CODEINISM

From Big Medical Encyclopedia

CODEINISM — the form of drug addiction, at a cut a subject of addiction serves codeine. Separate messages on a possibility of abuse of codeine appeared at the end of 19 century. To. — the least common form of opium drug addiction since receiving drug is unprofitable to underground production: codeine (see) develop from more valuable drug — morphine. To get drug, addicts go on crimes — thefts in the state production, simulation of the diseases demanding purpose of drug. To. increases when distribution of other opiates is taken under control. «Epidemics» To. are registered in 1931 in Canada and in 1933 in the USA after sharp restriction of legal use of heroin and morphine and to the organization of trade in these opiates in the black market.

The clinical picture

Euphoric effect of codeine is shown at reception 3 — a 5-fold therapeutic dose and differs from effect of other opiates in the expressed effect psychophysical. stimulations. Intoxication is followed by gaiety, feeling of ease, an elation, desire to speak, communicate, work, an itch in an upper half of a trunk, feeling of a pleasant skin pricking, the waves of heat extending from a stomach and a waist up. Reddening and puffiness of face skin, neck, dryness of mucous membranes, narrowing of pupils, tachycardia, raising of the ABP and muscle tone, increase in tendon jerks is objectively observed. There are no lacks of coordination. Intoxication lasts 5 — 6 hour. The need for a dream is reduced to 3 — 4 hours a day, appetite falls, constant locks are noted.

The first symptom of a disease is increase of administration of drug, euphoric stimulating psychophysical. action to-rogo weakens each time and becomes less long, the itch, a hyperemia and puffiness of skin decreases. The patient increases doses for achievement of former effect. Duration of a dream and activity of intestines are recovered, but appetite remains reduced, the patient considerably grows thin. If there was an inclination to alcohol, then it often is replaced by disgust. There is a conscious inclination to codeine and understanding that a state mental and physical. comfort perhaps now only in an ebrietas. The way of life, acquaintances change so that it was possible to provide regular administration of drug. The abstinence syndrome develops on 4 — the 6th month of regular consumption of codeine. It is qualitatively similar to an abstinence syndrome at morphinism (see), but differs in smaller sharpness and bigger duration (to 3 — 4 weeks in the absence of the medicamentous help), dominance of the dispeptic phenomena and relative softness of affective frustration and muscular pains. At long disease the abstinence syndrome changes: dacryagogue, cold, muscular pains disappear, also the hypomyotonia, sharp weakness, a depression is noted vascular. At height of a disease the dose of codeine can reach 3,0 — 4,0 g a day at 4 — 5-fold reception. Portability of drug begins to decrease on 3 — the 5th year of a disease of subjects rather, than the previous doses were higher. The former amount of codeine makes sick, headaches, weight in a stomach, mental discomfort, a dysphoria. The depression does not differ in considerable depth, the feeling of powerlessness is most characteristic of it. Patients reside in gloomy, sometimes spiteful mood with the expressed hostility to all surrounding, they do not feel safe anywhere.

Effects To. are the general psychophysical. exhaustion similar with observed at a morphinism, but coming rather, disability, social degradation of the personality. Dementia is not characteristic. Organic and funkts, the pathologies specific for To., it is not revealed.

The diagnosis

the Diagnosis is made on the basis of the anamnesis, interest of the patient in receiving codeine, the social degradation inherent to addicts. The differential diagnosis should be carried out with a morphinism, for to-rogo traces of intravenous injections, an obliteration of veins, a smaller progrediyentnost of a disease are characteristic; distinctions in psychophysical. the status are insignificant. At establishment of the diagnosis To. it is necessary to exclude a probable additional narcotization.

Treatment

Treatment is carried out in the conditions of a psychiatric hospital. Break of reception of codeine single-step. At any stage of a disease it is shown glutaminic to - that in a dose to 10,0 — 12,0 g a day, small doses of insulin. In an onset of the illness, against the background of the high tolerance and abstinent symptomatology reflecting excitement of c. N of page, good effect give aminazine, Tisercinum, amitriptyline. Eventually at increase of exhaustion need of purpose of the means toning cardiovascular system increases.

See also Drug addiction .



Bibliography: Kuznetsov A. I. To a question of a codeinism, Zhurn, a neuropath, and psikhiat., t. 57, appendix, page 65, 1957; Pyatnitskaya I. N. Clinic of a kodeinomaniya, in the same place, t. 66, century 5, page 757, 1966; Tadtayev A. V. To a question of dynamics of toxicomanias, in book: Probl, alcoholism, under the editorship of B. M. Ne-zhentsev, page 55, L., 1968; Shamoian S.A. of Codeine and glutethimide, euphoretic, addicting combination, N. Y. St. J. Med., v. 75, p. 97, 1975.


And. H. Pyatnitskaya.

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