Злоупотребления лекарственным средствами

Зависимость от назначаемых препаратов, как правило, объясняется тягой, нарастанием

толерантности к дозам и использованием лекарств с целью достижения эффектов, не связанных

с облегчением боли. Исследования закономерностей формирования хронического

употребления опиатов пациентами со злокачественными новообразованиями показали, что

несмотря на обычно имеющие место в таких случаях повышение толерантности и физическую

зависимость, склонность к злоупотреблению препаратами практически никогда не наблюдается

без предшествующего развитию заболевания наркологического анамнеза (Kanner и Foley, 1981).

Все возрастающая потребность в опиоидных анальгетиках обычно списывается пациентами на

нарастание болей или прогрессирование заболевания. Страх развития наркотической

зависимости также может влиять на приверженность пациента назначенному лечению, что

увеличивает риск возникновения болей даже на фоне терапии (Breitbart и Holland, 1990; Charap,

1978; Twycross и Lack, 1983). Когда у пациента присутствует активная наркомания, особенно

если речь идет об опиатах, или заболевание осложняется сопутствующим психическим

расстройством, лечение может оказаться достаточно сложной задачей. В таких случаях

целесообразно оказание комплексной медицинской помощи при содействии консультантов‐

наркологов.

ЗАКЛЮЧЕНИЕ

Диагностика и лечение болевого синдрома и депрессии являются существенным показателем

качества оказания медицинской помощи, однако и депрессия и боль нередко не распознаются

специалистами. Взаимное влияние боли и депрессии может сделать лечебный процесс

достаточно сложным. В этой связи может оказаться необходимой дополнительная подготовка

специалистов в данной области. В конечном счете, успешная терапия болевого синдрома и

депрессии способна в известной мере облегчить состояние пациентов и повысить качество их

жизни.

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