Intervensi Farmakologi Sindrom Putus Obat pada Penyalahguna Opioid

Nisa Maria; Larasati A. Kusumawardani; Farah S. Salahuddin

doi:10.15416/ijcp.2021.10.4.330

Intervensi Farmakologi Sindrom Putus Obat pada Penyalahguna Opioid

Nisa Maria, Larasati A. Kusumawardani, Farah S. Salahuddin

Abstract

Sindrom putus obat opioid terjadi setelah penghentian konsumsi opioid secara-tiba-tiba, dengan gejala seperti mata dan hidung berair, nyeri pada tulang atau sendi, ansietas, kondisi kedinginan atau kepanasan, dilatasi pupil, menguap, gangguan gastrointestinal, dan peningkatan detak jantung. Penyalahgunaan opioid masih menjadi masalah utama di dunia, sehingga penanganan terhadap sindrom putus obat pada penyalahguna opioid yang tepat sangat diperlukan, terutama penanganan farmakologi. Penelusuran artikel ini bertujuan untuk menelusuri, mengetahui, dan menganalisis manajemen pengobatan farmakologi yang diberikan kepada pasien yang menyalahgunakan opioid. Pemilihan dan penelusuran artikel ini dilakukan pada PubMed, Sciencedirect, dan SpringerLink, menggunakan kata kunci opioid withdrawal syndrome treatment dengan kombinasi kata kunci lain heroin, fentanyl, morphine yang diseleksi berdasarkan batasan yang telah ditetapkan. Berdasarkan hasil penelusuran, ditemukan sebanyak 21 artikel yang dipublikasi tahun 2015–2020, dengan kebanyakan merupakan penyalahgunaan heroin. Terapi farmakologi utama yang diberikan pada penyalahguna opioid adalah terapi substitusi baik golongan opioid maupun non-opioid yaitu; lofeksidin, naltrekson, buprenorfin, dronabinol, metadon, pregabalin, oksitosin, antagonis corticotropin releasing factor tipe 1 (CRF1), tramadol, klonidin, dan pioglitazon. Selain itu pasien juga dapat diberikan terapi simtomatik sesuai dengan gejala yang muncul. Jenis terapi farmakologi yang dipilih dan keinginan setiap individu untuk menerima pengobatan terhadap sindrom putus obat opioid menjadi faktor yang berperan dalam tingkat keberhasilan terapi, yang terlihat dari penilaian putus obat opioid berdasarkan kriteria objektif, subjektif, maupun klinis.

Kata kunci: Efikasi dan keamanan, ketergantungan opioid, terapi rumatan, terapi simtomatik

Pharmacological Intervention in Opioid Withdrawal Syndromes among Opioid Abusers

Abstract

Opioid withdrawal syndrome appears after abrupt discontinuation of opioids characterized by watery eyes, runny nose, muscle pain, anxiety, yawning, gooseflesh, mydriasis, gastrointestinal discomfort, and rapid heartbeat. Globally, opioid abuse remains a significant problem, necessitating adequate treatment of drug syndrome in opioid addicts, particularly pharmaceutical therapy. Therefore, this study aimed to identify, evaluate, and analyze pharmacological management in opioid abusers. The articles used were retrieved based on specific limitations using the main keywords "opioid withdrawal syndrome treatment" and additional keywords "heroin, fentanyl, morphine" that were published in PubMed, ScienceDirect, and SpringerLink. From the 21 articles included, heroin abuse was the most prevalent. The primary treatment for opioid abuse is substitution therapy of opioid or non-opioid such as lofexidine, naltrexone, buprenorphine, dronabinol, methadone, pregabalin, oxytocin, antagonist corticotropin-releasing factor type 1 (CRF1), tramadol, clonidine, and pioglitazone. Additionally, the patient received symptomatic therapy based on the condition. The drugs used for treatment and willingness to obtain therapy are the factors for the withdrawal completion rate. The results were evaluated using opioid withdrawal assessment, either from a subjective, objective, or clinical perspective.

Keywords: Efficacy and safety, opioid dependence, maintenance treatment, symptomatic therapy

Keywords

Efikasi dan keamanan; ketergantungan opioid; terapi rumatan; terapi simtomatik

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