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Contemporary abuses hypnotics--barbiturates/Abuzuri contemporane hipnotice--barbiturice.

Motto:

"Sleep is the only gift that the gods have given us freely." (Plutarch)

Motto:

"Somnul este singurul dar gratuit pe care ii acorda zeii." (Plutarh)

INTRODUCTION

Sleep and dream activity

The new-born sleeps sometimes from 20 to 24 hours and the adult cannot conceive life without a restful sleep that revitalize the energy consumed during various activities, so that the need for sleep is ubiquitous and is, definitely, a condition of human existence.

A refreshing sleep provides the necessary energy for one's aspirations. Through its millenary history, mankind has treasured rest and sleep. It pursued more rest and better sleep and this may constitute a guarantee of physical and mental health.

As the result of an increasingly accelerating pace of human activity, mankind lives under a quasi-permanent time pressure, so that many of personal achievements affect the time for sleep.

Until recently, sleep and dream, the counterpart of sleep that is so little understood, was wrapped in impenetrable mystery and was susceptible to fantasy and superstition. The sleep of reason produces monsters is just an apt expression of a state of facts.

Lately, humanity begins to reveal most of the secrets of dream activity and to understand the structure, mechanisms, physiology, sleep--wake biorhythms. Electroencephalographic recordings provide data of high complexity, which is an achievement that was unthinkable some years ago.

Mankind lives fully the impressive process of progress in all areas, is found to be involved in an increasingly accelerating pace of development, at the expense of losing sleep, when the secrets of sleep had just started to be unraveled and when sleep was already established throughout human history as a true myth.

It is assumed that sleep has a really comforting soothing effect, only when sleep cycles and stages follow the usual sequence, including a normal dream activity. However, insomnia turns from a common symptom into a disease of civilization.

Sleep in numbers

In clinical practice, there are many cases of false insomnia, especially in individuals who complain of lack of sleep, even if polygraphic records show a quantitatively normal, but disorganized sleep, with prevailing stages of superficial sleep and little deep sleep.

In general, sleep duration is about six-eight hours. Sleep comprises disparate units, each of them lasting 80-120 minutes, made of a long sleep phase and a paradoxical sleep phase. These are separated by short transitional phases, when sleep becomes shallow and the individual may awaken after two-three minutes. When these short periods of transition are overcome without awakening, they might create the impression of deep sleep, but they are not superior in the overall recovery of psychophysiological resources.

Psychopathology of sleep

Hyposomnia was erroneously called insomnia, but the latter term is now generally accepted. It is the most common phenomenon in general pathology and especially in the neuropsychical pathology. Unfortunately, in modern society, insomnia has become an impediment due to its high incidence.

The intensity of insomnia is highly various: it ranges from alternation of good and bad nights to long periods of insomnia. The most important consequences of insomnia are at a cerebral, electroencephalographic, behavioural and psychological level. Some people have a hard time falling asleep and need short-acting sleep-inducing products, while others have a short duration sleep and therefore they need products to extend the duration of sleep.

Hypnotics

Hypnotic drugs and preparations are used both on the patient's own initiative and by prescription. Nowadays there is a huge consumption of hypnotics in the world; they are drugs or preparations which have the effect of inducing and maintaining sleep.

The progress of synthetic chemistry and their immediate application in the pharmaceutical industry have led to a marked increase in the number of substances with hypnotic action and barbiturates in particular.

Barbiturates are substances with sedative-hypnotic action and were the first pharmacological agents with this effect (4). Barbiturates started to be used since the early 1900s, but their popularity reached its peak in the 1960s--1970s, especially in the treatment of anxiety, insomnia and epilepsy, but also as substances of abuse (mainly due to the anxiolytic effect of reducing general inhibitory states).

Barbiturates centrally act by potentiating and prolonging the action of neurotransmitters with inhibitory effect on the central nervous system and by blocking the receptors of some neuroexcitatory substances.

Barbiturate substances are used in therapy to inhibit the action of central nervous system. The use of barbiturates may provide any degree of depression of the central nervous system: from mild sedation to deep coma. The central inhibitory action induces calming, sleep induction, inhibition of seizures or the onset of anaesthesia in surgical practice. However, they are used more for sleep induction. Within 20-40 minutes, any barbiturate substance induces sleep, if delivered in the appropriate dose. The sleep provided by barbiturates resembles closely the physiological sleep, it is dreamless and it is usually restful. Barbiturate substances partially increase the disregard of external stimuli, thereby improving natural sleep when the surrounding situation is favourable.

Barbiturates inhibit respiration due to the direct effects on bulbar respiratory centres. However, this action is proportional to the dose of barbiturates used. Therefore, there is a high risk of barbiturate intoxication (death caused to poisoning with barbiturates is due, usually, to respiratory distress). That is why the use of barbiturate substances requires special caution, especially in elderly patients and children, due to the potential danger of inhibiting respiratory centres.

Barbiturates tend to uniformly decrease gastrointestinal muscle tone. The suppression of various gastrointestinal symptoms by sedative doses may be largely attributed to the central inhibitory action.

FROM USE TO ABUSE OF BARBITURATES

Most psychotropic drugs alter sleep, causing withdrawal phenomena after their discontinuation.

Irrational treatments with hypnotics and especially barbiturates, which are so popular, yet so little known by the public in terms of side effects, produce severe distortions of normal sleep--wake profiles and rebel insomnia recurs frequently at withdrawal and sleep is dominated by dream activity. Given the circumstances, the intensity and frequency of dreams and nightmares increase resulting ultimately in extreme anxiety, with greater visibility than the ordinary insomnia that initially required the administered narcotic drug.

All psychopathological phenomena culminate in the emergence and evolution of the phenomenon of addiction and barbiturate addiction.

Drug addiction is a state of periodic or chronic intoxication detrimental to the individual and society, caused by repeated administration of medications. Citing J. Molto and C. Radel (1), the authors of Medical Sociology argue that "undoubtedly, there is no etiology for addiction, but there is still a number of factors that often coexist". The addiction is characterized by impulses to continue the ingestion of the drug, to increase the dose, and by psychological and, sometimes, physical dependence to that drug.

Addiction seems to resemble a suppressing cancer that affects not only the body of the drug user, but also his psyche through the tragic disruption of human personality (1).

Chronic drug poisoning is the most common result of hypnotic barbiturate addiction that evolves in time through phases of habituation, addiction and ultimately of decay of the individual (2). Dependence occurs within a few months, especially among labile people after tensions, failures and psychological trauma.

The number of addicts was, initially, relatively small and they emerged after the First World War. Nowadays, the number of addicts is growing continuously, leading to serious social problems in the future.

In conclusion, chronic barbiturate intoxication is characterized by a number of psychiatric, neurologic and somatic phenomena.

Barbiturates induce the depression of the central nervous system. Large doses cause depression of respiratory and cardio-vasomotor bulbar centres, leading to severe cardiovascular and respiratory disorders. It acts on thermoregulatory centres, causing hypothermia. The action of barbiturates is enhanced in association with analgesics, psycholeptics and ethyl alcohol.

Psychological phenomena are characterized by lack of energy, neglect of professional duties, narrowing of the sphere of interests, permanent interest in finding means of purchasing the drug, gradual and extremely marked loss of conscientiousness, severe memory and attention disorders, emotional lability with pronounced tendency to suicide. On this basis, phenomena of acute toxic psychosis, confusional syndrome and hallucinatory delusional phenomena may sometimes occur.

Neurological phenomena are characterized by slurred speech. Ocular events such as nystagmus, diplopia, strabismus with insufficient accommodation, dizziness, generalized hypotonia may also occur.

In drug addicts, abstinence is extremely alarming and it is quite similar to psychopathological phenomena seen in delirium tremens.

It is characterized by tremors, hallucinations, delirium, nausea, fever, dehydration, tachycardia, seizures that usually occur with drug withdrawal in individuals that became addicted (6).

SOCIOPSYCHOLOGICAL ASPECTS

Modern life is highly challenging in terms of psychological pressure and modern man surrenders to various situations and conflicts, from minor events to apparently hopeless psychotraumatic conditions.

Noise is a simple, but extremely important factor that acts on the body; door slamming, falling objects, plumbing defects, wrong calls, all these require a severe, permanent and frequent use of hypnotics. If other sources of noise, pollution are also found in the proximity, a hypnotic tablet is taken in the first days totally accidentally, but one day it might become a necessity.

Hypnotics are often misused as their actions and indications are not well known. Therefore, ordinary toothaches or neuralgia are treated with sleeping pills, in order to induce sleep. It is certain that this goal is not achieved, yet some degree of apparently pleasant ataraxia is experienced and this will be pursued at the earliest opportunity. If in time the ignorant individual, who has achieved spontaneously a special mental sensation, will use products of the type, originally used also in the future to the same end, becoming prone to barbiturate toxicophilia.

TOXICOPHILIA TODAY

Since 1949, World Health Organization strongly drew attention to the danger of addiction tendencies in modern man. Even then, it showed, maybe a little exaggerated, that one person in four is found to be, in one form or another, under the influence of abusive consumption.

This includes also caffeine addiction and smoking, which characterize modern people through their quasi-generalized spread and therefore are considered by many simple habits and not toxicophilia (6).

The phenomenon of medical drug addiction with its serious problems extends beyond the medical field, becoming one of the major problems of contemporary society (6).

Under these circumstances, it is fully justified to discuss this issue, even if not at the same level, but at least, in the same forums where disarmament and pollution, the main concerns of contemporary society at a planetary level.

The general increase of drug use at all levels tends to reach catastrophic proportions and the average age of those affected by this problem decreases rapidly, raising serious problems of mental health for future generations, as maximum interest to drugs during adolescence and youth was found.

Is it fair to refer to the great group of insomniacs as addicts, when they use only the most different substances to get the rest so much needed? However, the path to drugs takes often the most unexpected and unusual ways to expand.

Nine out of ten addicts initially use the drug accidentally, out of curiosity, due to a wish to be entertained and the spirit of imitation, paying the heavy price for a curiosity or a passing pleasure.

SOCIOPREVENTION

It is necessary to explain to the public the danger of the phenomenon of toxicophilia in all its forms, because it is the only way a strong current of opinion against this social peril can be achieved (7).

The most effective means of communication, such as press, radio, TV, scientific papers presented in conferences, round-table discussions and public debates, help fighting all kinds of drug use, by creating a negative image of the world of drugs.

Along with these measures, it is crucial to encourage a healthy lifestyle. The words of Auguste Tournay are still meaningful today: "in order to be able to sleep well, one should have an easy stomach, a quiet conscience and a warm feet".

Physical activity and the movement in its various forms are health-preserving factors which successfully induce sleep.

The proper therapy of potential organic disorders without using hypnotics to treat insomnia secondary to these conditions is also required.

In order to prevent insomnia, it is also recommended to avoid, especially in the evening, nervous stimulants, a hearty or indigestible meal and only relaxing activities.

Modern people are responsible for their chronic intoxication with various drugs and they follow a very dangerous path that actually leads to the degradation of their personality and intellect.

This path seems longer and more distant from us than it really is and it can be avoided by several methods involved in many aspects of human activity that we have tried to describe. Might these methods, taken together, succeed in limiting the continuous growth of severe phenomena of toxicophilia?

We all hope to receive a positive answer. If we can achieve, at first, a minor decrease of drug consumption, this means that we have saved lives of people that the society needs.

Therefore, in order to promote a better health status, we have to stand against the abuse of sleeping pills!

CONCLUSIONS

Even if drug consumption seems to be an everyday aspect of any changing society, an alarming increase of this phenomenon should raise concern and lead to a series of social and legislative activities in order to adequately manage such a phenomenon.

ACKNOWLEDGMENTS AND DISCLOSURES

Authors state that there are no declared conflicts of interest regarding this paper.

REFERENCES

(1.) Molto, J., Radel, C., Drogues. Impact--Internat. Psychiatrie, Sante Publique, 1995, no. 21, p. 115, apud Iustin Lupu, loan Zanc, Sociologie medicala. Teorie si aplicatii, Editura Polirom, 1999, p. 183

(2.) Banciu, D., Radulescu, S., Voicu, M., Introducere in sociologia deviantei, Editura Stiintifica si Enciclopedica, Bucuresti, 1985, p. 58

(3.) Roibu, Al. Mircea, Flagelul drogurilor, Editura Mirton, Timisoara, 1997

(4.) Stroescu, Valentin, Farmacologie, Editura All, Bucuresti, 1999

(5.) Prepeliceanu, Dan, Ghid de tratament in abuzul de substantepsiho-active, editia a Il-a, Editura Informatica, 2002

(6.) Gorun, Gabriel Stefan, Paradisuri artificiale--Toxicomaniile, Editura Viata Medicala Romaneasca, Bucuresti, 2003

(7.) Babor, T. F., McRee, B. G., Kassebaum, P. A. et al., Screening, Brief Intervention, and Referral to Treatment (SBIRT) Toward a Public Health Approach to the Management of Substance Abuse. Substance Abuse, 2007, vol. 28, no. 3, pp. 7--30

Correspondence:

ISABELLA CRISTINA BRU]BU "Apollonia" University, Department of Anatomy No. 2 Str. Muzicii, Iasi, Romania Phone: +40 744 633 927

E-mail: isabeHabrjbu@yahoo.com

Date of Submission: September, 26, 2014/ Acceptance: November, 21, 2014

INTRODUCERE

Somnul si activitatea onirica

De la nou-nascutul care doarme uneori 20 din 24 de ore la adultul care nu poate concepe viata fara somnul odihnitor, revitalizator al energiilor consumate in cursul celor mai diferite activitati, nevoia de somn este ubicuitara si reprezinta, in ultima instanta, o conditie a existentei umane.

Obtinand energia necesara aspiratiilor sale dupa un somn reconfortant, in decursul existentei sale multimilenare, omenirea a crezut in odihna si somn. A cautat sa doarma si mai mult si mai bine, acest fapt constituind, poate, o dovada a sanatatii sale fizice si psihice.

In contextul actiunii tot mai intense a fenomenului general al acceleratiei, omenirea traieste intr-o cvasipermanenta criza de timp, astfel ca multe dintre realizarile fiecaruia dintre noi afecteaza timpul destinat somnului.

Somnul, pana nu demult, alaturi de corolarul sau atat de necunoscut--visul, a fost invaluit intr-un mister de nepatruns, leagan al fanteziei si superstitiilor. Somnul ratiunii ce zamisleste monstri a fost, se pare, doar o fericita "gaselnita" plastica a unei stari de fapt.

In ultimul timp, omenirea incepe sa-si dezvaluie o mare parte dintre tainele activitatii onirice, incepe sa inteleaga structura, mecanismele, fiziologia, bioritmurile somn--veghe, iar inregistrarile electroencefalografice ii ofera date de o complexitate de neimaginat cu catva timp in urma.

Or, aceasta omenire, care traieste din plin impresionantul proces general al progresului in toate domeniile, se vede antrenata in ritmul tot mai accelerat al dezvoltarii, pierzand tocmai somnul, in tainele caruia abia incepuse sa patrunda si din care isi facuse, in decursul existentei sale, un adevarat mit.

Se admite ca numai o buna organizare a somnului in ciclurile si stadiile existente, inclusiv o normala activitate onirica, ii imprima acestuia un caracter cu adevarat reconfortant, odihnitor. Si cu toate acestea, insomnia devine dintr-un banal simptom o adevarata boala a civilizatiei.

Somnul in coordonate cifrice

In practica medicala se intalnesc frecvent cazuri de falsuri insomnii, mai precis indivizi care afirma ca nu dorm, dar la care inregistrarile poligrafice evidentiaza un somn cantitativ normal, dar dezorganizat, cu preponderenta stadiilor de somn superficial asupra celui profund.

In general, durata somnului este in jur de sase --opt ore. Somnul este format din unitati disparate care au, la randul lor, o durata de 80-120 minute, constituite dintr-o perioada de somn lung si una de somn paradoxal. Aceste unitati sunt despartite prin scurte faze de tranzitie, cand somnul devine superficial si individul se poate destepta dupa doua--trei minute. Trecerea fara trezire peste aceste scurte perioade de tranzitie creeaza impresia de somn adanc, profund, care nu este cu nimic superior in ceea ce priveste refacerea generala a potentialului psihofiziologic.

Psihopatologia somnului

Hiposomnia, incorect denumita insomnie (termen care s-a impus), este fenomenul cel mai des intalnit in patologia generala si, in special, in cea neuropsihica. Din pacate, prin frecventa sa, s-a ajuns ca insomnia sa fie definita drept un impediment al societatii moderne.

Intensitatea insomniilor este foarte variata: de la alternanta noptilor bune cu cele rele la existenta unor lungi perioade de insomnii. Urmarile acesteia sunt dintre cele mai importante pe plan cerebral, electroencefalografic, comportamental si psihic. Unii oameni adorm greu, necesitand folosirea unor produse cu actiune scurta de inducere a somnului, in timp ce altii au un somn cu o durata scurta, deci au nevoie de produse care sa le prelungeasca durata somnului.

Hipnoticele

Drogurile si preparatele hipnotice sunt utilizate atat din propria initiativa a pacientilor, cat si in urma diferitelor prescriptii medicale. Se ajunge astfel, astazi, in intreaga lume, la un consum imens de substante hipnotice; acestea sunt droguri sau preparate care au ca efect caracteristic inducerea si mentinerea somnului.

Progresele generale ale chimiei de sinteza, cu imediata lor aplicabilitate in industria farmaceutica, au dus la o crestere marcanta si a numarului de substante cu actiune hipnotica, dintre care barbituricele s-au detasat in mod deosebit.

Barbituricele sunt substante cu actiune sedativhipnotica, numarandu-se printre primii agenti farmacologici cu aceasta actiune (4). Barbituricele au inceput sa fie utilizate inca de la inceputul anilor 1900, insa popularitatea lor a atins cote maxime in anii 1960-1970, in special in tratamentul anxietatii, insomniei si epilepsiei, dar si ca substante de abuz (in principal datorita efectului anxiolitic, de reducere a starilor inhibitorii generale).

Substantele barbiturice sunt utilizate in terapie pentru actiunea lor de inhibare a sistemului nervos central prin potentarea si prelungirea actiunii unor neurotransmitatori cu efect inhibitor pe sistemul nervos central, precum si prin blocarea receptorilor unor substante neuroexcitatorii.

Cu ajutorul lor se poate obtine orice grad de deprimare a sistemului nervos central: de la o sedare usoara pana la coma profunda. Actiunea inhibitoare centrala este utilizata pentru producerea linistirii, provocarea somnului, inhibarea convulsiilor sau instalarea anesteziilor in practica chirurgicala. Cu toate acestea, ele sunt utilizate mai mult pentru producerea somnului. Administrandu-se doze corespunzatoare, cu oricare substanta barbiturica se produce somnul intr-un interval de 20-40 de minute. Acesta seamana indeaproape cu somnul fiziologic, este lipsit de vise si, de regula, este odihnitor. Substantele barbiturice accentueaza in parte indiferenta fata de stimulii externi, ajutand prin aceasta somnul natural atunci cand situatia inconjuratoare este favorabila.

Barbituricele inhiba respiratia, datorita efectelor directe asupra centrilor respiratori bulbari. Aceasta actiune este insa proportionala cu doza de barbiturice folosita, de unde deriva si pericolul major in intoxicatia cu barbiturice (moartea prin otravirea cu barbiturice se datoreaza, de regula, insuficientei respiratorii). De aceea, in administrarea substantelor barbiturice, se impune o precautie deosebita in special la bolnavii in varsta si la copii, dat fiind pericolul potential de inhibare a centrilor respiratori.

Barbituricele tind, in mod uniform, sa scada tonusul musculaturii gastrointestinale. Suprimarea diverselor simptome gastrointestinale prin dozele sedative se poate atribui, in mare masura, si actiunii inhibitorii centrale.

DE LA UZUL LA ABUZUL DE BARBITURICE

Majoritatea drogurilor psihotrope altereaza somnul, producand, dupa abandonarea acestora, fenomene de sevraj.

Tratamentele irationale cu hipnotice si in special cu barbiturice atat de iubite, dar atat de necunoscute sub aspectul efectelor secundare de catre marele public, produc serioase distorsiuni ale profilurilor normale de somn--veghe, iar la sevraj reapar frecvent insomnii rebele, somnul fiind dominat de activitate onirica. In aceste conditii, creste intensitatea si frecventa viselor si a cosmarurilor, determinand, in final, un nivel maxim de anxietate, cu mult mai mare rasunet decat banala insomnie pentru care se administrase initial narcoticul.

Toate fenomenele psihopatologice culmineaza cu aparitia si evolutia fenomenelor de dependenta, glisand mai apoi catre toxicomania barbiturica.

Toxicomania reprezinta o stare de intoxicatie cronica sau periodica in detrimentul individului si al societatii, provocata de administrarea repetata a unor medicamente. Citandu-i pe J. Molto si C. Radel (1), autorii Sociologiei medicale sustin ca, "fara indoiala, nu exista o etiologie pentru toxicomanie, ci (...) o serie de factori care adeseori coexista". Caracteristicile sale sunt impulsiunea de a continua ingerarea medicamentului, cresterea dozei, precum si o dependenta psihica si uneori fizica fata de respectivul drog.

Toxicomaniile par sa fie cancerul care suprima nu numai organismul consumatorului de droguri, dar si/mai ales psihicul acestuia, prin dezorganizarea tragica a personalitatii umane (1).

Intoxicatia medicamentoasa cronica reprezinta cea mai frecventa modalitate a toxicomaniei hipnotic-barbiturice, a carei evolutie in timp trece prin fazele de obisnuinta, dependenta si, in final, poate sa ajunga la degradarea persoanei. (2) Dependenta se instaleaza in decurs de cateva luni, mai ales in randul persoanelor labile, dupa tensiuni, esecuri si traume psihice.

Numarul toxicomanilor, initial relativ mic, aparut dupa Primul Razboi Mondial, cunoaste astazi o crestere continua, punand mari probleme de viitorologie sociala.

Prin urmare, in general, intoxicatia cronica barbiturica se caracterizeaza printr-o serie de fenomene de ordin psihic, neurologic si somatic.

Barbituricele au o actiune depresiva asupra sistemului nervos central. Dozele mari produc depresia centrilor respiratori si cardiovasomotori bulbari, determinand aparitia unor tulburari respiratorii si cardiovasculare grave. Acestea actioneaza, de asemenea, si asupra centrilor termoreglarii, producand hipotermie. Actiunea barbituricelor este potentata de asocieri cu analgezice, psiholeptice si alcool etilic.

Fenomenele psihice se caracterizeaza prin lipsa de energie, neglijarea profesiei, ingustarea sferei intereselor cu preocuparea constanta pentru procurarea drogului, pierderea treptata si extrem de marcata a constiinciozitatii, mari tulburari de memorie si atentie, labilitate emotionala, cu accentuata tendinta catre sinucidere. Pe acest fond pot aparea uneori fenomene de psihoza toxica acuta, cu sindrom confuzional si fenomene delirant halucinatorii.

Fenomenele neurologice se caracterizeaza prin vorbire greoaie, neclara. Pot aparea si fenomene oculare, cum ar fi nistagmus, diplopie, strabism cu greutate in acomodare, ameteli, hipotonie generalizata.

In cazul persoanelor dependente de drog, abtinerea devine extrem de alarmanta, in mare, aceasta fiind similara cu fenomenele psihopatologice intalnite in delirium tremens.

Se caracterizeaza prin tremuraturi, halucinatii, delir, greturi, febra, deshidratare, tahicardii, convulsii care apar, de obicei, in momentul intreruperii administrarii drogului la o persoana devenita toxicomana (6).

SLALOM SOCIOPSIHOLOGIC

Viata moderna este extrem de consumptiva din punct de vedere nervos, omul zilelor noastre capituland la cele mai diferite situatii si conflicte, de la fapte minore si pana la stari psihotraumatizante aparent fara iesire.

Un factor simplu, dar cu rasunet extrem de important asupra organismului il constituie zgomotul; usi care se trantesc, obiecte care cad, instalatii sanitare defecte, apeluri telefonice gresite, toate acestea impun un drastic, permanent si frecvent consum de hipnotice. Iar daca prin apropiere se gasesc si alte surse de poluare sonora, o tableta hipnotica este luata si astazi, si maine, cu totul accidental, pentru ca intr-o buna zi sa ne trezim ca a devenit o necesitate.

Adesea hipnoticele sunt folosite in mod gresit, necunoscandu-li-se corect actiunile si indicatiile. Astfel, nu putine sunt cazurile cand pentru o banala durere de dinti sau nevralgie, se folosesc si somnifere pentru a induce somnul. Ca bolnavul nu realizeaza acest deziderat este un fapt cert, dar se obtine un oarecare grad de ataraxie, aparent placuta, care va fi cautata si cu proxima ocazie. Si cand, in timp, individul neavenit a realizat spontan, pe plan mintal, o senzatie aparte, va folosi si pe viitor in acelasi scop un produs de tipul celui folosit initial, inscriindu-se din acest moment pe orbita teoretica a toxicofiliei barbiturice.

TOXICOFILIA AZI

Inca din 1949, Organizatia Mondiala a Sanatatii atragea in mod ferm atentia asupra pericolului reprezentat de tendintele toxicomanice ale omului modern. Se arata inca de atunci, poate putin fortat, ca o persoana din patru se gaseste, sub o forma sau alta, sub influenta unui consum abuziv.

Se include aici si cafeinomania, si tabagismul, devenite, prin raspandirea lor cvasigenerala, caracteristici ale omului modern, din aceasta cauza, fiind considerate de multi simple obiceiuri si nicidecum toxicofilii (6).

Fenomenul toxicomaniei medicamentoase, prin gravele probleme pe care le ridica, depaseste cu mult domeniul medical, impunandu-se realmente ca una dintre problemele majore ale contemporaneitatii (6).

In aceste conditii este pe deplin justificata discutarea acestei probleme, chiar daca nu de pe aceleasi pozitii, dar cel putin in aceleasi foruri unde se discuta dezarmarea, poluarea, fapte care atesta preocuparile prioritare ale societatii contemporane la nivel planetar.

Cresterea generala a consumului de droguri, sub toate aspectele, tinde sa atinga proportii catastrofale, iar media de varsta a celor cuprinsi de acest flagel scade intr-un ritm vertiginos, ridicand, pentru generatiile viitoare, problema sanatatii mintale, deoarece s-a constatat o maxima receptivitate fata de droguri in perioada adolescentei si tineretii.

Referindu-se la marea grupa a insomniacilor, care iau cele mai diferite substante pentru a obtine astfel, sau numai astfel, odihna atat de necesara, este oare corect sa vedem in acestia niste eventuali toxicomani? Dar drumul intortocheat al drogului imbraca, de cele mai multe ori, cele mai neasteptate si mai neobisnuite moduri de a se extinde.

Noua din zece toxicomani folosesc initial, cu totul intamplator, drogul, din curiozitate, dorinta de divertisment, spirit de imitatie, platind un pret incomensurabil unei curiozitati sau placeri de o clipa.

SOCIOPROFILAXIA

Este obligatoriu sa evidentiem dimensiunea integrala a pericolului prezentat de fenomenul toxicofil, sub toate aspectele sale, in fata opiniei publice, pentru ca numai astfel este posibila crearea unui puternic curent de opinie impotriva acestei adevarate racile sociale.

Mijloacele de propaganda cele mai eficace reprezentate de presa, radio, TV, expunerile specialistilor prin conferinte, mese rotunde si dezbateri publice etc., toate acestea ajuta in lupta impotriva drogului de orice natura, prin crearea unei adevarate imagini a nefastei lumi a drogului.

Alaturi de aceste masuri, se impune cu necesitate aplicarea unui mod sanatos de viata. Astfel, butada lui Auguste Tournay isi gaseste si astazi o integrala valabilitate: "pentru a putea dormi bine trebuie sa avem stomacul usor, constiinta linistita si picioarele la caldura".

Activitatea fizica, miscarea sub diferitele sale forme, constituie un factor sanogenetic, stimulator pentru obtinerea unor rezultate cu totul spectaculoase de inducere a somnului.

De asemenea, se impune tratarea corecta a eventualelor tulburari organice, fara a folosi hipnotice pentru rezolvarea insomniei secundare din cadrul acestor suferinte.

Pentru prevenirea insomniilor se recomanda, de asemenea, evitarea, mai ales seara, a excitantelor nervoase, a unei mese copioase sau indigeste, iar ca activitati sunt indicate numai cele relaxante.

Omul modern, vinovat al intoxicatiei sale cronice cu cele mai diferite droguri, merge pe un drum extrem de periculos, care duce, de fapt, la degradarea personalitatii si a intelectului sau.

Acest drum, care pare mai lung si mai departat de noi decat este in realitate, poate fi evitat printr-un cumul de metode ce vizeaza multe aspecte ale activitatii umane si pe care, in parte, am incercat sa le elucidam. Vor fi oare aceste metode, totalitar luate, eficiente in ingradirea expansiunii gravelor fenomene toxicofile?

Speranta noastra, a tuturor, este un raspuns pozitiv. Si daca vom obtine, pentru inceput, o reducere minora a consumului de droguri, inseamna ca am salvat niste oameni utili societatii.

De aceea, pentru a promova o stare de sanatate cat mai prospera, sa spunem un NU hotarat abuzului de somnifere!

CONCLUZII

Chiar daca consumul de droguri pare sa reprezinte un aspect cotidian al oricarei societati aflate in schimbare, cresterea alarmanta a acestui fenomen trebuie sa atraga atentia si sa genereze o serie de activitati sociale si legislative care sa gestioneze adecvat un astfel de fenomen.

Isabella Cristina Brujbu--M. D., Ph. D., Senior Doctor Family Medicine--Private Practice; Assistant Professor, Faculty of Dental Medicine, "Apollonia" University, Iasi, Romania

Luana Macovei--M. D., Ph. D., Assistant Professor, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi; Department of Internal Medicine, Physician, Department of Rheumatology, Rheumatology, Rehabilitation Hospital, Iasi, Romania

Eduard Iulian Dobos--Master Student, Faculty of Economics and Business Administration, Management and Human Resources Development, "Alexandru Ioan Cuza" University, Iasi, Romania

Isabella Cristina Brujbu--M. D., Ph. D., Medic Primar, Medicina de Familie in practica privata; Sef de Lucrari, Catedra de Anatomie, Facultatea de Medicina Dentara "Apollonia", Iasi, Romania

Luana Macovei--M. D., Ph. D., Sef de Lucrari, Departamentul de Medicina interna/Reumatologie, Universitatea de Medicina si Farmacie "Grigore T. Popa", Iasi; Spitalul de Recuperare, Iasi, Romania

Eduard Iulian Dobos--Masterand, Facultatea de Economie si Administrarea Afacerilor, Managementul si dezvoltarea resurselor umane, Universitatea "Alexandru loan Cuza" Iasi, Romania

MULTUMIRI SI DEVOALARI

Autorii declara ca nu au potentiale conflicte de interese declarate in legatura cu acest articol.

BIBLIOGRAFIE

(1.) Molto, J., Radel, C., Drogues. Impact--Internat. Psychiatrie, Sante Publique, 1995, no. 21, p. 115, apud Iustin Lupu, loan Zanc, Sociologie medicala. Teorie si aplicatii, Editura Polirom, 1999, p. 183

(2.) Banciu, D., Radulescu, S., Voicu, M., Introducere in sociologia deviantei, Editura Stiintifica si Enciclopedica, Bucuresti, 1985, p. 58

(3.) Roibu, Al. Mircea, Flagelul drogurilor, Editura Mirton, Timisoara, 1997

(4.) Stroescu, Valentin, Farmacologie, Editura All, Bucuresti, 1999

(5.) Prepeliceanu, Dan, Ghid de tratament in abuzul de substantepsiho-active, editia a Il-a, Editura Informatica, 2002

(6.) Gorun, Gabriel Stefan, Paradisuri artificiale--Toxicomaniile, Editura Viata Medicala Romaneasca, Bucuresti, 2003

(7.) Babor, T. F., McRee, B. G., Kassebaum, P. A. et al., Screening, Brief Intervention, and Referral to Treatment (SBIRT) Towards a Public Health Approach to the Management of Substance Abuse. Substance Abuse, 2007, vol. 28, no. 3, pp. 7--30

Corespondenta:

ISABELLA CRISTINA BRU]BU Universitatea "Apollonia", Catedra de Anatomie, Str. Muzicii nr. 2, Iasi, Romania Tel.: +40 744 633 927

E-mail: isabellabrjbu@yahoo.com

Primit: 26 septembrie 2014/ Acceptat: 21 noiembrie 2014
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Author:Brujbu, Isabeiia Cristina; Macovei, Luana; Dobos, Eduard Iulian
Publication:Bulletin of Integrative Psychiatry
Article Type:Report
Date:Dec 1, 2014
Words:4987
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