事件记录
这个内容最初是为音频创建的. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. 为了获得完整的体验，大发娱乐鼓励你订阅并收听——那样会更有趣.
Jeremy's Turning Point: Being Defined as Overweight
Dr. 杰里米Thueson是大学神经精神病研究所（UNI）门诊康复服务主任，他很关心自己的健康. Jeremy had his wake-up call during his medical residency. 由于长时间的工作、不良的饮食习惯和住院医师的压力，他的体重开始增加. He hit a lifetime high and his BMI qualified as overweight.
Jeremy fit the medical definition of overweight, and he was over it.
"It's easy to try and be drastic and overhaul everything,杰里米说。, 她解释说，很多男人在决定恢复身材后，会立即去办健身房会员，把橱柜里的食物都扔掉. But those changes aren't sustainable for most people.
为了减肥, 杰里米试着“保持清醒”，开始在他的生活方式上做一些容易做到的小改变. He got a pedometer started walking more in his daily routine. 他下载了一个卡路里追踪应用程序，主动去拿了一片水果，而不是他通常吃的一包薯片. Rather than trying to hit the gym hard for an hour a day, 当他繁忙的日程中有空闲时间时，他会安排更容易管理的15分钟运动休息时间.
在接下来的六个月到一年里, 这些变化加起来, 杰里米的体重也得到了控制. He admits that his diligence waxes and wanes through the year. 具体地说, 他在冬天很难锻炼——他讨厌寒冷，也不喜欢去健身房——但他注意到了这一点，并尽可能地“纠正”了这一点.
阿片类药物的大问题
阿片类药物成瘾, or opioid use-disorder, affects the lives of many Americans. And the overdose deaths related to those drugs are an epidemic. 2017年，美国有7万多人死于流感.S. 药物过量. In the state of Utah, 450 people die every year from opioid overdose. 也就是说，每天都有一到两个犹他人死去.
While those numbers may seem staggering already, Dr. 杰里米Thueson believes that the numbers are actually underreported.
Opioid overdose impacts more than just the people struggling with addiction. 特洛伊的急诊科最近完成了一项试点研究，调查过量死亡对社区的影响. 最初的研究询问了急诊室的200名患者，他们是否有家庭成员死于阿片类药物过量. One-third of patients responded that they had lost someone to opioid overdose death.
这些死亡通常是意外或无意的. 许多患有阿片类药物使用障碍的人完全没有意识到他们离过量有多近. 一些人服用大量的药物来感觉正常，而另一些人则无意中将药物与酒精等其他物质混合在一起.
这些死亡大多是可以预防的, 通过对这种障碍的教育, 适当的治疗, and overcoming the social stigma related to addiction.
人们是如何对阿片类药物上瘾的?
重要的是要记住，没有特定的“类型”的人会对阿片类药物上瘾. 阿片类药物成瘾 crosses all demographics and sectors of society. Many people struggling with opioids are high functioning. 他们在商业部门工作. 他们是医生. 他们的父母.
阿片类药物成瘾, 或者阿片类药物使用障碍, usually begins with a patient being prescribed the drug through legitimate means. 无论是手术、智齿拔除等. the patient is first exposed to opioids for acute pain management. 然后随着时间的推移慢慢增加使用. It can be years of slightly increased use before people realize they're addicted.
Many People Use to Prevent Withdrawal, Not to Get High
In the ER, Troy has first hand experience with opioid use disorder. One individual shared his experience with Tror and a group of physicians. This man explained that he was no longer using opioids to get high, 但为了避免因戒断症状而生病. 对于这个人来说，阿片类药物的戒断是如此可怕，他会做任何事情来度过它. 所以他继续使用这种药物.
无论人们使用阿片类药物的好处是什么，最终都会随着时间的推移而递减. 在阿片类药物滥用的早期阶段, addiction and physical dependence will take hold of the user. 对于这些人来说，如果他们没有得到阿片类药物，他们可能会出现严重的戒断症状.
"It's a horrifically stressful way to live," says Dr. Thueson说：“这对你的身体和精神都是一种负担. 这是地狱. 人们享受不了多久."
使问题复杂化, 医学界有一种倾向是尽量减少阿片类药物戒断的经历. 大多数医生都被告知，阿片类药物戒断不被认为是“医学上危险的”.“虽然阿片类药物戒断的死亡风险低于酒精等其他物质, the experience is every bit as awful for opioid users. 据博士说. 因此，人们在经历戒断的痛苦时自杀并不罕见.
有很多羞耻感，内疚，挫败感在系统中导航，以获得康复的大发娱乐. 对于大多数处理阿片类药物成瘾的人来说，对戒断的恐惧是使他们陷入药物滥用循环的原因.
治疗有许多障碍
许多发现自己依赖阿片类药物的人对自己的处境有一种否认的成分. 人们真的很害怕说出自己的问题，以及这可能会如何影响他们的个人和职业生活. 没有很多社会可以接受的方式来谈论阿片类药物成瘾而不面临评判.
There is still a social stigma today about opioid misuse. It can often be framed as a moral weakness or character flaw in the person suffering.
"There's more debate about [opioid addiction] than I'd like to see," says Dr. Thueson, “大发娱乐现在拥有的最好证据是将其概念化为需要治疗的医学问题, 和其他东西一样. And not something else we need to be shaming people for ending up in that situation. I have not yet seen a patient who set out to get addicted to opioids."
最好的阿片类药物成瘾治疗方法
The standard of care f或者阿片类药物使用障碍 in 2019 is medication. There are three FDA approved medications available that have proven effective:
美沙酮 - A medication that has been used for 40 years in the U.S. 治疗药物滥用. It's proven effective at helping treat withdrawal and minimizing cravings for opioids.
美沙酮也有一些缺点. 首先，治疗本身可能很麻烦. Each dose of the medication is given in a clinic or office every day of treatment, 这很困难. 这些诊所必须得到联邦政府的正式许可才能大发娱乐提供美沙酮. Additionally, there are many challenges and risks with the use of methadone.
丁丙诺啡 -通常以品牌名称Subutex而闻名, 这种药物通过一种可以在家里服用的处方药来治疗阿片类药物的戒断和渴望. 对于大多数患者来说，它已被证明是风险和易用性的最佳平衡. While the drug doesn't need to be dosed in an office and clinic, 它只能由有执照的医生开.
环丙甲羟二羟吗啡酮 - Unlike the other two medications, naltrexone is an opioid receptor blocker. The medication helps minimize cravings by preventing the body's reaction to opioids. Without the positive effects of taking the drug, patients are less likely to use it.
The drug can be administered through an oral medication or a once a month injection.
In addition to medication, behavioral therapy can help patients get off opioids. These mental health treatments can include individual and group psychotherapy, 互助小组, 以及正式的康复项目.
与行为疗法相结合的药物是对抗阿片类药物成瘾的一线治疗方法.
一个人如何获得大发娱乐
Once a person has decided to seek treatment for their dependence on opioids, there can be many barriers between them and the 适当的治疗 and resources. 对于大多数没有保险或经济能力的人来说，治疗可能是不可能的.
在犹他州, 犹他大学创建了一个项目来大发娱乐那些与阿片类药物成瘾作斗争的人. The BRIDGE program is run through the emergency department. If a patient is experiencing opioid dependency or suffering from withdrawal symptoms, they can go to the ER and receive immediate treatment. 患者被给予初始丁丙诺啡剂量以及初始用药月的处方. 在收到他们需要的药物后, 他们被转到门诊诊所，可以通过制定定制的长期护理计划继续治疗
对病人来说没有成本. 该项目由国家资助，旨在对抗犹他州的阿片类药物流行病. 大发娱乐的目标是让病人的毒瘾稳定下来，头脑清醒，这样他们就可以专注于生活中的其他挣扎.
For people not in Utah, there are similar programs available in other states. 患者应该与他们的初级保健医生交谈，或者去诊所寻求专业大发娱乐，并找出可用的治疗资源.
记住，医生需要联邦政府的豁免才能开滥用药物的处方. 重要的是要找出医生, 中心, and facilities are permitted to help treat opioid addiction
使用 SAMHSA在线数据库 to find a provider near you that can prescribe these drugs.
For a lot of people in withdrawal or actively using, navigating the already complicated system can be impossible. 像BRIDGE这样的项目和认证医生可以大发娱乐个人获得他们需要的大发娱乐.
“直到大发娱乐让它变得像海洛因一样容易，大发娱乐才会让人们变得艰难，”博士说. Thueson. He urges fellow physicians to step up and get certified to give the federal waiver. "We need to step up and stay aggressive so we can help treat [opioid addiction]"
把这个留在大发娱乐
在这一集 把这个留在大发娱乐, 特洛伊想知道新的大麻酒精测试仪将如何被警察使用，而斯科特则发现了一种新的体重锻炼方式，他试图在繁忙的日程中安排锻炼.
和大发娱乐谈谈
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