Lege Artis Medicinae

[Drug use and death-seeking behaviour attitudes toward death among opiate users]

PAP Ágota, HEGEDÛS Katalin

SEPTEMBER 22, 2013

Lege Artis Medicinae - 2013;23(09)

[Many times, behind mens’ fears there is the fear of death. Drug use can be defined as a kid of self destruction, so it is directly linked to attitudes toward death. In Hungary, suicide among young people is one of the leading causes of death, which is often associated with some kind of addiction or substance abuse. We can also say that drug use is an indirect way of “death search”, which prolongs the agony and the time of suffering. Drug-related death can be directly attributed to drug overdose. Intravenous drug use may cause a risk of infectious diseases (such as sharing needles/syringe/filter use) - HCV, AIDS, etc. Intravenous drug use is mostly - but not exclusively - characteristic to opiate users. Heroin’s mode of action is described as causing an intense feeling of euphoria and a way of feeling augmenting to stupor. Its addictive potential is very high, the degradation is visible and can be fatal. In this paper, we discuss previous observations on overdose that is the validity of harm reduction justified by former research, the possible predictors of overdose and the identification of the prevention area.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Letrozol therapy of postmenopausal women with early-stage breast carcinoma after four-six years of tamoxifen therapy: tolerability and quality of life]

TÓTH Éva Katalin, NEMESKÉRI Csaba, SZABÓ Barna, URBANCSEK Hilda, MÉSZÁROS Edina, NAGYKÁLNAI Tamás, PESTI Lajos, MARKÓ László, NAGY Beatrix, LANDHERR László

[INTRODUCTION - In patients with hormone- dependent breast cancer, five-year postoperative tamoxifen therapy is a standard treatment approach. Continuing this therapy for more than five years can increase the risk of recurrence of the disease. It has been shown that treatment with the third-generation aromatase inhibitor letrozol after discontinuation of tamoxifen therapy significantly improves disease-free survival. It is important to assess whether the substantial decrease of estrogen level shows a correlation with the occurrence of unwanted events/side effects or with changes in the quality of life. PATIENTS AND METHOD - Between 2005 and 2009, 921 women (mean age 63 years, age 40-94 years) with early-stage breast carcinoma were treated with expanded adjuvant letrozol therapy following tamoxifen treatment. Of these patients, 541 received previous tamoxifen therapy for 4-6 years. We studied relapses and quality of life - measured by the SF-36 survey - during letrozol therapy in the latter patient group and the occurrence of unwanted events and side effects in all 921 patients. The patients were examined eight times and completed the survey four times. RESULTS - At the check-ups, relapses were recorded in case of 20 patients. Quality of life scores significantly increased in two main categories - physical and mental health -, and within these in three subcategories, whereas decreasing scores were not recorded in any categories. In 921 patient taking letrozol, 73 experienced unwanted events/side effects, of which nine were severe and three patient died. The two most common side effects were joint and bone pain (18 patients) and heat rash (12 patients). CONCLUSION - Extended adjuvant therapy with letrozol efficiently decreased the number of relapses and the number of patients continuing therapy. On the basis of the SF-36 survey the patients’ quality of life generaly improved. Letrozol therapy was well tolerated by most patients, which can have a favourable effect on the outcome of the therapy.]

Lege Artis Medicinae

[Flying High and Low – The Opus of Oscar Wilde and his Ear Disease]

GERLINGER Imre

Lege Artis Medicinae

[Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fi brillation: a secondary analysis of a randomised controlled trial]

LIPTÁK Judit

Lege Artis Medicinae

[Marc Chagall and Imre Ámos in Budapest ]

NAGY Zsuzsanna

Lege Artis Medicinae

[Our experiencies using goserelin in St. Barbara Hospital in Tatabánya]

PÁDI Éva

All articles in the issue

Related contents

Lege Artis Medicinae

[EFFECT OF END-OF-LIFE EDUCATION ON MEDICAL STUDENTS’ AND HEALTH CARE WORKERS’ DEATH ATTITUDE]

HEGEDÛS Katalin, ZANA Ágnes, SZABÓ Gábor

[INTRODUCTION - The aim of our research was to evaluate the effect of courses for health care workers and medical students that deal with death, dying and bereavement and that of courses on hospice care of dying patients. The goal of the courses is to make communication on death more open by exploring critical issues related to fear of death to reduce inner anxiety and to improve attitude to dying patients. PARTICIPANTS AND METHOD - Participants (n=168) completed Neimeyer and Moore's Multi-dimensional Fear of Death Scale (MFODS) and Shortened Beck Depression Questionnaire (BDI) on the first and last day of the courses. In case of health care workers a follow-up survey was also performed 2 to 3 months after the course (n=32). RESULTS - The most significant factors of fear of death are: fear for significant others, fear of the dying process and fear of premature death. Overall fear of death scores are reduced as an effect of the courses, the alteration of the components of fear of death depends on the participants’ gender, age and profession as well. Improvement was observed in both groups in attitudes that can be related to the increase of knowledge on the quality care of dying patients like fear from the process of dying and fear from conscious experience of death. CONCLUSION - Besides education containing training as well it is important to strengthen the support function of workplaces in caring for the mental health of the health care staff. Furthermore it is important during gradual education that students participate in courses that aim to achieve opened communication in the most anxiety-evoking issues.]

Lege Artis Medicinae

[PAIN RELIEF IN THE CLINICAL PRACTICE - THE USE OF MAJOR ANALGETICS]

HORVÁTH J. Attila

[The use of opioids to relieve strong, unbearable pain is a method that has been known for thousands of years and is still effective today. In contrast to the earlier view, opioids today are not only given to cancer patients. The application area of morphine derivatives is generally the relief of exceptionally strong pain regardless of the diagnosis, but opiates are undoubtedly most commonly used to treat cancer-related or strong acute pain. Strong pain reducers are used much more in developed countries for the treatment of non-cancer related severe pain refractory to other approaches. Today the use of opiates and their derivatives (fentanyl, oxycodon) for non-cancer related pain relief is recognized by the national health insurance in that it allows general practitioners to prescribe them, upon the recommendation of a neurosurgeon, orthopaedic surgeon, traumatologist or rheumatologist, with a significant 90% subsidy for six months to ensure easy access for patients in severe, refractory pain due to degenerative musculoskelatal diseases (ICD: M47, M48, M16.9, M17.9, M54.4, M51.0, M51.1). The indications of opioid use, however, are not limited to strong nociceptive pain since they are also effective in certain types of peripheral neuropathic pain. In brief, a basic principle of the use of major analgetics is that their indication is primarily based on the intensity of pain and not on the nature of the disease, even though the latter has a major influence on the clinician's strategy of pain relief.]

Hypertension and nephrology

[About the care of patients with hyperuricaemia and gout]

[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]