What You Should Know About Opioids and Painkillers | Body Stuff with Dr. Jen Gunter | TED

Opioids are one of the most commonly prescribed painkillers.

Prevodilac: Una Kavazović Lektor: Milenka Okuka

Opioidi su jedni od najčešće propisivanih analgetika.

From broken ribs to back pain to treating pain after surgery.

Od slomljenih rebara do bola u leđima, pa do ublažavanja bola posle operacije.

But there's a lot of misconceptions around them,

Ali postoji dosta zabluda u vezi s njima,

so it's important to take the time to understand them better.

te je bitno odvojiti vreme da ih razumemo bolje.

[Body Stuff with Dr. Jen Gunter]

[„Body Stuff” sa dr Džen Ganter]

The first misconception is that opioids are the best,

Prva zabluda je da su opioidi najbolji,

strongest form of pain medication.

najjači oblik analgetika.

But in almost every well-designed study

Ali u skoro svakoj dobro skrojenoj studiji

comparing opioids to anti-inflammatory drugs such as ibuprofen,

koja poredi opioide sa antiinflamatornim lekovima kao što je ibuprofen,

the anti-inflammatories come out on top.

antiinflamatorni lekovi su prednjačili.

From a safety or effectiveness perspective, or both.

Bilo iz sigurnosne ili delotvorne perspektive, ili čak obe.

Let's talk about the effectiveness first.

Hajde da popričamo prvo o delotvornosti.

How do opioids work?

Kako opioidi funkcionišu?

To understand that, we have to first know a little bit about how pain works.

Da bismo to razumeli, prvo moramo znati bar ponešto o tome kako bol funkcioniše.

Pain is our body's way of telling us that something's wrong.

Bol je pokušaj našeg tela da nam kaže da nešto nije u redu.

You stubbed your toe, you burned your hand.

Udarili ste nožni prst, opekli ste šaku.

Pain gives us the message that it's time for us to rest,

Bol nam šalje poruku da je vreme da se odmorimo,

recover and treat the damage.

oporavimo i saniramo štetu.

In the body, pain is created by multiple chemical signals and receptors,

U telu, bol je stvoren od strane više hemijskih signala i receptora,

and different medications can target different parts of that pain pathway.

a različiti lekovi mogu ciljati na različite delove te staze bola.

Medications like acetaminophen, such as Tylenol,

Lekovi poput acetaminofena, kao što je paracetamol,

or nonsteroidal anti-inflammatory drugs,

ili nesteroidnih antiinflamatornih lekova,

also known as NSAIDs, like ibuprofen, aspirin and naproxen,

poznatih i kao NSAIL, poput ibuprofena, aspirina ili naproksena,

all treat pain in different ways from opioids.

svi ublažavaju bol na različite načine od opioida.

Opioids work by binding to and activating the opioid receptors

Opioidi rade tako što se vezuju za opioidne receptore i aktiviraju ih

located throughout the body, blocking pain signals.

duž celog tela, blokirajući signale bola.

This activation also triggers the release of dopamine,

Ova aktivacija takođe izaziva lučenje dopamina,

a hormone associated with pleasure.

hormona vezanog za zadovoljstvo.

So in addition to pain relief,

Tako da pored ublaženog bola,

some people can feel relaxed or even euphoric.

neki ljudi mogu da se osete opuštenim ili čak euforičnim.

In higher doses, opioids can affect cognition and even breathing.

U većim dozama, opioidi mogu uticati na kogniciju ili čak disanje.

But here's a really important point that people often don't know.

Ali evo jako važne stvari koju ljudi često ne znaju.

Opioid receptors can adapt, often in a short amount of time,

Opioidni receptori se mogu prilagoditi, često u kratkom vremenskom periodu,

to expect opioids.

tako da očekuju opioide.

And when a patient doesn’t take them,

I kada ih pacijent ne uzme,

they experience symptoms of withdrawal.

oni osećaju simptome krize.

And withdrawal is very uncomfortable.

A kriza zna biti jako neprijatna.

People can mistake that discomfort

Ljudi zbog tog osećaja neprijatnosti

for thinking the opioids were actually working.

mogu pomisliti da su opioidi zapravo delovali.

And what people don't know is this can happen after just a few doses.

Ono što ljudi ne znaju je da se ovo dešava i nakon samo par doza.

When you're a patient needing relief from pain,

Kada ste pacijent kome je potrebno ublažiti bol,

it can be confusing to know the difference.

može biti zbunjujuće prepoznati razliku.

All you want is to feel normal again.

Samo želite da se osećate normalno.

In this way, opioids, if not used very carefully and intentionally,

Na ovaj način, opioidi, ako se ne koriste veoma pažljivo i namenski,

can create physical dependence.

mogu stvoriti fizičku zavisnost.

They can also paradoxically worsen pain.

Takođe mogu, paradoksalno, da pogoršaju bol.

And there's a risk of developing addiction.

I tu je rizik stvaranja zavisnosti.

There's nuance here.

Postoji nijansa ovde.

People who have become physically dependent

Oni koji su postali fizički zavisni

often don't even know they are.

često ne znaju da to jesu.

They just know that the opioids seem to be offering relief

Samo znaju da im opioidi izgleda pružaju olakšanje

without realizing that they could actually be contributing to the pain.

i ne shvataju da bi oni zapravo mogli doprineti bolu koji osećaju.

I want to be clear here.

Želim biti jasna ovde.

Opioids can be effective, appropriate therapy,

Opioidi mogu biti delotvorna, prikladna terapija,

but they should be prescribed with great care.

ali ih treba propisivati sa velikom pažnjom.

This is the doctor's responsibility.

To je odgovornost doktora.

Here's some advice so you can be an educated patient.

Evo nekoliko saveta kako biste bili upućen pacijent.

If you or a loved one experience acute pain,

Ako vi ili vaši bližnji osećate akutni bol,

ask to explore alternatives to opioids like Tylenol,

zatražite da probate alternative za opioide kao što su paracetamol,

NSAIDs, muscle relaxants and physical therapy.

NSAIL, miorelaksansi i fizikalna terapija.

If your doctor doesn’t bring those up first,

Ako vaš doktor to ne pomene sam,

and if you or a loved one are prescribed opioids,

i ako su vama ili vašim bližnjima propisani opioidi,

make sure your doctor has a plan to taper you off,

postarajte se da doktor ima plan kako smanjiti unos,

accounting for the risk of dependence.

uzimajući u obzir rizik od zavisnosti.

And finally, ask for naloxone.

I konačno, zatražite nalokson.

This is a drug that can reverse opioid overdose.

Ovo je lek koji može poništiti predoziranje opioidima.

It can be easy to forget if you’ve taken a dose,

Može biti lako zaboraviti da li ste već uzeli svoju dozu,

and you never know who in your household could take your medication.

i nikad ne znate ko u vašoj kući može uzeti vaše lekove.

Naloxone can literally save a life.

Nalokson doslovno može spasiti život.

Remember, when it comes to pain,

Zapamtite, kada je u pitanju bol,

opioids are not always the most effective way to safely offer relief.

opioidi nisu uvek najdelotvorniji način da sigurno osetite olakšanje.

And when they are prescribed,

A kada su propisani,

they should always be prescribed with a plan.

uvek bi trebalo da budu propisani planski.