iu tr Lm dng Cht gynghin L g? Cm nang Gia nh

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESSubstance Abuse and Mental Health Services AdministrationCenter for Substance Abuse Treatmentwww.samhsa.gov

ii

Cm tTi liu ny c cng ty Johnson, Bassin & Shaw son tho, theo Hp ng S 270-99-7072 vi Trung tm iu tr Lm dng Cht gy nghin (CSAT), C quan Qun l Lm dng Cht gy nghin v Sc khe Tm thn (SAMHSA), B Y t v An sinh X hi Hoa K (DHHS). Tin s Karl D. White v tin s Andrea Kopstein lm vic theo Chng trnh D n Chnh ph.

Min tr Cc quan im v kin trong n bn ny khng nht thit l quan im hay chnh sch ca CSAT, SAMHSA hay DHHS.

Thng bo Cng khaiTt c ti liu trong cm nang ny c thng bo cng khai v c th ti bn hoc phn phikhng cn s cho php ca c quan SAMHSA. Nn trch dn ngun khi tham kho. Tuy nhin,cm nang ny khng c php ti s dng hoc phn phi c thu ph nu khng c s cho php c th bng vn bn ca Phng Thng tin ca SAMHSA, DHHS.

Bn sao Cm nang ny v Truy cp Trc tuynCm nang ny v cc sn phm lin quan n iu tr lm dng cht gy nghin c cung cp bi Phng Thng tin quc gia v Ru v Ma ty (NCADI), thuc SAMHSA. nhn min ph cc sn phm ca SAMHSA, vui lng gi NCADI theo s 800-729-6686 hoc 800-487-4889 TDD (dnh cho ngi khim thnh) hoc vo trang web www.ncadi.samhsa.gov.

Khuyn co ngun Trch dnTrung tm iu tr Lm dng Cht gy nghin. iu tr Lm dng Cht gy nghin L g? Cmnang Gia nh. n bn ca DHHS S (SMA) 04-3955. Rockville, MD: C quan Qun l Lm dng Cht gy nghin v Sc khe Tm thn, 2004.

Vn phng ChnhChi nhnh Trin khai Thc t, Phng Pht trin Dch v, Trung tm iu tr Lm dng Cht gynghin, C quan Qun l Lm dng Cht gy nghin v Sc khe Tm thn, 1 Choke Cherry Road, Rockville, MD 20857.

Da theo n bn Ting Anh ca What is Substance Abuse Treatment? A Booklet for Families, n bn ca DHHS S (SMA) 04-3955In nm 2004

iu tr Lm dng Cht gy nghin L g? Cm nang Gia nh (What Is Substance Abuse Treatment? A Booklet for Families) This booklet for Vietnamese-speaking clients answers questions often asked by family members and signifi cant others of people entering treatment. It also has a section with resources to access more information and/or treatment in Vietnam-ese and/or English.

iii

iu tr Lm dng Cht gy nghin L g?Cm nang Gia nh

MC LC

Gii thiu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Lm dng Cht gy nghin L g?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

iu tr Lm dng Cht gy nghin L g? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Dnh ring cho Bn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Ti E rng iu Khng c Tc dng . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

c bit dnh cho Thanh nin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Gii thch t ng . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Ngun tham kho. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

B Y t v An sinh X hi Hoa K(U.S. Department of Health and Human Services)C quan Qun l Lm dng Cht gy nghin v Sc khe Tm thn(Substance Abuse and Mental Health Services Administration)Trung tm iu tr Lm dng Cht gy nghin(Center for Substance Abuse Treatment)1 Choke Cherry RoadRockville, MD 20857

1Gii thiuCm nang ny dnh cho gia nh c thnh vin b l thuc ru hoc ma ty. D cho ngi trong gia nh b l thuc vo ru, cocaine, heroin, cn sa, thuc theo toa ca bc s hoc bt k loi ma ty no khc, th cng s gy nh hng n bn v gia nh.

Cm nang ny s tr li nhng cu hi thng gp nhng gia nh c ngi ang c iu tr. Phn Ngun tham kho cui ti liu ny lit k cc ngun thng tin v nhm h tr gip bn trong thi gian cng thng. Hy s dng tr gip ny, tham kho kin ca cc c s iu tr v by t nhng cm xc vi nhng ngi bn h tr hoc nhng thnh vin gia nh khc.

M c hng triu ngi b l thuc hoc nghin ru hay cc loi ma ty. Tt c nhng ngi ny u c gia nh v vy hy nh rng, bn khng phi l duy nht. Vic thnh vin gia nh bn ang c iu tr l mt du hiu tt v l mt bin chuyn ng hng. Ngi b l thuc vo ru hoc ma ty c th hi phc c.

Lm dng Cht gy nghin L g?Tnh trng nghin, l thuc hoc lm dng ru v ma ty, c gi chung l s dng ba bi cht gy nghin, l nhng vn phc tp. Nhng ngi s dng ba bi cht gy nghin c thi b coi l khim khuyt trong tnh cch hoc km v o c; v cho n nay vn cn nhng suy ngh nh vy. Tuy nhin, hu ht cc nh khoa hc v nghin cu y t hin nay thng nht rng tnh trng l thuc ru hoc ma ty l mt chng bnh lu di, nh bnh suyn, cao huyt p hoc tiu ng. Hu ht nhng ngi ung ru u ung rt t v nhiu ngi c th ngng s dng ma ty m khng gp kh khn no. Tuy nhin, mt s ngi lm vo tnh trng s dng ba bi cht gy nghin tc l s dng ru hoc ma ty mt cch bt buc hoc nguy him (hoc c hai).

TI SAO MT S NGI GP KH KHN M NGI KHC LI KHNG?S dng ba bi cht gy nghin l mt chng bnh c th xy ra vi bt k ai: giu hay ngho, nam hay n, c vic lm hay tht nghip, gi hay tr v thuc bt k chng tc hay sc tc no. Khng ai bit chc nguyn nhn chnh xc ca tnh trng ny, nhng kh nng vng phi tnh trng ny phn no do di truyn nhng c im sinh hc c truyn li trong gia nh. Mi trng, c im tm l v mc cng thng cng ng vai tr quan trng trong vic ung ru hoc s dng ma ty. Cc nh nghin cu cho rng vic s dng ma ty trong thi gian di s to s thay i lu di v quan trng cho no b. iu ny ging nh mt cng tc trong b no c bt ln ti mt thi im no . Thi im ny khng ging nhau mi ngi, nhng khi c bt ln, ngi ny s bc qua mt ranh gii v hnh v tr nn l thuc vo cc cht gy nghin. Nhng ngi bt u s dng ma ty hoc ung ru sm trong i s c nguy c ln hn trong vic bc qua ranh gii v hnh ny v tr nn l thuc vo cc cht gy nghin. Nhng s thay i trong no s nh hng rt lu sau khi ngng s dng ru hoc ma ty.

2Cho d thnh vin trong gia nh bn mc mt chng bnh no , th cng khng phi l l do c nhng hnh vi xu thng i km theo. Ngi thn ca bn khng c li khi b bnh nhng h phi c trch nhim vi vic cha tr.

NHNG DU HIU CA VIC S DNG BA BI CHT GY NGHIN?Mt trong nhng du hiu quan trng nht ca tnh trng nghin hoc l thuc cht gy nghin l vic s dng lin tc cc loi ma ty hoc ru bt chp cc nh hng xu nghim trng ca vic phi s dng nhiu ma ty v ru. Thng thng, mt ngi nh vy s li cho ngi khc hoc hon cnh thay v tha nhn rng nhng vn ny xut pht t vic s dng ru hoc ma ty. V d, v/chng ca bn c th tin rng mnh b cho thi vic l v ng ch khng bit cch iu hnh cng vic kinh doanh. Hoc con gi ca bn c th tin rng chu b cnh st giao thng pht li ung ru khi li xe v cnh st c tm li ca chu. C th ngi thn ca bn li cho c bn na. Nhng ngi b bnh ny thc s tin l vic h ung ru hoc s dng ma ty cng bnh thng nh nhng ngi khc. Suy ngh sai lm ny c gi l ph nhn, v ph nhn l mt phn ca cn bnh.

Nhng triu chng quan trng khc ca tnh trng s dng ba bi cht gy nghin bao gm

Liu lng Ngi nghin s phi ngy cng tng lng ru hoc ma ty tm cm gic thng hoa.

S thm mun Ngi nghin s cm thy mt nhu cu mnh lit, b thi thc, khao kht c s dng ru hoc ma ty v s s dng ru hoc ma ty bt chp hu qu xu v s cm thy bn chn, bc bi nu khng c s dng. S thm mun l triu chng ch yu ca tnh trng nghin.

Mt kim sot Ngi ny thng ung nhiu ru hoc s dng nhiu ma ty hn mc d nh hoc c th ung ru hay s dng ma ty thi gian hoc a im bt k. Ngi nghin cng rt c gng gim bt ru hoc ma ty nhiu ln nhng u tht bi.

S l thuc v th cht hoc triu chng trm ut Trong mt s trng hp, khi ngng dng ru hoc ma ty, ngi nghin c triu chng trm ut do nhu cu c th cn cc cht

Hi: Chng ti ni rng anh y b nghin. Ti sao li nh th trong khi anh y c mt cng vic rt tt?

p: Tht kh m hiu c ti sao mt ngi b l thuc vo ru hoc ma ty li vn lm vic tt. Cc phng tin truyn thng thng m t nhng ngi s dng ba bi cht gy nghin l nhng ngi tht nghip, khng lm vic ch li, ti phm v v gia c. Tuy nhin, nhiu ngi l thuc vo ru hoc ma ty khng nm trong nhm ny; h c vic lm v sng vi gia nh. Bnh ny c khuynh hng nng hn theo thi gian. Nh vy, chng ca bn s s dng ma ty ngy cng nhiu hn v nu khng c gip , anh y s gp phi nhng vn nghim trng. Cng iu tr sm bao nhiu th chng bn cng c c may hi phc sm by nhiu.

3ny. Cc triu chng trm ut c biu hin khc nhau ty theo loi ma ty, nhng c th l nn ma, m hi, run ry v bn chn cc . Ngi nghin c th c gng lm gim cc triu chng ny bng cch s dng vi liu cao hn loi cht hoc mt cht tng t.

iu tr Lm dng Cht gy nghin L g?NGI CUNG CP IU TR?C nhiu t chc chuyn nghip khc nhau cung cp dch v iu tr vic s dng ba bi cht gy nghin. Trong hu ht cc chng trnh iu tr, ngi chm sc chnh l cc c nhn c hun luyn c bit, c chng nhn hoc cp php hnh ngh t vn vic iu tr lm dng cht gy nghin. Khong mt na cc cc nh t vn l ngi cai nghin. C nhiu chng trnh s dng nhn vin thuc cc sc tc hoc nhm vn ha khc nhau.

Hu ht cc chng trnh iu tr u b tr bnh nhn vo mt nhm iu tr ca cc chuyn vin. Ty theo hnh thc iu tr, nhng nhm ny c th bao gm cc cn s x hi, nh t vn, bc s, y t, nh tm l, bc s tr liu tm l hoc nhng ngi chuyn mn khc.

VY TRC HT PHI LM G?Tt c mi ngi tham gia iu tr s c nh gi lm sng. Phi c mt bn nh gi y v c nhn ny gip chuyn vin lm cng tc iu tr a ra hnh thc iu tr ph hp nht vi ngi . Bn nh gi cng gip cho nh t vn chng trnh lm vic vi bnh nhn lp k hoch iu tr hiu qu. Mc d vic nh gi lm sng vn tip tc trong sut qu trnh iu tr, nhng vic nh gi ny s c thc hin ngay trc khi hoc ngay khi bt u chng trnh iu tr. Nh t vn s bt u bng vic thu thp thng tin v ngi bnh, thng qua nhng cu hi v

Loi, s lng v thi gian s dng ma ty hoc ru

Vn v vn ha xung quanh vic s dng ru hay ma ty

nh hng ca ru hay ma ty i vi cuc sng ca bnh nhn

Hi: M ti ni l khng c cch no cha bnh nghin, cho nn b khng cn iu tr. C ng vy khng?

p: C l m ca bn khng hiu mc tiu ca vic iu tr. Trong mt phng din no , m ca bn ni ng; tnh trng s dng ba bi cht gy nghin thng l bnh mn tnhnhng c th cha tr c. iu ny cng ng vi nhiu chng bnh mn tnh khc, nh tiu ng hay cao huyt p. Vic iu tr s dng ba bi cht gy nghin gip ngi bnh ngng s dng ru hoc ma ty v gi c trng thi tnh to. Hi phc l qu trnh ko di sut i. Gi c trng thi phc hi l mt vic kh khn, nn m ca bn phi hc mt li suy ngh mi, cm xc mi v hnh vi mi. Vic iu tr s gip m ca bn chp nhn, kim sot v sng vi cn bnh ca mnh.

4Tin s y t

Cc nhu cu hoc vn hin ti v y t

Tnh trng iu tr y t hin ti (k c vic dng thuc gim au)

Cc vn v sc khe tm thn hoc vn v hnh vi

Nhng vn v nhu cu ca gia nh v x hi

Nhng vn v php l hoc ti chnh

Nn tng v nhu cu gio dc

Hon cnh v mi trng sng hin ti

Qu trnh lm vic, tnh n nh, rc ri v nhu cu trong cng vic

Nhu cu, rc ri v kt qu hc tp trng, nu c lin quan

Nhng kinh nghim iu tr trc y hoc nhng ln c gng b ru hay ma ty.

Nh t vn c th mi bn, vi t cch l thnh vin gia nh, tr li cc cu hi v by t s quan tm ca mnh. Hy thnh tht y khng phi l lc che du hnh vi ca ngi thn. Nh t vn cn hiu tht y v vn c th hoch nh v p dng bin php iu tr hiu qu nht. iu c bit quan trng l nh t vn phi bit thnh vin trong gia nh bn c vn nghim trng no v sc khe khng hoc nu bn nghi ng rng ngi thn ca mnh c vn v cm xc. Bn c th cm thy kh tr li i vi mt s cu hi hoc gp kh khn khi phi in vo bn phng vn, nhng hy nh: nh t vn l ngi s gip bn v ngi thn ca bn. Nhm iu tr s dng cc thng tin thu thp c xut mt hnh thc iu tr tt nht. Khng c mt hnh thc iu tr chung cho tt c mi ngi; c th mang li hiu qu, vic iu tr phi p ng ng cc nhu cu c nhn ca ngi thn trong gia nh bn.

Sau phn nh gi, nh t vn hoc ngi qun l trng hp s c b tr cho ngi thn ca bn. Nh t vn s lm vic vi ngi bnh (v c th c vi gia nh ngi bnh) v k hoch iu tr. K hoch ny bao gm cc vn phi gii quyt, mc tiu iu tr v cch thc t c cc mc tiu ny.

Da vo bn nh gi, nh t vn c th gii thiu ngi thn ca bn n mt bc s quyt nh c nn s dng thm thuc cho vic cai nghin ru hoc ma ty mt cch an ton hay khng.

Cai nghin c gim st y t (thng gi l qu trnh gii c) s dng thuc gip ngi bnh b c ru hoc ma ty. Nhng ngi tng s dng cc cht opiods (v d: heroin, OxyCotin hoc codeine) thuc an thn hoc thuc ng, thuc gim au hoc ru c th thuc

5hoc ru, c th c hai s cn dch v cai nghin c gim st hoc qun l v mt y t. i khi, vic cai ru c th nghim trng n mc ngi bnh s b o gic, co git hoc gp phi nhng tnh trng nguy him khc. Vic iu tr bng thuc c th gp phn ngn chn hoc iu tr nhng tnh trng ni trn. Bt c ngi no tng b o gic hoc cn tai bin ngp mu do vic cai nghin ru hoc ngi tng b mt chng bnh nghim trng khc hoc (trong mt s trng hp) b ri lon tm thn gy phc tp thm cho vic gii c c th cn n vic gim st y t gii c mt cch an ton. Vic cai nghin c gim st y t c th c thc hin trong mt khoa bnh thng bnh vin, trong b phn gii c chuyn khoa cho bnh nhn ni tr, hoc thc hin ngoi tr c gim st y t cht ch. Qu trnh gii c c th ko di vi ngy hoc mt tun v cng c th lu hn. Trong thi gian ny, ngi bnh s c chm sc y t v c th bt u c hng dn hiu bit v bnh ca h.

Khng phi ngi no cng cn n qu trnh gii c c gim st y t ni tr. Nhng ngi c triu chng trm ut nh trong vic cai ru hoc ma ty v nhng ngi s dng cocain, cn sa, opiods, hoc thuc an thn methamphetamine thng khng cn phi vo bnh vin thc hin qu trnh gii c. Tuy nhin, h c th cn n vic chm sc y t ngoi tr, cn nhiu s h tr v cn c ngi trng nom.

Gii c x hi c th p ng nhu cu ny. i khi cc trung tm gii c x hi l cng tham gia vo chng trnh iu tr ti nh; c khi nhng trung tm ny hot ng c lp. Cc trung tm ny khng phi l bnh vin v t khi dng n thuc, nhng ngi bnh s phi y t vi ngy cho n 1 tun. Nhn vin y gm c c y t v nh t vn. Nhn vin s theo di cht ch tnh trng y t ca ngi bnh, v cc nh t vn s h tr ngi bnh trong nhng thi im kh khn nht cai ru v ma ty.

iu quan trng l phi nhn thc c rng gii c khng phi l iu tr; y l bc u tin chun b cho ngi bnh c iu tr.

Hi: V ti va bt u iu tr. Hm qua ti gi cho chng trnh xin t vn mt vi iu. Ngi t vn ni rng khng th xc nhn hay ph nhn vic v ti c mt ti trung tm hay khng! V sao li nh vy?

p: Lut php Lin bang v Tiu bang yu cu bo v s ring t ca c nhn trong qu trnh iu tr. Trc khi nhn vin t vn c th ni chuyn vi bt c ai (k c bn) v vic iu tr cho v ca bn, th chng trnh phi c s cho php ca ngi ang iu tr, bng vn bn. Cho d nhn vin t vn c bit v bn ang c mt ti th vn khng th cho bn bit l v bn ang tham gia chng trnh iu tr nu nh c y cha xc nhn vo mu cung cp thng tin hoc cho php tit l thng tin. Bn nn ni chuyn vi v v phi chc l c y hiu c bn mun tham gia h tr cho c y trong vic iu tr.

6HIN C NHNG HNH THC IU TR NO?Hin c mt s hnh thc iu tr sau:

iu tr ni tr

Chng trnh iu tr ti nh

iu tr theo hnh thc bnh vin bn thi gian hoc ban ngy

Chng trnh ngoi tr v ngoi tr tp trung

Cc dng ng iu tr lm dng thuc ng (cn gi l chng trnh iu tr opioid).

iu tr ni tr, c thc hin ti cc kha c bit ca bnh vin hay dng ng, cung cp cc dch v gii c v cai nghin. Cch y vi nm, c nhiu chng trnh iu tr ti bnh vin. Ngy nay, v c nhng s thay i trong dch v bo him nn vic iu tr ti bnh vin khng cn ph bin nh trc kia na. Nhng ngi b ri lon tm thn hoc c vn nghim trng v sc khe cng nh tnh trng ri lon trong vic s dng ma ty l nhng ngi c kh nng c iu tr ni tr nht. Thanh thiu nin cng c th cn n c ch cha bnh ni tr bo m c nh gi y tnh trng lm dng cht gy nghin v tnh trng ri lon tm thn ca h.

Chng trnh iu tr ti nh to mi trng sng km theo dch v iu tr. C nhiu hnh thc iu tr ti nh (nh iu tr ti cng ng) v vic iu tr trong nhng chng trnh ny thng ko di t mt thng cho n mt nm hoc lu hn. Cc chng trnh ny khc nhau trn mt s phng din, nhng cng c nhiu im tng ng.

Chng trnh iu tr ti nh thng chia ra nhiu giai on, vi nhiu d nh v hot ng khc nhau cho mi giai on. V d trong giai on mt, quan h ca ngi c iu tr vi gia nh, bn b v cng vic c th b hn ch. Thanh thiu nin c th c lin lc vi cha m nhng khng c tip xc vi bn b hoc i hc. S hn ch ny gip cho ngi c iu tr gn lin vi iu tr ti cng ng v iu chnh theo hon cnh. giai on sau, ngi c iu tr c th tr li lm vic v tr li c s iu tr vo bui chiu. Nu c ngi thn ang thc hin chng trnh iu tr ti nh, iu quan trng l bn phi bit v hiu c cc quy nh v d nh ca chng trnh.

Thng thng cc chng trnh iu tr ti nh thng ko di vi thi gian cho cc lp d b cho bc trung hc (GED), o to ngh tm vic sau ny, thm ch cn c o to mt ngh vng vng. Trong cc chng trnh iu tr ti nh dnh cho thanh thiu nin, ngi bnh phi tham gia vo chng trnh hc vn ha.

7Mt s chng trnh iu tr ti nh c thit k cc ph n ang c iu tr c th chm sc con nh. Nhng chng trnh ny cung cp dch v gi tr v c cc lp tp hun cho cha m.

Chng trnh iu tr ti nh thch hp cho ngi c cuc sng hoc vic lm khng n nh v/hoc c t hay khng c s h tr ca gia nh. Chng trnh iu tr ti nh c th gip ngi s dng ba bi cht gy nghin nghim trng v khng th c c hay gi c s tnh to hoc khng th cai nghin ma ty theo nhng hnh thc iu tr khc.

Chng trnh iu tr theo hnh thc bnh vin bn thi gian hay ban ngy c th c t chc ti cc bnh vin hoc nhng dng ng c lp. Trong cc chng trnh ny, ngi bnh c iu tr t 4 n 8 gi mt ngy nhng vn sng ti gia nh. Chng trnh ny thng ko di t nht l ba thng v thch hp nht cho nhng ngi c mi trng sng ti gia nh n nh c nhiu s h tr.

Chng trnh ngoi tr v ngoi tr tp trung iu tr bnh ti mt a im ca chng trnh, nhng ngi c iu tr sng ni khc (thng l nh). iu tr ngoi tr thng c t chc nhiu ni khc nhau: dng ng sc khe, dng ng sc khe tm thn cng ng, vn phng t vn, dng ng trong bnh vin, vn phng s y t a phng hoc cc chng trnh iu tr ti nh c dng ng cho bnh nhn ngoi tr. Chng trnh ny thng c t chc vo bui chiu v vo cc ngy cui tun ngi bnh c th i hc hoc i lm bnh thng. Cc chng trnh iu tr ngoi tr c yu cu tham gia khc nhau. C nhng chng trnh yu cu phi c mt mi ngy; c nhng chng trnh ch yu cu c mt t mt n ba ln mi tun.

Chng trnh iu tr ngoi tr tp trung yu cu ngi bnh phi tham d t 9 n 20 gi hot ng iu tr mi tun. Chng trnh ngoi tr thng ko di t 2 thng n 1 nm.

Ngi thch hp nht vi chng trnh iu tr ngoi tr l nhng ngi mun tham d cc bui t vn u n, c bn b hoc ngi thn h tr, c ni n nh v c phng tin di chuyn n tham d cc bui iu tr (mt s chng trnh c cung cp phng tin di chuyn nu c yu cu).

Chng trnh iu tr Opioid (OTPs), cn gi l dng ng iu tr lm dng thuc ng, thng a ra phng thc iu tr ngoi tr c h tr y t cho nhng ngi b l thuc vo cc cht gy nghin (nh heroin, OxyContin hay vicodin). Cc chng trnh ny s dng thuc, nh thuc ng hoc LAAM, gip ngi bnh khng cn dng cc loi thuc opiods na. Chng trnh OPT ny cung cp dch v t vn v cc dch v khc cng vi vic iu tr bng thuc.

8CHNG TRNH IU TR THC S BAO GM CC HOT NG G?Mc d cc chng trnh iu tr c khc nhau, nhng v c bn vn ging nhau. Hu ht cc chng trnh gm nhiu hoc tt c cc yu t sau y:

nh giNh tho lun trc y, tt c cc chng trnh iu tr u bt u bng mt bn nh gi lm sng v nhu cu iu tr ca bn thn ngi bnh. Vic nh gi ny s gip lp c mt k hoch iu tr hiu qu.

Chm sc Y tCc chng trnh trong cc bnh vin c th cung cp dch v ny ngay ti c s. Cc chng trnh ngoi tr hoc chng trnh iu tr ti nh c th b tr bc s hoc y t n a im ca chng trnh mi tun vi ngy hoc ngi bnh c th c gii thiu n nhng ni khc c chm sc y t. Vic chm sc y t bao gm c vic xt nghim v iu tr HIV/AIDS, vim gan, lao v cc vn sc khe ph n.

K hoch iu trNhm iu tr, cng vi ngi ang iu tr bnh lp ra mt k hoch iu tr da trn kt qu nh gi. K hoch iu tr l mt hng dn bng vn bn bao gm c mc tiu cho ngi bnh, cc hot ng iu tr c thit k gip cho ngi bnh t c nhng mc tiu ra, nhng cch thc nhn bit mc t c mc tiu v mt khung thi gian d kin t c cc mc tiu ny. K hoch iu tr gip ngi bnh v nhn vin chng trnh khng iu tr lc hng v tp trung vo nhng vic cn lm. K hoch iu tr c iu chnh trong qu trnh iu tr p ng nhng nhu cu thay i v phi bo m rng k hoch ny lun thch hp.

Hi: Em trai ti ang c iu tr ti gia. N ni l c th chm dt iu tr bt c lc no. C ng vy khng?

p: ng vy. Mi ngi u c quyn chm dt iu tr. Tt c cc chng trnh iu tr nghin ru v thuc gy nghin u mang tnh t nguyn, mc d c th c nhng hu qu ca vic ngng iu tr v d nh ngi ny ngng iu tr trong khi ang giai on th thch hoc chu n. Nu em ca bn chm dt trong khi vic iu tr cha hon tt, nhn vin iu tr c th yu cu anh ta k vo giy xc nhn vic anh ta ngng cha tr khng phi l kin ca ngi chuyn mn. Nhn vin ny cng s c tm hiu ti sao em ca bn mun chm dt iu tr v s c gng gii quyt cc kh khn ny.

9T vn Nhm v T vn C nhnTrc ht, t vn c nhn thng tp trung vo vic ng vin ngi bnh ngng s dng ru hoc ma ty. Vic iu tr sau s chuyn sang gip cho ngi ny khng ti s dng cc cht na. Nh t vn s gip cho ngi bnh

Nhn r vn v c ng lc thay i

Thay i hnh vi ca h

Hn gn mi quan h vi gia nh v bn b b xu i

Thit lp mi quan h bn b mi vi ngi khng s dng ru

hoc ma ty

To mt li sng hi phc.

T vn nhm khc nhau ty theo chng trnh, nhng cc thnh vin ca nhm thng h tr v c gng gip nhau i ph vi cuc sng m khng cn dng n ru hoc ma ty. Chia s kinh nghim, tho lun v cc cm xc v kh khn, t bit c ngi khc cng c nhng kh khn tng t. Cc nhm cng c th tm hiu kha cnh tinh thn v vai tr ca n trong vic hi phc.

Bn nh gi c nhnNgi ang iu tr c th c yu cu c mt s ti liu no (hoc nghe mt s bng ghi m), lm mt vi bi tp vit (hoc c vo trong bng ghi m) hoc c gng thc hin nhng hnh vi mi.

Gio dc V vic S dng Ba bi Cht gy nghinMi ngi s tm hiu v cc triu chng v nh hng ca ru v ma ty i vi no v c th. Nhng nhm gio dc s dng bng ghi hnh v bng ghi m, bi ging hoc cc hot ng khc gip ngi bnh hiu r v chng bnh ca h v cch kim sot cn bnh ny.

o to K nng SngPhn o to ny c th bao gm c vic hc tp v thc hnh nhng k nng lm vic, cc hot ng gii tr, nhng k nng x hi, k nng giao tip, kim sot c nhng cn gin d, kim sot c s cng thng, t ra mc tiu, cng nh qun l thi gian v tin bc. Xt nghim s dng Ru hoc Ma tyNhng nhn vin chng trnh thng xuyn ly mu nc tiu ca ngi bnh lm xt nghim ma ty. Mt s

chng trnh ang bt u xt nghim mu nc bt thay v dng nc tiu. H cng c th dng BreathalyzerTM xt nghim vic s dng ru.

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o to Ngn nga Ti nghino to ngn nga ti nghin gip cho ngi bnh nhn ra nhng yu t c th dn n ti nghin, cch i ph vi s thm mun, cch lp ra cc k hoch x l cc tnh hung cng thng v nhng vic phi lm nu ti nghin. Mt yu t dn n ti nghin l bt k mt iu g lm cho ngi bnh cm thy thm ma ty. Nhng yu t dn n ti nghin thng lin quan n cc kiu lm cho ngi bnh nghin trc kia, nh c ngi tng chia s ma ty, thi gian hoc a im, vt dng c nhn (v d nh ng chch, ng iu, hoc mt dng s dng thuc), hoc mt tnh hung hay cm xc c th no .

nh hng n cc Nhm T Gip Nhng ngi tham gia vo cc nhm t gip s h tr v ng vin nhau cai nghin ru hoc ma ty v khng ti nghin. C l chng trnh 12-Bc l chng trnh ni ting nht trong s cc nhm t gip . Chng trnh ny bao gm Hi Cai nghin Ru (AA), Hi Cai Cht gy nghin (NA), Hi Cai nghin Cocaine v Hi Cai nghin Cn sa. Cn c nhng nhm t gip khc nh SMART (o to T Qun l v Phc hi) Recovery, Hi Ph n Cai ru.

Khng phi cc c s iu tr m chnh bn thn cc thnh vin s iu hnh cc nhm t gip . Ti nhiu ni, nhng nhm t gip s t chc nhng bui hp cho ngi bnh c nhu cu c bit. Bn c th tm nhng bui hp cho thanh nin, ph n, ngi ng tnh n, ngi ng tnh nam, ngi quan h lng tnh, ngi mi gia nhp v nhng ngi c nhu cu gp mt s dng ngn ng khc ngoi ting Anh. Mt s nhm cn t chc nhng cuc tho lun trn Internet v nhng cuc hp trc tuyn.

Cc chng trnh iu tr khuyn co hoc yu cu ngi bnh phi tham gia cc nhm t gip . Khi tham d, rt nhiu ngi c thm bn gip h gi c tnh trng cai nghin. S bui hp c yu cu s thay i ty theo chng trnh; c nhiu chng trnh yu cu ngi tham gia phi d 90 bui hp trong 90 ngy, theo khuyn co ca AA v NA. Mt s chng trnh iu tr khuyn khch ngi bnh tm mt ngi bo tr, tc l ngi tng tham gia nhm mt thi gian lu v c th a ra nhng li khuyn hoc h tr mang tnh ring t.

Nhng nhm t gip cng c vai tr quan trng trong vic phc hi i vi rt nhiu ngi. Tuy nhin, iu quan trng l phi hiu c vic tham gia nhng nhm ny khng ging nh vic iu tr.

C nhng nhm t gip dnh cho cc thnh vin gia nh, v d nhm Al-Anon v nhm Ala-teen (xem phn Dnh ring cho Bn trong ti liu ny).

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iu tr Ri lon Tm thnNhiu ngi s dng cht gy nghin rt ba bi v ng thi gp phi mt s vn khc v cm xc nh chn nn, bn chn hoc tnh trng ri lon do cng thng sau tn thng. Trong thi gian iu tr, thanh thiu nin c th gp cc vn v hnh vi, mt thng bng trong c x, hoc thiu tp trung/c hnh vi thi qu. Vic iu tr ng thi tnh trng lm dng v ri lon tm thn s lm tng c may hi phc cho ngi bnh. Mt s nh t vn cho rng ngi bnh nn trnh xa ru v ma ty t nht l ba hoc bn tun trc khi chuyn vin iu tr c th nhn dng c cc chng bnh v cm xc mt cch chnh xc. Chng trnh c th cung cp chm sc sc khe tm thn hoc c th gii thiu ngi bnh n mt c s khc iu tr. Vic chm sc sc khe tm thn thng c s dng thuc, nh cc loi thuc chng trm ut.

Gio dc Gia nh v Dch v T vnChng trnh gio dc ny c th gip bn hiu c cn bnh cng vi nguyn nhn, nh hng v cch iu tr. Cc chng trnh c hng dn theo nhiu cch: bi ging, tho lun, hot ng, v hp nhm. C nhng chng trnh cung cp t vn cho gia nh hoc cc cp v chng.

Vic t vn gia nh c bit quan trng trong vic iu tr cho thanh thiu nin. Cha m cn phi tham gia vo vic lp k hoch cho qu trnh iu tr v cc vn chm sc sau cai nghin cho thanh thiu nin. Cc thnh vin trong gia nh cng cn phi tham gia y trong nhng bui t vn gia nh do chng trnh t chc.

iu tr bng thucC nhiu chng trnh s dng thuc h tr qu trnh iu tr. Mc d khng phi l thuc vo vic iu tr bng thuc i vi ru hay ma ty, nhng mt s trng hp vn c th gip cho ngi bnh gi c s iu v c th mang tnh sng cn.

Vic iu tr bng thuc l trng tm chnh ca mt s chng trnh, v d nh chng trnh OTP c h tr y t c ni trn. Thuc ng l mt phng php iu tr bng thuc gip ngn nga cc triu chng trm ut khi ngng dng thuc opioid trong 24 gi, do ngi bnh phi s dng hng ngy. Khi dng theo ch nh, loi thuc ny khng gy cm gic cao m vn gi cho ngi bnh hot ng bnh thng. Ni mt cch chnh xc, thuc ng ngn chn thng hoa xy ra i vi ngi s dng ma ty.

Hi: Nhng k nng sng tnh to m v/chng ti hay ni l g?

p: Nhng k nng sng tnh to l nhng hnh vi mi v cch sng mi m v/chng ca bn phi tp luyn. Trc khi iu tr, v/chng ca bn dnh nhiu thi gian s dng ru, ma ty v tnh to li sau khi s dng nhng cht ny. Phn ln cc hot ng ca ngi y xoay xung quanh vic ung ru hay ma ty. Phn ln cc hot ng gii tr ca ngi y u bao gm vic s dng ru hay ma ty v bn b ca ngi y cng c nhiu ngi s dng hoc lm dng cht gy nghin. V nhng l do ny, nhng ngi mun phc hi tnh trng s dng ba bi cht gy nghin u cn phi hc mt li sng hon ton mi v c bn b mi.

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Mt s ngi bnh ch s dng thuc ng trong khong 6 thng n 1 nm v dn dn ngng s dng; phn ln nhng ngi ny ti nghin v bt u s dng li opiod. Tuy nhin, nhng ngi b l thuc vo thuc ng trong thi gian di hoc sut i, c gi l iu tr bng cch duy tr thuc ng. Ngi c iu tr theo hnh thc ny thng c cng vic lm n nh v c cuc sng vui v, thnh t.

Nu ngi thn ca bn ang phi dng thuc iu tr HIV hay AIDS hoc ang dng bt c thuc no khc, th vic nhn vin ca chng trnh OTP cn phi c bit chnh xc h ang dng loi thuc g l rt quan trng. Vic dng cng lc mt s loi thuc no vi thuc ng hoc LAAM c th buc ngi thn ca bn phi chu s gim st c bit v y t.

Buprenorphine l mt hnh thc iu tr bng thuc khc c th c dng iu tr tnh trng l thuc vo opiod v c khi cng c s dng trong chng trnh OTP. Buprenorphine gn y c chp thun cho vic iu tr ca cc bc s chm sc sc khe ban u ti phng mch. Bc s iu tr cho ngi bnh bng Buprenorphine s t vn hoc gii thiu bnh nhn n gp nh t vn.

Disulfi ram (Antabuse) l loi thuc gy phn ng xu nu ngi bnh ung ru khi ang dng thuc. Phn ng ny c th l gy mt, bun nn, nn ma v kh chu. V ngi bnh bit rng thuc c th lm cho h rt kh chu nu ung ru nn h s phi c km ch. Antabuse c dng theo liu hng ngy.

Mt loi thuc khc, naltrexone (ReVia), lm gim s ham mun ung ru. Loi thuc ny c th gip ngi bnh ung ru t khng c mun ung thm. Cc chng trnh cng c khi dng naltrexone iu tr nghin heroin hoc cc loi thuc opiod khc v loi thuc ny ngn chn nh hng ca ma ty. iu quan trng l ngi s dng heroin phi qua qu trnh gii c trc, h khng cn s dng heroin trc khi bt u dng naltrexone.

V ngi nghin rt kh gii c khi cc loi thuc opiod, nn khng c nhiu ngi t c kt qu tt; buprenorphine c khi c s dng gip ngi bnh thc hin c s chuyn i ny. Nu mt ngi gii c cht thuc opiod v bt u s dng naltrex-one, thuc ny s khng c c tc dng mong mun nu ngi bnh khng c c h thng h tr x hi mnh m, bao gm c vic nhc nh ngi ny ung thuc u n. Khi thanh thiu nin s dng thuc naltraxone iu tr bnh nghin thuc opiod, th s h tr v gim st ca cha m c vai tr ht sc quan trng.

Chm sc sau cai nghin (Cn Gi l Chm sc Lin tc)Cho d mt ngi hon tt thnh cng chng trnh iu tr th vn cn nguy c ti s dng ru hoc ma ty (c gi l ti nghin). Ngi tham gia chng trnh iu tr cng lu, k c chng trnh hu cai nghin, th kh nng khng ti nghin cng ln. Khi ngi bnh hon tt phn iu tr c bn, chng trnh s ngh chng trnh hu cai nghin ti trung tm iu tr hoc gii thiu ngi ny n mt c s khc. Hu ht cc chng trnh u khuyn co ngi bnh nn tham gia chng trnh hu cai nghin trong thi gian t nht l 1 nm. Thanh thiu nin cng cn phi tham gia chng trnh hu cai nghin trong thi gian lu hn.

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Chm sc hu cai nghin c tm quan trng rt ln c th iu tr thnh cng. Khi ngi bnh tr li cng ng, trng hc, hoc ni lm vic, h s gp phi nhng s cm d v s thm mun s dng ru hoc ma ty tr li. Trong vic chm sc hu cai nghin, ngi thn ca bn s gp g nh k vi nh t vn hoc mt nhm h tr xc nh cch i ph v gip ngi bnh i u vi nhng th thch trong vic hi phc.

i vi mt s ngi, c bit l nhng ngi tham gia chng trnh iu tr ti nh hoc chng trnh cai nghin trong tri giam, th cn nn c nhng hnh thc chm sc hu cai nghin tp trung. Nh ngh tm hoc nh cai ru l nhng ni khng c ru hoc ma ty ngi va ra khi cc chng trnh cai nghin trong tri giam hoc ti nh. Ngi bnh thng y trong thi gian t 3 thng n 1 nm, ti nhng ni ny hoc nhng c s iu tr ngoi tr u c cung cp dch v t vn.

Nhng cn h chuyn tip hoc h tr sng b tr cho nhng nhm nh sng chung, dnh cho nhng ngi cn mt mi trng sng khng c ru v ma ty. Nhng ngi sng y h tr nhau v thng tham gia vo vic t vn ngoi tr cng nh cc nhm t gip .

TI SAO VIC CHA TR MT NHIU THI GIAN N TH?S dng ba bi cht gy nghin nh hng mi mt i sng ca ngi bnh. V l do , s iu tr cn phi tc ng n tng gc trong i sng ca ngi bnh.

Vic iu tr cn bao gm nhiu vn ngoi vic gip ngi bnh khng ung ru hoc s dng ma ty na.

Tht s th vic ngng s dng ru hoc ma ty ch l bc khi u cho qu trnh hi phc. Ngi thn ca bn s cn phi hc nhng cch thc mi i ph vi cuc sng hng ngy. Ngi ny s cn phi hc li cch i ph vi s cng thng, gin d, hoc nhng tnh hung x hi v cch tm c nim vui khng cn s dng n ma ty hoc ru. Hc c nhng k nng mi m ny khng phi l chuyn d dng.

C nhng ngi tham gia iu tr ch v sc p ca h thng php lut, s lm, cha m, v chng, hoc cc thnh vin khc trong gia nh. Bc u tin trong vic iu tr s l gip h thy rng h khng c vn g rc ri v s c ng c thay i chnh h. Qui trnh ny rt mt thi gian.

Hi: Nu tnh trng s dng ba bi cht gy nghin l mt chng bnh, vy c loi thuc no cha tr khng?

p: C nhng loi thuc c th cha tr c, tuy nhin ch c tc dng vi mt s loi nghin. Khng c thn dc no c th cha tr c tnh trng s dng ba bi cht gy nghin, nhng thuc c th ng vai tr quan trng trong vic iu tr. Thuc ch s dng gii c cho ngi bnh, ngn h c cm gic cao khi s dng thuc, gim s thm thuc hoc cha tr tnh trng ri lon tm thn ca ngi bnh.

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Cc thnh vin trong gia nh bn cng cn thi gian hiu v bt u s dng s h tr ca cc nhm t gip ni trn. Nhng nhm ny c vai tr rt quan trng i vi s hi phc ca ngi bnh trong nhng nm tip theo.

Hy nh rng: Phi mt mt thi gian di th bnh mi pht trin v thng thng s l bnh mn tnh; do , cn phi mt thi gian mi iu tr c.

Dnh ring cho BnNh vy l thnh vin trong gia nh bn hin ang c iu tr v mi chuyn s bt u thay i. Mt s cng thng v xo trn trc y din ra thng xuyn trong cuc sng gi y c th bt u gim bt i. Nhng nhng tun l iu tr u tin rt cng thng. Mi thnh vin gia nh u ang t iu chnh theo cc thay i, bt u gii quyt cc xung t qua v thit lp nn nhng thi quen mi. Gia nhng s thay i ny, iu quan trng l bn phi t chm sc ly bn thn ngh ngi y , n ung ng gi, tp th dc u n v tho lun thng xuyn vi cc bn b v ngi thn. Nh th, n th hay nhng ni tn knh hoc nhng t chc h tr tinh thn khc u c th l ngun h tr ln cho bn.

S hi phc khng ch l mt s iu chnh cho chnh ngi ang c iu tr m cn l s iu chnh ca chnh bn na. Trong my nm qua, bn c th m nhn nhng vai tr hoc nhng cng vic thuc trch nhim ca ngi thn ca mnh. Gi y, khi thi gian tri qua, bn v ngi thn ca mnh c th cn phi hc hi nhng cch thc mi trong quan h vi nhau v hc nhng cch thc khc trong vic chia s cng vic v hot ng. Nu l cha m ca mt thiu nin ang c iu tr, c th bn s phi tham gia vo k hoch v qu trnh iu tr nhiu hn. Bn c th phi iu chnh cuc sng v quan h gia nh dnh thi gian tham gia vo cng vic ny.

Bn c th c nhiu cu hi v vic ngi thn ca mnh s c hnh vi nh th no trong nhng giai on hi phc ban u. Mi ngi hnh x theo mt cch khc nhau. C ngi rt vui v tip nhn s iu tr; c ngi li cm thy kh s khi phi iu chnh theo mt li sng mi v phi n lc sng khng cn n ru v ma ty. H c th bun b, gin d, hoc bi ri. iu quan trng l bn phi nhn ra rng y l nhng phn ng bnh thng v tm s h tr cho chnh mnh.

Al-Anon l ngun tip sc c bit n nhiu nht v sn sng h tr cc thnh vin gia nh v bn b ca ngi nghin ru. Al-Anon c thnh lp cch nay 50 nm cung cp s h tr cho nhng ngi sng chung vi ngi nghin ru. Alateen, t chc dnh cho tr em v thanh thiu nin, cng c thnh lp sau khng lu. Ngy nay, nhiu thnh vin gia nh ca ngi lm dng ma ty cng tham gia vo mt trong hai t chc ny. Nhng cuc hp mt ca h u min ph v c t chc hu ht cc cng ng.

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Cng ng ca bn cng c th c nhng cuc hp mt ca Nar-Anon. Nhm ny c thnh lp cho cc gia nh v bn b ca ngi s dng ma ty. Nhng nhm khc na cng c th gip ch cho bn, nh nhm Co-Dependents Anonymous v Adult Children of Alcoholics. Chng trnh iu tr cng s cho bn lch t chc nhng cuc hp mt ti a phng ca cc nhm ny hoc bn cng c th tm kim thng tin lin h trong phn Ngun tham kho trong cm nang ny.

Nhiu chuyn vin iu tr xem tnh trng s dng ba bi cht gy nghin l mt chng bnh ca c gia nh. gip cho c gia nh hi phc v i ph vi nhng thay i ang xy ra, bn c th c yu cu tham gia trong vic iu tr. Hnh thc ny c th bao gm c vic tham d chng trnh gio dc cho gia nh hoc t vn cho gia nh hoc c hai v chng.

Quan trng l bn phi nh nhng iu sau y khi bn v ngi thn ang trong qu trnh hi phc:

Bn ang tham gia vo vic iu tr cho chnh bn thn, khng ch cho ngi lm dng cht gy nghin

S hi phc, tnh to hoc cai ru v ma ty ca ngi thn khng ty thuc vo bn.

S hi phc ca gia nh bn khng ty thuc vo s hi phc ca ngi s dng cht gy nghin.

Bn khng phi l nguyn nhn gy ra tnh trng s dng ba bi cht gy nghin cho ngi thn. khng phi l li ca bn.

Bn c th c cm gic b xc phm v gin d t trong qu kh, cn phi c gii quyt. Bn cn s h tr hiu v i ph vi nhng cm gic ny v bn cn h tr cho ngi thn trong n lc hi phc.

Hy nh rng: Lun sn c s gip cho bn. Hy hi nhn vin t vn c hng dn v xem phn Ngun tham kho trong cm nang ny.

Ti phi lm g khi Cn n s Gip cho cc Vn C bn ca Cuc sng?Bn c th cn n nhng s gip rt c th trong khi ngi thn ang c iu tr. Nu ngi thn ca bn l lao ng chnh trong gia nh v hin nay khng th lm vic do phi i iu tr, lm th no bn c th trang tri cho cuc sng? Nu ngi thn ca bn l ngi chm sc chnh cho con ci hoc cho mt ngi ln tui trong nh, lm th no bn c th p ng c nhng nhu cu ny? Chng trnh iu tr c th gip bn xin ngh php chm sc ngi thiu nng hoc nhn tin bo him thng qua ni ngi thn ca bn lm vic. Hy hi nh t vn v nhng hnh thc h tr khc nhau c th gip bn p ng c nhng nhu cu khc nhau. Hu ht cc chng trnh iu tr u hp tc vi cc chng trnh cng ng khc. Nhng chng trnh ny c th bao gm c vic h tr lng thc, qun o, phng tin i li, chm sc tr em, chm sc ngi gi, h tr php l, t

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vn ti chnh v dch v chm sc y t. Gia nh bn c th nhn c gip t nhng chng trnh gip ngi ang hi phc sau cai nghin.

Ti E rng iu Khng c Tc dngVic iu tr ch l bc u trong vic hi phc. Trong qu trnh ny, i khi cc thnh vin gia nh s c nhng cm xc ln ln. Bn c th cm thy kit sc, gin d, nh nhm, lo lng v s rng nu iu ny khng c tc dng th s khng cn g na. Bn c th cm gic nh th ang i trn dy v nu lm iu g sai tri, bn c th lm cho ngi thn ca mnh ti nghin tr li. iu quan trng l bn phi nh rng khng th gy ra s ti nghin ch c ngi thn ca bn phi chu trch nhim nu h li cm ly ru hay s dng ma ty tr li.

Khng ai c th tin on c ngi thn ca bn c hi phc c hay khng, trong bao lu, nhng nhiu ngi tr nn tt hn sau khi c iu tr. Ngi ta cng tham gia chng trnh iu tr lu bao nhiu, h cng trnh xa ru v ma ty c by nhiu. Khong mt na s ngi hon tt vic iu tr ln u vn tip tc qu trnh hi phc. D nhin, iu ny c ngha l khong mt na ti s dng thuc hoc ung ru tr li (gi l ti nghin) trc khi h c th t b hon ton. Thanh thiu nin l ngi c kh nng ti nghin ru hoc ma ty nhiu hn. Mt ngi cn phi c iu tr nhiu ln cng khng c g bt thng c. Thng thng ngi bnh phi c nhanh chng a tr li ni iu tr ngn nga tnh trng sa ng hoc ti nghin c th dn n tnh trng mn tnh.

iu quan trng l bn phi hiu rng s ti nghin thng l mt phn trong qu trnh hi phc. ng vi chn nn nu nh ngi thn ca bn ti s dng ma ty hoc ung ru. Thng thng thi gian ti nghin khng ko di v ngi ny s tip tc hi phc.

Mt chng trnh iu tr c th nh n bn trong vic hoch nh ngn nga ti nghin v c th gip bn bit c phi lm g nu ngi thn ti nghin. Ngi thn ca bn s c gip nhiu nu bn khng ung ru hoc s dng ma ty gn h, c bit l trong nhng thng u khi qu trnh cai nghin bt u. Khi khng s dng ma ty hoc ru, bn s gip cho ngi thn ca mnh trnh c nhng yu t kch thch. Khi c hai u hiu v chp nhn c tnh trng bnh tt ny, nguy c ti nghin s gim i rt nhiu. Nhng thay i v thi , hnh vi v gi tr m c hai ngi ang hc hi v thc hnh s tr thnh mt phn ca cuc sng hi phc mi.

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c bit dnh cho Thanh ninBn c th gp phi nhiu kh khn khi gii quyt nhng vn quan tm v vic sng chung vi mt ngi lm dng ru hoc ma ty. Cho d ngi l cha, m, ng, b, anh ch em th iu quan trng l bn phi trnh by cc vn , s s hi v s quan tm ca mnh vi nhng ngi c th hiu v thng cm c.

Bn c th cm thy rng mnh gy ra tnh trng s dng ba bi cht gy nghin cho ngi thn hoc trong mt chng mc nht nh, l li ca bn. Bn c th ngh rng nu trc kia bn c x tt hn, hc hnh gii giang hn, hoc khc i theo mt cch no th cha m ca bn hoc ngi bn thng yu s khng phi ung ru hay s dng ma ty nhiu n th. Bn hon ton khng c li trong vic ngi thn b nghin ngp. Khng ai gy ra tnh trng s dng ba bi cht gy nghin cho ngi khc. Khng ai c li trong vic ngi bn thng yu li mang mt chng bnh nh th.

Ngi thn ca bn c th tng lm bn kh x trc mt bn b, thy c hoc bt k ngi no khc. Bn c th ngng a bn b v nh hoc khng cho cha m bit v cc hot ng trng. Gi y, ngi thn ca bn ang c iu tr, hnh vi ca h s tt hn ln.

Bn c th sng vi s chin u cng thng v cng c th b lm dng hoc chng kin nhng chuyn bo hnh khc. Bn c th cm thy tc gin v bun b v nhng iu ny. Gi y bn c th ni v nhng iu ny v cc cm xc

Hi: V/chng ti ni l nhiu bn b ca anh y b ti nghin. iu ny c ngha l g?

p: Khng phi ngi no phc hi c cng gi c tnh trng . Khi khng gi c, th gi l ti nghin. C nhiu ngi b ti nghin nhiu ln. V cng nh i vi nhiu chng bnh mn tnh khc, nh tiu ng hay suyn, cc triu chng c th xut hin ri c th lui. Hu ht cc chng trnh iu tr u tho lun chuyn ti nghin mt cch ci m v thng xuyn. iu quan trng l ngi ti nghin phi tr li iu tr ngay, tm hiu v nhng yu t kch thch ti nghin v ci thin hnh vi i ph ca mnh. Vic tr li nhanh chng l mt du hiu lnh mnh (thay v l mt iu ng xu h) v l mt c mun c c cuc sng khng ru v ma ty. iu quan trng l phi hiu c khi nim ti nghin. N c ngha l ngi ngng s dng ru hoc ma ty trong mt thi gian, by gi s dng li ru hoc ma ty. S ti nghin c th lm cho ngi ta chn nn. Tuy nhin, vic ti nghin khng c ngha l ngi thn ca bn khng bao gi phc hi c.

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khc vi gia nh v nhn vin ca chng trnh iu tr. iu quan trng l bn chia s nhng ngh v cm xc v nhng g xy ra. Bn c th n cc nhm t gip nh Al-Anon hoc Alateen. C mt s thanh nin thy rng cc bui hp ca nhng nhm ny c th hu ch cho h. Nhng nhm ny s gii thch v ba iu: Bn khng phi l Nguyn nhn gy ra chuyn nghin ngp, bn khng th Kim sot c n, cng nh khng th iu tr c n. Hy nh l ba iu ny s hu ch cho bn.

iu quan trng l phi bit tnh trng s dng ba bi cht gy nghin c th c trong gia nh. Ngi no c ngi thn mc phi bnh ny th c xc sut mc bnh gp bn ln so vi ngi khc. iu ny c ngha l bn c th k tha mt xu hng mc bnh v bn nn cn thn khi ung ru hoc s dng ma ty. Thng tin ny ch nhm h tr cho bn, khng c nh lm cho bn lo s.

Tnh trng gia nh c th s kh hn khi ngi thn ca bn c iu tr. Cng ging nh vic iu tr cho cc chng bnh khc, vic iu tr cho tnh trng s dng ba bi cht gy nghin cng s c tc dng, nhng khng phi ai cng bit v tin iu ny. Ngi ta vn cho rng vic mc phi bnh ny l chuyn ng h thn. Bn v gia nh phi t quyt nh phi ni g v ni r n mc no cho bn b hay gio vin. C th ch cn ni n gin: M ti bnh, nhng s khe v v nh sm. Cm n bn hi thm.

Bn c th ni cho mt s bn b thn thit v tnh trng bnh tt ca ngi thn v s tin trin trong qu trnh iu tr. Hoc bn c th khng chia s thng tin ny vi h. l la chn ca bn.

Hy nh, bn khng phi l nguyn nhn gy ra chuyn ny, nhng bn c th ng mt vai tr quan trng trong vic gip ngi khc hi phc. Hy kin tr.

Hi: B ti mi l ngi ung rt nhiu ru. Vy ti sao t vn vin li mun ni chuyn vi ti?

p: Nhng ngi lm cng tc chuyn mn iu tr bit rng tnh trng s dng ba bi cht gy nghin c th nh hng n c gia nh. Vy vic h tr c gia nh l iu hon ton hp l. C nhng chng trnh h tr c gia nh tm hiu v c nhng chng trnh khc li cun c gia nh hoc c hai v chng trong cc bui t vn. Sng chung vi cha m c s dng ru hoc ma ty l iu rt kh khn. V s l mt iu hon ton c ch khi bn tm hiu c v chng bnh ny v nh hng ca n i vi gia nh v c vi bn. Tho lun vi ngi hiu bit v tnh trng s dng ba bi cht gy nghin s gip ch nhiu cho bn.

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GII THCH T NGPh nhnL mt quy trnh t duy trong mt ngi khng tin rng mnh c vn , bt chp cc bng chng cho thy iu ngc li. y l mt cch ngi ta t bo v mnh trc nhng suy ngh hoc cm xc au n.

Gii cL mt qui trnh gip cho c th loi b cc cht gy nghin trong khi cc triu chng trm ut c iu tr. y thng l bc u tin trong chng trnh iu tr lm dng cht gy nghin.

Chm sc sau cai nghinCn c gi l chm sc thng xuyn. L s iu tr c thc hin sau khi hon tt vic iu tr ni tr hoc ngoi tr. S chm sc ny c th l s tham gia vo vic t vn c nhn hoc nhm, thng xuyn tip xc vi nh t vn, hoc cc hot ng khc c thit k ngi bnh tip tc hi phc.

Nh ngh tm/nh cai ruL ni dnh cho ngi va mi hi phc sau tnh trng s dng ba bi cht gy nghin. Thng thng s c nhiu ngi va hi phc cng sng chung nhau v c rt t hoc khng c s gim st ca nh t vn.

iu tr ni trL hnh thc iu tr trong c s c lin kt vi bnh vin hoc mt c s t chc nh bnh vin ni ngi bnh s lu li mt vi ngy trong mi tun.

iu tr ngoi trL s iu tr ti mt c s. C nhiu dch v khc nhau nhng khng bao gm vic li m. C khi hnh thc iu tr ny c dng sau khi iu tr ni tr.

Ti nghinL s xy ra nhng triu chng lp li ca mt cn bnh sau mt thi gian tin trin tt; tc l mt ngi ti s dng ru hoc ma ty sau khi hi phc.

Ngn nga ti nghinL bt c chin lc hoc hot ng no gip cho ngi va hi phc khng s dng ru hoc ma ty tr li. C th bao gm vic thit lp nn cc phn ng i ph mi, thay i nim tin v k vng, thay i thi quen, li sng v lch lm vic ca c nhn.

iu tr ti nhL s iu tr trong mt c s ni c nhn vin v ngi ng ng c th h tr qu trnh iu tr. Hnh thc ny cung cp cc dch v hon chnh hn v tp trung hn vic iu tr ngoi tr. Ngi tham gia sng ti c s iu tr. iu tr ti nh l hnh thc iu tr ko di, thng t 1 thng cho n hn 1 nm.

Nhm t gip /Nhm 12-BcNhng nhm t gip bao gm nhng ngi hi phc cung cp mt ni an ton cho nhng ngi ang hi phc c th chia s kinh nghim, sc mnh v hy vng. 12 bc ca Nhm Cai nghin Ru gip cc thnh vin hi phc sau thi gian nghin ngp, nhng hnh vi nghin ngp v nhng au n tinh thn. Cc nhm ny hot ng t do v khng c s h tr ca bt c chng trnh iu tr no.

H tr cuc sngCn gi l nhng ni c ng chuyn tip. L mt c s hc cc k nng v thi cn thit cho cuc sng c lp. Ni y cung cp mt nhp cu ni gia s chm sc c gim st v cuc sng c lp.

iu tr ti cng ngHnh thc iu tr ti nh di hn tp trung vo s thay i hnh vi v trch nhim c nhn trong mi lnh vc ca cuc sng cho khng ch ring v vn s dng cht gy nghin.

K hoch iu trL mt k hoch cung cp nhng chi tit ca vic iu tr. K hoch ny m t nhng vn phi c gii quyt, mc tiu ca vic iu tr v nhng bc c th cho chuyn vin iu tr v ngi c iu tr phi thc hin theo.

Nhm iu trMt nhm chuyn vin (v d nh gim st bnh vin, ngi t vn v bc s) chu trch nhim iu tr v gip cho gia nh ngi bnh.

Yu t kch thchL bt c s kin, ni chn, vt, mi v, tng, cm xc hoc con ngi c th to nn mun s dng ru hoc ma ty.

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NGUN THAM KHOTi liu tham kho ca Chnh ph Lin bangLm dng Cht gy nghin v C quan Sc khe Tm thn v Qun l Lm dng Cht gy nghin (SAMHSA)Tm C s iu tr www.fi ndtreatment.samhsa.gov/facilitylocatordoc.htmTrung tm Thng tin Quc gia v Ru v Ma ty ca SAMHSA (NCADI).C quan ny cung cp hng ngn n phm (phn ln l min ph) v iu hnh mt ng dy h tr 24 gi (bng ting Anh v ting Ty Ban Nha) cho SAMHSA. Nhn vin ng dy h tr c th tr li cc cu hi v vic s dng ba bi cht gy nghin, xut nhng ngun tham kho bng vn bn v gii thiu iu tr da theo thng tin Tm C s iu tr Lm dng Cht gy nghin Quc gia.

11420 Rockville PikeRockville, MD 20852ng dy h tr: 800-729-6686 S a phng: 301-770-5800 TDD: 800-487-4889 www.ncadi.samhsa.gov

Trung tm Thng tin Quc gia v Sc khe Tm thn800-789-2647TDD: 866-889-2647www.mentalhealth.samhsa.gov

Trung tm iu tr Lm dng Cht gy nghin ca SAMHSA (CSAT)www.csat.samhsa.gov

Trung tm Phng chng Lm dng Cht gy nghin ca SAMHSA (CSAP)www.csap.samhsa.gov

NGUN tham kho khcDanh sch sau y ch l mu, khng phi l danh sch hon chnh ca nhng ti liu tham kho c sn. Nhng tn trong danh sch ny khng c ngha l c SAMHSA h tr.

Hu ht cc chnh quyn Tiu bang v a phng u c mt vn phng ph trch cc vn lin quan n lm dng cht gy nghin v y l ngun tham kho ng tin cy. C th c thm cc vn phng ca nhng Hi ng v Cai Ru v Ma ty ni bn sng; hy tham kho s danh b a phng.

Adult Children of Alcoholics World Service Organization, Inc.P.O. Box 3216Torrance, CA 90510 310-534-1815www.adultchildren.orgAl-Anon Family Group Headquarters, Inc.(Al-Anon and Alateen)1600 Corporate Landing ParkwayVirginia Beach, VA 23454-5617888-4AL-ANON (ng dy trao i thng tin)www.al-anon.alateen.orgTrang Web ting Ty Ban Nha: www.al-anon.org/alaspan.html

Alcoholics AnonymousP.O. Box 459Grand Central StationNew York, NY 10163212-870-3400www.aa.org

Cocaine Anonymous World Services (CAWSO)3740 Overland Avenue, Suite CLos Angeles, CA 90034310-559-5833www.ca.org

Co-Dependents Anonymous (CoDA)P.O. Box 33577Phoenix, AZ 85037-3577602-277-7991www.codependents.org

Dual Recovery Anonymous (DRA)Vn phng Trung tmP.O. Box 8107Prairie Village, KS 66208877-883-2332www.draonline.org

Join TogetherOne Appleton StreetFourth FloorBoston, MA 02116-5223617-437-1500www.jointogether.org

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Marijuana Anonymous World ServicesP.O. Box 2912Van Nuys, CA 91404800-766-6779http://www.marijuana-anonymous.org/

Nar-Anon22527 Crenshaw Boulevard Suite 200 BTorrance, CA 90505310-547-5800Narcotics Anonymous World Services Offi ceP.O. Box 9999Van Nuys, CA 91409818-773-9999www.ca.org

National Asian Pacifi c American Families Against Substance Abuse (NAPAFASA)340 East Second StreetSuite 409Los Angeles, CA 90012213-625-5795www.napafasa.org

National Association for Children of Alcoholics (NACoA)11426 Rockville PikeSuite 100Rockville, MD 20852888-554-COAS www.nacoa.org

National Association on Alcohol, Drugs and Disability (NAADD) 2165 Bunker Hill DriveSan Mateo, CA 94402-3801650-578-8047

National Clearinghouse on Families and Youth (NCFY)P.O. Box 13505Silver Spring, MD 20911-3505301-608-8098www.ncfy.com

National Families in Action (NFIA)2957 Clairmont Road N.E.Suite 150Atlanta, GA 30329404-248-9676www.nationalfamilies.org

Nicotine Anonymous419 Main Street, PMB 370Huntington Beach, CA 92648415-750-0328www.nicotine-anonymous.org

Parents, Families and Friends of Lesbians and Gays (PFLAG)1726 M Street, N.W.Suite 400Washington, DC 20036202-467-8180www.pfl ag.org

Secular Organizations for Sobriety/Save Our Selves (SOS) Clearinghouse4773 Hollywood BoulevardHollywood, CA 90027323-666-4295www.secularsobriety.org

SMART Recovery7537 Mentor Avenue Suite #306Mentor, Ohio 44060 440-951-5357www.smartrecovery.org

Women for Sobriety, Inc.P.O. Box 618Quakertown, PA 18951-0618215-536-8026www.womenforsobriety.org