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Subuxone - nová šance?

15.12.2010 | Sekce: Zdravotní

Vyšlo v Dekontaminaci - 2/2008

 

Subuxone je obchodní název přípravku k substituční léčbě závislosti na opioidech (správné označení opiátů). Je vlastně mladším bratrem vám již dobře známého Subutexu. Obsahuje stejnou účinnou látku, tedy opioid buprenorfin. Oproti Subutexu je však doplněn ještě naloxonem.

Když se začal u nás v České republice před šesti lety distribuovat Subutex, spousta klientů či pacientů substitučních center, AT ordinací, praktických lékařů, psychiatrických ambulancí, začla tento substituční lék zneužívat stejně jako jakoukoliv jinou drogu. Víceméně si tito klienti vytvořili mýtus o tom "ŽE SE LÉČÍ". Přitom se jenom naučili, rozmíchávat si tablety Subutexu s vodou a píchat si je do žil. Někteří z těchto klientů začali prodávat Subutex na černém trhu a po čase se z toho stal fenomén o kterém jsme psali v loňské Dekontaminaci věnované Subutexu. Lékaři, hlavně ti svědomití, o tomto závažném problému věděli, a proto vyvinuli tlak na to, aby byl vyroben lék, který by znemožnil jeho injekční zneužití.

 

Celý vtip je v tom, že pokud Suboxone použijete tak jak máte, tedy vycucáte ho, buprenorfin obsažený v tabletě přejde do krve a bude působit tak jak má a naloxon, který se vycucáním nevstřebá zůstane neúčinný. To se však nestane pokud si tabletu Suboxonu budete chtít "šlehnout" rovnou do žíly. Naloxon se vstřebá, zabere opiátové receptory a buprenorfin ani jiný opiát tam dobré dvě hodiny nepustí . Ty dvě hodinky vám bude pěkně zle. Už chápete?

Jde o to, abyste si milí klienti nenalhávali, že se léčíte Subutexem, když si ho bezostyšně šleháte a ubohým lékařum věšíte bulíky na nos, řkouce jak se děsně snažíte, ale přitom jenom fetujete dál.

 

V nadpisu tohoto článku se praví: "Suboxone - nová šance?" Proč nová šance? Nová šance pro vás, kteří jste se stali obětí vlastního mýtu o "substituční léčbě". Ano vy, kteří nejste schopní opustit jehlu jako rituální předmět aplikace drogy, přičemž je to právě ona, která vás drží za srdce a nechce vás jen tak, po tolika letech společného života, opustit. Suboxone vás prostě "potrestá" po každé, když si zkusíte tuto tabletu našlehnout jehlou. Subutex asi hned tak z lékáren a ordinací nezmizí, ale v mnoha substitučních programech, tam kde to se substitucí myslí opravdu vážně, se připravte na to, že Suboxone Subutex vystřídá.

 

Časté otázky a odpovědi

 

Jsem 8 let na heroinu, myslíte, že je Suboxone pro mě vhodný?

Samozřejmě. Záleží však na tom, jak často, jakým způsobem a jaké množsví heroinu užíváte. Samozřejmě v tom hraje roli také kvalita konzumované drogy.

Při vyšších dávkách heroinu nemusí být Suboxone účinný a může vyvolávat abstinenční příznaky, i když je užitý tak jak má, tedy vycucaný, protože buprenorfin se váže silněji na opioidní receptory a heroin z nich vytlačí. Pak je třeba nejprve začít substituci metadonem, který je heroinu chemicky velmi podobný.

 

Jsem v substituci metadonem, ale dozvěděl jsme se, že metadon je údajně na strašně dlouhou dobu substituce, a pro někoho snad i do konce života. Brát metadon takhle dlouhou dobu opravdu nechci. Může mi v tom Suboxone pomoci?

Pokud berete vyšší dávky metadonu, nelze Suboxone doporučit. Mluvte se svým lékařem o vysnižování metadonu na úroveň, která je pro přechod na Suboxone doporučená a při které nehrozí riziko vzniku abstinenčního syndromu.

 

Doktor mi píše Subutex. Nejsem schopná vydržet jenom u cucání a Subutex si i píchám.

Suboxonem bych se ráda zbavila šlehání.

Pokud berete stabilní dávku Subutexu a opravdu chcete cucat, neměl by být s přechodem na Suboxone velký problém. Promluvte si o této možnosti se svým lékařem, který Vám Subutex předepisuje. Právě pro Vás by mohl být Suboxone novou šancí jak se zbavit jehly.

 

Mám podobný problém jako předchozí tazatelka, ale můj lékař mi Suboxone předepsat nechce. Podotýkám, že jsem již ve čtvrtém měsíci těhotenství, může to být kvůli tomu?

Jednak byste si měla uvědomit, že pokud jste těhotná, máte v bříšku nový život, který ohrožujete tím, že si do těla zapichujete cizí předměty, které mohou být cestou pro různé infekce, jež můžou dítě zahubit. Pokud Vám na dítěti opravdu záleží, nechte jehlu jehlou a cucejte Subutex. Lékař Vám Suboxone nepředepíše, protože se nesmí podávat těhotným ženám. Je to proto, že může způsobovat při nesprávném použití abstitnenční příznaky, které mohou ohrozit plod v těle matky. V tomto případě je třeba vyčkat až do doby po porodu a pak teprve přejít na Suboxone.

 

 

Naloxon je protijed opiátů, tedy heroinu, metadonu, braunu, morfinu, kodeinu a samozřejmě buprenorfinu. Podává se zejména při předávkování tlumivými látkami na bázi opioidů.Vytlačuje opioidy z jejich receptorů v těle, čím způsobí, že se postižený z předávkování probere, ale zároveň, pokud je tento postižený závislý na opiátech, způsobí nepěkné stavy, které jsou veskrze známy jako ABSŤÁK.

Pokud se vám stane, že se (třeba omylem) našlehnete Suboxonem a dostaví se abstinenční příznaky, nezkoušejte v žádném případě tento nepříjemný stav zaplašit dalším užitím opiátů či benzáků!!! Naloxon po dvou hodinách přestane účinkovat a mohlo by se vám stát, že se tímto způsobem předávkujete!!

 

Pamatujte!! Pokud jste na opiátech, Suboxone je třeba užít až v momentě, kdy pociťujete počínající absťák. Jinak vám bude ještě hůř!

 

Aleš Termer

Terénní programy o.s. SANANIM

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14.09.2015 21:00 | dominik
Beru Dolsin, Dneska jsem si zašel k lékaři pro subuxone, chci se zbavit inj. aplikací kdy si můžu sluponout subuxone tak aby mě neohrozil zbytkový dolsin?


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Beru na vědomí