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Macam macam Macam macam Terapi Terapi KETERGANTUNGAN KETERGANTUNGAN NAPSA NAPSA

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Page 1: Terapi NAPZA

Macam macamMacam macam

TerapiTerapi

KETERGANTUNGAN KETERGANTUNGAN NAPSANAPSA

Page 2: Terapi NAPZA

KETERGANTUNGAN KETERGANTUNGAN ( ADDICTION ) ( ADDICTION )

TIDAK HANYA PENGGUNAAN ZAT TIDAK HANYA PENGGUNAAN ZAT SECARA KRONIKSECARA KRONIK JUGA MELIPUTI :JUGA MELIPUTI : > DORONGAN BERULANG UTK > DORONGAN BERULANG UTK MEMAKAIMEMAKAI > KEHILANGAN KONTROL JUMLAH > KEHILANGAN KONTROL JUMLAH PEMAKAIANPEMAKAIAN > TDK PEDULI AKIBATNYA> TDK PEDULI AKIBATNYA

Page 3: Terapi NAPZA

AKIBAT BURUK :AKIBAT BURUK : > PHYSIC > PHYSIC > PSYCHOLOGIC – > PSYCHOLOGIC – COGNITIVECOGNITIVE

- - EMOTIONAL EMOTIONAL

> SOCIAL > SOCIAL > SPIRITUAL > SPIRITUAL

HEALTHHEALTH

Page 4: Terapi NAPZA

MEDICAL PERSPECTIVEMEDICAL PERSPECTIVE : :ADDICTION : ADDICTION :

- CHRONIC- CHRONIC - PROGRESSIVE - PROGRESSIVE - RELAPSING - RELAPSING - POTENTIALLY - POTENTIALLY FATAL FATAL DISEASEDISEASE

Page 5: Terapi NAPZA

Development and progression :Development and progression :

Dipengaruhi oleh :Dipengaruhi oleh : jenis dan kekuatan zatjenis dan kekuatan zat

cara pcara paakai zatkai zat

risk faktor individurisk faktor individu

lingkunganlingkungan

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Understanding the basic Understanding the basic principle of drug use principle of drug use

= =important step important step in in understanding understanding addictionaddiction

Page 7: Terapi NAPZA

Why Do People Use DrugWhy Do People Use Drug ? ? To experience the To experience the euphoriaeuphoria to help social to help social interactioninteraction to decrease anxiety to decrease anxiety and painand pain to fight insomnia to fight insomnia for performant for performant enchancementenchancement to stay alert/to drown to stay alert/to drown outout

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What is Drug Abuse ?What is Drug Abuse ?1960 : drug abuse = use illegal drug 1960 : drug abuse = use illegal drug marijuana illegal drugmarijuana illegal drug Alcohol notAlcohol not

Drug abuse :Drug abuse : use of psychoactive drug use of psychoactive drug interferes with person’s life : interferes with person’s life : physical, psichological, legal, physical, psichological, legal,

educational, spiritual or social educational, spiritual or social functioningfunctioning

Page 9: Terapi NAPZA

Define Addiction :Define Addiction : progressiveprogressive chronicchronic primary primary

with characteristic :with characteristic : > Cumpulsion> Cumpulsion > Loss of control> Loss of control > continued drug use> continued drug use > distortions of thinking> distortions of thinking

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Effects of Addiction :Effects of Addiction :

>>> Physical health> Physical health > Cognitive health> Cognitive health > Psychological haelth> Psychological haelth > Emotional health> Emotional health > Social health> Social health > Spiritual health> Spiritual health

Page 11: Terapi NAPZA

TERAPI uth mencapai :TERAPI uth mencapai :> KESEMBUHAN> KESEMBUHAN>TIDAK HANYA BEBAS DARI >TIDAK HANYA BEBAS DARI PEMAKAIAN ZAT PEMAKAIAN ZAT> JUGA BEBAS DARI EFFECT> JUGA BEBAS DARI EFFECT ZAT ZAT> TIDAK MENGULANG> TIDAK MENGULANG

“ FULL RECOVERY“ FULL RECOVERY “ “

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PEMBERIAN OBAT :PEMBERIAN OBAT :> SEBAGAI SALAH SATU ASPEK > SEBAGAI SALAH SATU ASPEK DARI PROGRAM PENYEMBUHANDARI PROGRAM PENYEMBUHAN

ADA BATAS WAKTUADA BATAS WAKTU

“ “ NO DRUG TREATMENT NO DRUG TREATMENT CURES DRUG ADDICTION “CURES DRUG ADDICTION “

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PEMBERIAN “OBAT” :PEMBERIAN “OBAT” :

Mengatasi Gejala Lepas ZATMengatasi Gejala Lepas ZAT

Membantu Penyembuhan : Membantu Penyembuhan : DisulfiramDisulfiram

NaltrexoneNaltrexone

Mengatasi Gangguan PsikiatriMengatasi Gangguan Psikiatri

- Anxiety, depresi, - Anxiety, depresi,

- Gg Jiwa berat- Gg Jiwa berat

Page 14: Terapi NAPZA

To Manage WithdrawalTo Manage Withdrawal

Severity : - specific drugSeverity : - specific drug

- amount of drug use- amount of drug use

- drug combination- drug combination

- chronicity drug use- chronicity drug use

Ada dua fase : acuteAda dua fase : acute

prolongprolong

Page 15: Terapi NAPZA

Sedative-Hypnotic Withdrawal : Sedative-Hypnotic Withdrawal : >Anxiety/ apprehension >Anxiety/ apprehension > insomnia- Nigthmere > insomnia- Nigthmere > emotional and behavior > emotional and behavior stimulation stimulation agitationagitation irritability irritability

> Elivated Heart rate, blood > Elivated Heart rate, blood pressure, respiration rate. pressure, respiration rate. . . Muscle pain, weakness, nauseaMuscle pain, weakness, nausea Vomiting, slight tremor Vomiting, slight tremor > seizures (possible) > seizures (possible)

Page 16: Terapi NAPZA

Obat yang dipakai :Obat yang dipakai :

Basic concept : Basic concept :

> minimized withdrawal symptom> minimized withdrawal symptom

> Cross-tolerant sedative-hypnotic> Cross-tolerant sedative-hypnotic

> gradually tapering the dosage> gradually tapering the dosage

Example :Example :

Insomnia Insomnia Chloral hydrate / antihistamin Chloral hydrate / antihistamin

Anxiety Anxiety propanolol/tenormin propanolol/tenormin

Alpha-blocker Alpha-blocker clonidine clonidine

BuspironBuspiron

Page 17: Terapi NAPZA

Stimulant Withdrawal :Stimulant Withdrawal : Dysphoric -- .Agitation Dysphoric -- .Agitation Depression Depression suicid suicidee drug craving drug cravingManagement :Management : Antidepressan, Antidepressan, dopamine agonis dopamine agonis neurotranmiter precosure neurotranmiter precosure

Page 18: Terapi NAPZA

Opioid Withdrawal :Opioid Withdrawal :Seperti Gejala Flu : Seperti Gejala Flu :

Nyeri otot, Nyeri otot,

G.I. Distress : mual, muntahG.I. Distress : mual, muntah

Mata dan hidung berairMata dan hidung berair

Insomnia, demam, berkeringatInsomnia, demam, berkeringat

Bisa, Cemas, tachycardi,irritable Bisa, Cemas, tachycardi,irritable

Page 19: Terapi NAPZA

Cara Mengatasi Withdrawal:Cara Mengatasi Withdrawal:

> > Pemberian Substitusi :Pemberian Substitusi :

- Long-acting opioid :- Long-acting opioid :

MethadoneMethadone

> Symptomatic Treatment :> Symptomatic Treatment :

- Sedative-Hypnotic- Sedative-Hypnotic

- Antihypertensi - Antihypertensi clonidine clonidine

Page 20: Terapi NAPZA

Methadone Maintenance :Methadone Maintenance : Reduction in criminal behavior.Reduction in criminal behavior. Vocational stabilizationVocational stabilization Social stabilationSocial stabilation Masuk pelayanan Medis/PsikiatrisMasuk pelayanan Medis/Psikiatris Reduction of needle-borne diseaseReduction of needle-borne disease Reduction hazards ( wanita hamil )Reduction hazards ( wanita hamil ) Recovery from Opioid addictionRecovery from Opioid addiction

Page 21: Terapi NAPZA