Morphinism
| Classification according to ICD-10 | |
|---|---|
| F11.2 | Mental and behavioral disorders caused by opioids (addiction syndrome) |
| ICD-10 online (WHO version 2019) | |
Morphinism or morphine addiction is the habit or dependence after multiple intake of morphines and opiates such as z. B. Heroin .
It is usually taken intravenously , nasally or by smoking (e.g. on aluminum foil). There is a euphoric state of intoxication, but with increasing habit, above all, apathy and sleepiness. In an effort to compensate for the habituation effect, the dose is increased in quick succession. A side effect is constipation (sluggishness of the bowel). Often, even with the same dose, agonizing withdrawal symptoms occur: tremors, sweating, chills, diarrhea, muscle cramps, weakness, internal restlessness, pain (muscles and joints, digestive tract), insomnia, nightmares.
A neurotoxic effect of morphines could not be proven, the intravenous consumption of contaminated heroin, however, can cause a rapid and drastic physical decline, especially if a polytoxic consumption pattern is present.
The therapy options are detoxification (often with subsequent therapy) or substitution (substitutes).
Substitution agents can be methadone , L-polamidone or buprenorphine (Subutex), in individual cases codeine or DHC . In Germany , Austria and Slovenia , retarded morphine is also used successfully as a substitution agent.
A newer treatment concept is the original substance substitution, in which the primary addictive substance (heroin) is administered to the patient under medical supervision without contamination. Treatment also includes psychosocial support and regular urine tests to rule out the use of other drugs such as cocaine and benzodiazepines . Original substance substitution has been used successfully in Switzerland for years. In Germany, a pilot study has been carried out in several cities since 2002. Due to the promising results of this study, the SPD and all opposition parties advocated inclusion in the standard care in 2009 and enforced it against the resistance of the CDU .
Web links
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- Klaus Aktories, Ulrich Förstermann, Franz Bernhard Hofmann, Klaus Starke (eds.): General and special pharmacology and toxicology: Founded by W. Forth, D. Henschler, W. Rummel . 10th edition. Urban & Fischer Verlag / Elsevier, 2009, ISBN 978-3-437-42522-6 , pp. 230 .
- §5 BtMVV
- Heinz Lüllmann, Klaus Mohr, Lutz Hein: Pharmacology and toxicology: Understanding the effects of drugs - using drugs in a targeted manner . 17th edition. Thieme, Stuttgart 2010, ISBN 978-3-13-368517-7 , p. 294-308 .
- Pierer's Universal Lexicon . 12th edition. Altenburg 1861, p. 313-314 (entry opiates ).