लागु औषधी दुर्ब्यसनी तथा उपचार (drug abuse in nepal)

Nffu' cf}ifwL b'Jo{;gL tyf pkrf/

lztf/fd !^ jif{sf] s]6f xf] . pm cfO{=P:;L k9\b} 5 . pm 5fqjf;df a:5 . o;=Pn=;L= df p;sf] /fd|f] c+s 5 t/ xfn p;sf] k9fO{ cToGt gfh's cj:yfdf k'u]sf] 5 . p;n] sIffx? 5f]l8 aflx/ 8'N5 . p;sf] afj', cfdf, 5f]/f]sf] jfgL b]v]/ lrlGtt5g\ . pm klxn] eGbf w]/} k};f dfU5 cg]s jxfgfdf 3/jf6 k};f dflu 8«u lng] u5{ . sof}+ k6s p;n] k};f 3/jf6 rf]¥of] . jfj' cfdfnfO{ p;sf] 8«u vfg]jfgL yfx 5}g,  plgx?nfO{ 5f]/fn] lsg k};f w]/} dfU5 eGg] dfq rf;f] 5 . p ;fyLefO{sf] s'ntdf km:of] . klxn] lzj/fqLdf ufFhf vfg ;'? u¥of] . To;}n] Brawn Sugur, Nitrazepam, Bupernorphine, Diazepam cflb cf}iflw ;]jg ug{ nfUof] . p;sf] /ut hfFr ubf{ HIV positive cfPsf] 5 h'g cToGt vt/gfs hLjg lng] /f]u xf] . clxn] p;nfO{ c:ktfn egf{ ul/Psf] 5 / p;nfO{ 8fS6/sf] ;Nnfx cg';f/ cf}iflw lbO{ tL nfu' cf}iflwjf6 6f9f /flvPsf] 5 . p;nfO{ ;fOsf]y]/fkL klg lbOPsf] 5

To:t} sfG5f tdfª sIff !) df k9\5g\ . pgn] unt ;fyLsf] ;+utaf6 ufFhf vfg l;s], la:tf/} cGo 8«u, lx/f]O{g cfbL cf}iflw lng nfu] . pgL la:tf/ la:tf/ sIffdf cg'kl:yt x'g nfu] . 3/af6 laleGg axfgfdf /sd dfuL 8«u ;]jg ug{ nfu] . pgL km]n eO{ :s'n klg 5f8] . xfn pgnfO{ c:ktfndf 8«u 5'6fpg pkrf/ eO{/x]sf] 5 . klxnf] lbgdf pfnfO{ 56kl6 eof] t/ bf];|f] lbgk5L pgsf] cj:yfdf ;'wf/ cfPsf] 5 . pgnfO{ 8«u lng} dg gnfUg] cf}iflw lbg] of]hgf c:ktfnsf] 5 . clxn] pgLdf 8«u lng] dflg;nfO{ glng] pkfP l;sfpg]  larf/ klg cfPsf] 5 . pgL eG5g d lau|]sf] dflg; ;'w|sf] 5', ca bfh' efO{nfO{ o; s'ntdf gkm:g ;d]t ;NNffx lbG5g .

g]kfndf nfu' cf}ifwL tyf /S;L lkpg] ;d:of j9\bf] 5 . nfu' cf}ifwL ;]jg ug]{ jfgLnfO{ drug abuse -8«u Pljo'h_ elgG5 . vf;u/L xfO{ :s"n / SofDk; k9\g] ljBfyL{x? of] ;d:ofaf6 k|efljt b]lvG5g\ .

       sltko nfu'kbfy{ b"Jo{;lgsf dflg;x? of}g /f]uaf6 lkl8t x'G5g\ h:t} P8\;, x]kf6fOl6; ælaÆ cflb . o:tf dflg;x?nfO{ cf}iflw lsGg cg]sf} h3Go ck/fwdf d'l5osf x'G5g\ . sl/a !)Ü b"Jo{;gLx? nfu' cf}iflw a]Rg] sfd u5{g . Ps ltxfO{ b"Jo{;lgx? JolQmTjsf] ;d:of klg b]lvG5 . nfu' cf}iflw b"Jo{;lgnfO{ pkrf/ ug]{ s]lx pkrf/ s]Gb|n] pkrf/ ug]{ lgx'Fdf 8fS6/sf] ;Nnfx ljgf cf}iflw vfg lbg] / hl6n cj:yf ePkl5 c:ktfn Nofpg] u/]sf] e]l6Psf] 5 .

       k6s k6s nfu' cf}iflw lng] x'gfn] o:tf dflg;sf] lbdfu ;':t x'g] / cGo dfgl;s /f]u nfUg uO{ czSt x'G5g\ . 3/kl/jf/df e'm6f] af]ln k};f dfUg] / ToxL /sd 8«udf vr{ ug]{ u5{g .

       g]kfndf 3/ 5fqfjf;df a;L k9g] ljBfyL{x?df nfu' cf}ifwL lng ;'? u/]sf] k|df0f k5L e]l6Psf] 5 . o;df cleefjs / lzIfssf] rgfvf] x'g'kg]{ b]lvG5 . sltko cfdfafa'n] 5f]/f5f]/LnfO{ 5f8f 5fl8lbbFf klg nfu' cf}iflw lng] k|j[lt e]l6Psf] 5 . b"Jo{;gL /f]Sg ;dfh tyf ;/sf/sf] klg bfloTj /x]sf] x'G5 .

g]kfndf nfu' cf}ifwL b'A{o;lgsf] ;d:of hl6n ag]sf] 5 . sf7df08f} pkTosf tyf t/fO{sf ef/t;+u l;df hf]l8Psf ;x/x? k|d'v ?kdf b'A{o;lg ul/g] 7fpFx? x'g . vf; ul/ :s'n k9\g] pd]/ jf sn]h k9\g] laBfyL{x?df of] ;d:of ;'? x'G5 t/ h'g ;'s} pd]/sf hftLklg o;df km;]sf] b]lvPsf] 5 . sl/a !)Ü b'A{o;lgx? nfu' cf}iflw  a]Rg] sfd klg ub{5g . dlgfsf] $, % xhf/ b]vL @ nfv ;Dd nfu' cf}iflwdf vr{ ug]{ u/]sf] lkl8tx? atfpF5g\ .

dflg;x? s;/L b'A{o;lgdf  km:g k'U5g\ <

·     v/fa ;flyefO{sf] ;+ut

·     cfdfafa'n] 5f]/f 5f]/LnfO{ jf:tf gub{f

·     5f]/f 5f]/LnfO{ a9L lgoGq0f(over protection) ubf{

·     nfu' kbfy{ ;lhn} ;+u pknAw x'Fbf

·     dflg;sf] v/fa AolQmTj

·     gofF s'/f cg'ej ug{ vf]Hbf afgL a:gfn]

·     nfu' kbfy{sf] g;fsf] v/fa c;/ af/] yfxf gx'Fbf

·     dfgl;s /f]uaf6 u|;Lt x'Fbf

·     dgf]/~hgsf] ;fwgsf] ?kdf lnFbf, k5L z/L/nfO xfgL x'g] s'/f yfxf gx'Fbf

·     afa' cfdf lab]z uO{ a:bf jf kfl/afl/s lav08g x'Fbf

s'g s'g nfu' cf}iflw k|of]u ul/G5g\  <

• Heroin (lx/f]Og)- (Brawan Sugar, White Sugar) .
• Cough Syrup -skm l;/km_ .
• Canabis -ufFhf_ .
• Cocaine -sf]sfOg_ .
• Nitrazepam -gfO6«fh]kfd_, diazepam -8fOlhkfd_ .
• Tidegesic -l6l8h]l;s_ .
• phencyclidine -km]g;fOSlnl8g_ .
• h'Qf 6fF:g] ud .

s;/L afgL j:5 <

             vf; u/L nfu' kbf{y ;fyL efO{sf] ;+utn] ubf{, cfgGb lng] afxgfdf o:tf cf}iflw ;]jg ub{5g\ . hj #–$ lbg lnG5g\ tj afgL j:5 -dependence_ x'G5g . g]kfndf 3/df j:g] ljBfyL{ eGbf 5fqfjf;df j:g] ljBfyL{x?df of] ;d:of j9L kfOPsf] 5 .

s'g s'g tl/sfjf6 lnG5g <

skm l;/km, Nitrazepam, Diazepam cflb cf}iflw d'v jf6 vfG5g\ . a|fpg ;'u/ pull ub{5g\ . h;nfO{ r]lhª elgG5 . ufFhf r'/f]6 lkP h:t} u/L lkp5g\ . a|fpg ;'u/ -lx/f]Og_ OGh]S;g sf] ?kdf klg k|of]u u5{g . h'Qf 6f:g] Ulnp ;F'3/] lnG5g .

nfu' cf}ifwL b'A{o;lgdf s:tf dflg; a9L km:5g\ <

·      3d08L :jefj ePsf (personalitility disorder)

·     3/  5f8L 5fqaf;df a:g] :s'n, sn]hsf laBfyL{

·     !% b]vL @% aif{f o'jfo'ltx?

·     v/fa ;+ut ug{ k'u]sf o'jfo'jltx?

·     cfdfafa'af6 clrt k|f]T;fxg / lgb]{zg gkfPsf dflg;x?

      nfu' cf}ifwL a]Rg] AolQmx? k5L uP/ cfkm' klg 8«u lng ;'? ub{5g\ .

      sl/j @% b]vL %) Ü ;Dd nfu' cf}ifwL lng] AolQm P8\;af6 lkl8t x'g] u/]sf] Ps ;j]{If0fn] b]vfPsf] 5 .

s:tf] dflg;df nfu' cf}iflw lnPsf] eGg] z+sf ug]{ <

·     laleGg axfgfdf  k};f dfUg] jf w]/} vr{ eof] eg]  jf 3/df k};f dfu]df .

·     3/sf kl/jf/;+u 3'nd]n x'g g?rfpg]

·     a9L l/;fpg]

·     laleGg ?kdf ;flyx?;+u 3/af6 aflx/ lg:sg] / l9nf 3/ cfpg]

·     5fqfaf;df a;]tfklg k9fO{df k|ult gx'g]

·     :s'ndf sIffdf cg'kl:yt /xg]

·     kfv'/fdf ;'O{ nufPsf] 3fp klg b]Vg ;lsG5 .

s] vt/f x'G5 <

nfu' cf}iflw ;]jg ugf{n] cf}iflw d:lt:sdf k|ToIf tyf ck|ToIf ?kdf k'Ug] x'gfn] dfgl;s /f]u nfU5g . ;+sf nfUg], 8/ nfUg], sfgdf cfjfh cfpg], l8k|];g x'g] cflb ;d:of b]lvG5 . dflg;n] b}lgs sfd ug{ ;Sb}g, l/;fx aG5 . OGh]S;gjf6 cf}iflw ln+bf x]kf6fOl6; jL tyf P8\; h:tf /f]u nfUb5 .

o;jfx]s ;'O{ ;f+6f ;f+6 ubf{ jf zf/Ll/s ;Dks{ ubf{ P8\;, x]kf6fOl6; jL tyf ;L= cflb /f]u nfU5 .

pkrf/ s;/L ul/G5 <

   nfu" cf}ifwL lng]nfO{ d"Voto @ lsl;daf6 pkrf/ ul/G5 M

!= cf}ifwL k|of]u (Detoxification)

@= ;fOsf]y]/fkL tyf sfpG;Llnª

ljleGg cf}ifwL lbO{ nfu" cf}ifwL lng] JolQmnfO{ !–$ xKtf ;Dd pkrf/ ul/G5 . o;nfO{ l86Sl;lkms];g elgG5 . nfu" cf}ifwL lng] JolQmnfO{ crfgs cf}ifwL 5f8\bf vt/f klg x'g ;S5, To;}n] ;§fdf csf]{ cf}ifwL lbg] rng 5 h'g 8f]h 36fpFb} uOG5 / !,@ xKtfdf aGb ul/G5 . csf]{ tl/sf ;fOsf]y]/fkL xf] h;df ;fOsf]nf]lhsn ;d:of cWoog ul/ pkfo l;sfOG5 jf df]l6le;]g (Motivation) ul/G5 / sfpgl;lnª ul/G5 . sltko lj/fdLdf dfgl;s /f]u nfUg k'u]sf] x'G5 To:tf] ePdf dflg;s /f]usf] pkrf/ klg ul/G5 .

b'A{o;lgnfO s;/L sd ug{ ;lsG5 <

·     b'A{o;lgnfO 8«usf] ;§f cGo cf}iflw lbP/ pkrf/ ul/G5 .

·     xfn nfu' cf}iflw lng dg gnfUg] cf}iflw klg pknAw 5 .

·     b'A{o;lgnfO c:ktfndf egf{ u/]/ dfq pkrf/ ul/G5, cf]=lk=l8= ;]jfaf6 dfq pkrf/ k'/f x'Fb}g .

·     dgf]/~hg lng], lut ufpg nufpg, zf/Ll/s Aofofd u/fpg], dfbn ahfpg nufpg], grfpg] h:tf Relaxation exercise klg u/fpg ;lsG5 .

·     cfTd–lge{/ ug]{ pkfP canDag u/fpg]

·     vfgf agfpg], cfˆgf] efF8f cfFkm} df‰g]  s/];f af/Lsdf sfd ug{ nufpg], elnan, km'6an, r];  cfbL v]ndf efu lng], km'naf/Ldf ;/;kmfO{ ug}{ cfbL .

·     Group thrapy – b'A{o;lgdf km;]sf dflg;x? Pscfk;df cfˆgf lttf cg'ejj af/] 5nkmn ug]{ .

·     sltko b'A{o;lgx? cGo dfgl;s /f]uaf6 klg lkl8t x'G5g To;d] eP dfgl;s /f]usf] pkrf/ klg ug'{ lg]{  x'G5 .

·     sltko P8\;, x]kf6fO6L; aL= af6 klg lkl8t x'G5g , To;f] eP o:tf la/fdLnfO 5'§} /fvL pkrf/ u/fpg' kg]{ klg x'g ;S5 .

·     b'A{o;lgsf la/fdLnfO b}lgs lqmofsnfkdf Ao:t /fVg' kg]{ x'G5 .

·     sltko b'A{o;lgsf la/fdLnfO Harm reduction programme cg';f/ pkrf/ u/fpg' k5{ .

·     sltko b'A{o;lgsf la/fdLx?df Personalitility disorder sf] ;d:of klg x'g ;S5 , o:tf] ca:yfdf pkrf/ ug{ sl7g klg x'g ;S5 .

·     b'A{o;lgsf la/fdLx?nfO{ c:ktfnaf6 l8:rfh{ u/]klg w]/} ;do;Dd la/fdLnfO cf]=lk=l8= df r]s ul/ /xg' kg]{ x'G5 ,h;af6 k'gM s'ntdf km:g] ;+efagf sd /xG5 .

pkrf/df b]lvg] hl6ntf

–    klxnf] @ lbgdf w]/}  h;f]  la/fdLx? æ8«u l;s Æ b]vf  k5{, o; ;dodf cflQg], l/;fpg], 56k6L nfUg], zl// b'Vg], hf]gL{ b'Vg], 5ftL b'Vg], ?3fvf]sL  nfUg] tyf kvfnf nfUg] cflb x'G5 .

–    sltko la/fdLx? cr]t cj:yfdf af]Ng], c:ktfnaf6 efUg], cflb klg ug{ ;S5g\ eg] sltnfO{ t afFw]/ klg /fVg' kg]{ x'G5 .

–    slt la/fdLdf cGo d]l8sn ;f:of klg b]vLG5 . cfFvf kx]Fnf] x'g], /Qm cNktf x'g], zl// ;'GgLg] klg x'g ;S5 To;f] ePdf cGo /f]u klxrfg u/L To;sf] pkrf/ klg ug'{ k5{ .

b'A{o;lg pkrf/ af/] hfGg}kg]{ s'/f 

–                                       pkrf/ u/] b'A{o;lgnfO lgsf] kfg{ ;lsG5 .

–    pkrf/ ug]{ qmddf cfpg] ;fyL;+utn] klg b'A{o;lgnfO nfu' cf}ifw lbg ;S5g\ .

–  sltko b'A{o;lgx?df AolQmTjsf'] (Personality disorder) klg ;d:of x'G5 . o:tf] cj:yfdf pkrf/  sl7gfO{ x'G5 .

–      o:tf dflg;n] cg]sf}+ axfgfdf 3/jf6 /sd nlu nfu' cf}ifwL lng yfN5g\ . lj/fdLnfO{ 8«u lng dg gnfUg] cf}ifwL klg pknJw 5 .

–      o:tf lj/fdL z'?df klxrfg ug{ ufx|f] x'G5 .

–      5fqjf;df a:g] ljBfyL{x? o:tf s'ntdf km;]sf a9L b]vLPsf] 5 .

–      !)–!%Ü dflg; nfu' cfifwL lng] dfl; o:tf cf}ifwL lng] dflg; o:tf cf}iflw a]Rg] sfd dlg u5{g\ .

–      cfifwL k;ndf cg]sf}+ axfgf agfO{  cf}ifwL nLG5g .

–    sltko b'A{;lgx? P8\; tyf cGo of}g /f]uaf6 klg lkl8t      x'g ;S5g, o:tf] cj:yfdf la/fdLnfO{ cGo 7fpFdf nu]/ klg pkrf/ ug'{ kg]{ x'G5 .

–    sl/j Ps ltxfO{ b'A{o;lgx? cGo dfgl;s /f]uaf6 klg lkl8t x'G5g, To:tf] cj:yfdf ;f] sf] klg pkrf/ ug'{ k5{ .

–  cleefjsx?n] cfˆgf 5f]/f5f]/L vf;ul/ - :s'n / sn]h k9\g] _ nfO{ /fd|f] /]vb]v ug'{ k5{ . a9L k};f dfUg], :s'n sn]hdf cg'kl:yt x'g], jf v/fj ;+utdf nfUg] u/]sf] z+sf nfu]df t'?Gt pkrf/ ug'{ k5{ .

–    nfu' kbfy{ b'A{o;lgsf] pkrf/ ug]{ gfddf 8fS6/sf] ;Nnfx lagf pkrf/ ug]{, ca}wflgs ?kdf cf}iflw v'jfpg] ;+:yf klg v'n]sf 5g o:tf] ;+:yf s]jn k};f sdfpg] gfpFdf cfPsf x'gfn] ;r]t x'g'kb{5 . cf}ifwL Jofj;fo ljefunfO{ 9fs5f]k ul/ lj/fdLnfO{ To;} cj}w v'jfpg] xFbf lj/fdL d/]sf]  36gf klg ;'lgG5

 

8f l; kL ;]8fO{

gzf tyf  dgf]/f]u laz]if1  

  lrtjg d]l8sn sn]h -cmc_