opioid withdrawal symptoms: a gateway to opioid dependence treatment. Am J Addict 2019; 28: 55–62. PMID: 30701615 PubMed  
  3. Amundsen EJ. Narkotikautløste dødsfall i 2021. Folkehelseinstituttet, sist oppdatert 09.06.2022. www.fhi.no  
  4. Shaygani S, Waal H. Behandling av opioid abstinens. Tidsskr Nor Legeforen 2009; 129: 114-5. Tidsskrift for Den norske legeforening  
  5. Amato L, Minozzi S, Davoli M, Vecchi S. Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification. Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD005031. DOI: 10.1002/14651858.CD005031.pub4. The Cochrane Library  
  6. Gowing L, Farrell M, Ali R, White JM. Alpha2‐adrenergic agonists for the management of opioid withdrawal. Cochrane Database of Systematic Reviews 2016, Issue 5. The Cochrane Library  
  7. Gowing L, Ali R, White JM. Opioid antagonists with minimal sedation for opioid withdrawal. Cochrane Database of Systematic Reviews 2017, Issue 5. The Cochrane Library  
  8. Dunn KE, Tompkins A, Bigelow GE, et al. Efficacy of tramadol extended release for opioid withdrawal. A randomized clinial trial. JAMA Psychiatry 2017. doi:10.1001/jamapsychiatry.2017.1838 DOI  
  9. Gowing L, Ali R, White JM, Mbewe D. Buprenorphine for managing opioid withdrawal. Cochrane Database of Systematic Reviews 2017, Issue 2. The Cochrane Library  
  10. Amato L, Davoli M, Minozzi S, Ferroni E, Ali R, Ferri M. Methadone at tapered doses for the management of opioid withdrawal. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD003409. DOI: 10.1002/14651858.CD003409.pub4. DOI  
  11. Watts BV, Gottlieb DJ, Riblet NB, et al. Association of Medication Treatment for Opioid Use Disorder With Suicide Mortality. Am J Psychiatry 2022; 179: 298-304. pmid:35360916 PubMed  
  12. Nielsen S, Larance B, Degenhardt L, Gowing L, Kehler C, Lintzeris N. Opioid agonist treatment for pharmaceutical opioid dependent people. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD011117. DOI: 10.1002/14651858.CD011117.pub2 DOI  
  13. Gowing L, Ali R, White JM. Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD002022. DOI: 10.1002/14651858.CD002022.pub3. DOI  
  14. National Institute of Health and Clinical Excellence. NICE clinical guideline 52.. Drug misuse: opioid detoxification. National Institute of Health and Clinical Excellence 2007.
  15. Day E, Ison J, Strang J. Inpatient versus other settings for detoxification for opioid dependence. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD004580. DOI: 10.1002/14651858.CD004580.pub2. DOI  
  16. Oesterle TS, Thusius NJ, Rummans TA, Gold MS. Medication-assisted treatment for opioid-use disorder. Mayo Clin Proc 2019; 94: 2072–86. PMID: 31543255 PubMed  
  17. Blanco C, Volkow ND. Management of opioid use disorder in the USA: present status and future directions. Lancet 2019; 393: 1760–72. PMID: 30878228 PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL