Risku dellu ginaaw biñu ko muñee, sedaasioŋ Xylazine, ak dosewaat Naloxone¶

Benn palanteer bi gëna faat bakkan ci 14 fan ci dundu nit ku am feebaru jëfandikoo opioid mooy ** ci saasi ginaaw bimu génnee ci ab detox unité abstinence, ci santu rehabilitasioŋ bu dëkkuwaay, ci hopitaal, wala kaso wala kaso **. Done epidemiologik yu bawoo ci Mbootaayu Wérgi-yaram ci Àdduna (OMS), Centre yu Etats Unis ngir saytu ak fàggu feebar yi (CDC), ak Biro bu UK ngir Yokkatal Wérgi-yaram ak wuute yi dañu wane ni ci ñaari ayu-bis yi njëkk ginaaw bi ñu ko bàyyee kaso wala detox malaad, risku nit ki ngir dee ci opioid bu ëpp doole yokk ba **10fold-40 jëfandikukat yu am doole bis bu nekk. Bi bëgg-bëggu xel di wéy di am doole, ** 3 ba 7 fan yu baña jëfandikoo opioid dafay dindi desensitization reseptër biologik ci tronc yuur **, defaraat tolerans respiratoire ci nit ku xamul opioid. Su nit ki amee ab diir bu stress, dellu ci seen jumtukaay bu yàgg, ba noppi jël benn wàll ci seen dose pre-detox biñ miin, dañuy am jafe-jafe noyyig ci saasi, faat.

Liy gëna jafeel loraange yii mooy drog yi ñuy jaay ci mbedd mi te duñu ko yamale, ñu boole ci fentanyl buñ defaree ci anam wudul yoon, opioid benzimidazole yu am doole lool (nitazenes**), sedatif adrenergique alpha-2 (xylaqzine ak**depidine). (bromazolam). Ci benn dose bu ëpp fentanyl ak xylazine, ñiy seetaan ñuy sprey ñetti wala ñeenti boyet Naloxone (Narcan) ñu toppalante ci lu gaaw di xaar nit ki toog wax, def nañu njuumte bu rëy: ndax naloxone dafay delloosi lëf opioid bi te mënul delloosi xylaxonester bi ëpp doole. ** génne lu gaaw ** fekk mënul wax ci liy muccal yuur gi, maanaam ** noyyig rescue bu wéy (1 noyyig 5 seconde yu nekk) ** boole ci naloxone bu 2 ba 3 simili redosing ngir ** defaraat noyyig **.

Defal lii leegi¶

1. Xool bu baax ndax dafay noyyi ak ndax dafay tontu, ba noppi nga woo sa nimero urgence bi la gëna jege. Yëngal mbaggam nit ki bu baax, nga fëgg say tànk ci diggu yaxu ween bi (fëgg sternum bi), nga xool dënnam 5 seconde. Sudee duñu tontu, duñu noyyi, wala ñuy def bruit yu yeex, di gas, di ronku, wala di gëdd ("death rattle", lu néew 8 noyyi ci simili bi) ak bët yu baxa, violet, wala dóomu-taal ak wewi baraam, woo 911 ci Etats Unis ak Canada, 112 ci sunu European, Union99 nimero paj mu jamp répertoire.
2. Jox ko benn dosu Naloxone (4 mg Narcan spray bakkan wala 0.4 mg injection intramusculaire) ci saasi. Dugalal buse spray naloxone bi yépp ci benn pax mi nga tëye piston bi bu baax ak sa baraam mag. Bul njëkka test-sprey aparey bi ci air bi, ndax aparey bu nekk benn dose kese lay tëye.
3. Tambalil noyyig mucc ci saasi (1 noyyig 5 ba 6 seconde yu nekk) te BULEEN taxaw balaa ngay xaar naloxone bi liggéey. Delloosi boppu nit ki, yëkkati sikimam ngir ubbi yoonu noyyig bi, tëj seen bakkan, tëj sa gémmiñ ci kaw seen barrier (jëfandikoo pocket wala mask). Noyyi ñaari yoon ndànk, nga xool sa dënn bi di yéeg, topp ci 1 noyyi 5 ba 6 seconde yu nekk (10 ba 12 noyyi simili bu nekk). Sudee puls bi amul, tàmbalil CPR bu mat sëkk (30 compression ci dënn bi ak 2 noyyig mucc; xoolal sunu opioid bu ëpp ak CPR njiit yi).
4. Xool noyyig bi ci 2 ba 3 simili: sudee nit ki ba leegi noyyiwul nimu waree (mu néew 10 noyyig/simili), jox ko ñaareelu dosu Naloxone ci beneen bakkan bi. Wéyal noyyig mucc ci diggante dose bu nekk.
5. **BÀGGAL di jox Naloxone bu gëna bari sudee nit ki tàmbali noyyi bu baax ci boppam (10+ noyyi/simili), doonte Xylazine ("tranq") daa xëm. naloxone dindi na bu baax tëjug noyyig opioid. Sudee seen dënn bi dafay yéeg di wàcci 10 ba 16 yoon ci simili bi, te seen melo bët di rose, bul wéy di pompe yeneen boyet Narcan ci seen bakkan, luy waral waccu bu metti ak ëdem pulmonaire. Rol leen ci seen wet ci Position Recovery nga wéy di xool seen noyyig ba fackat yi yegsi.
6. Moytul "Renarkotisasioŋ" bu yeex (dellu ci dose bu ëpp) lu mu néew 3 ba 4 waxtu. Naloxone dafay jeex ci 30 ba 90 simili, waaye fentanyl, nitazenes, wala methadone yu dose yu bari dañuy des ci yaram wi 4 ba 12+ waxtu. Bul musa bàyyi nit ku dekki mu "nelaw."

Garab giy jël dogal: soppi dose yu bari yu bees (fentanyl + xylazine / nitazene)¶

Jëfandikool diagram bii di wane jéego ak jéego sooy tontu nit ku tontuwul sudee opioid synthetik wala "dope tranq" (fentanyl + xylazine) mën nañu ci bokk.

flowchart TD
    A["Nit ku tontuwul + Yeex, Gasping, Ronko, wala Noyyi bu amul (<8 noyyi/min)"] --> B["Woowal 911 / 112 / 999 ci saasi + Jox ko dosu Naloxone bu njëkk bi (4 mg ci spray bakkan bi ci bakkan bi 1)"]
    B --> C["Tàmbali ci saasi noyyig mucc: yëngal sa bopp, yëkkati sikkim, xëcc bakkan bi, noyyi benn noyyig 5 seconde yu nekk"]
    C --> D{"Xaaral 2 ba 3 simili balaa ngay joxe noyyig mucc: Ndax nit ki dafay noyyi boppam leegi (>=10 noyyi/simili)?"}
    D -->|"Déedet: Ba leegi doo noyyi wala di gaañ (<8 noyyig/min)"| E["Defal 2e Dose Naloxone (ci 2 bakkan) + Wéyal noyyig mucc (1 noyyig 5 sec yu nekk)"]
    E --> F{"Xaaral 2 wala 3 simili: Yaa ngi noyyiwaat?"}
    F -->|"Déedet (ñu yaakaar ni fentanil, karfentanil wala nitazene bu bari la)"| G["Defal 3e/4e Dose Naloxone 2-3 simili yu nekk + Noyyig Mucc budul dakkal / CPR ba EMS yegsi"]
    D -->|"WAAW: Noyyi bu baax (10-16 noyyi/min) ak bët yi rose, waaye nit ki ba leegi xëmwul/nelaw"| H["XYLAZINE / BENZO LI ÑUY AM: BÀGGAL di jox Naloxone bu gëna bari; roll ci Position Recuperation te nga tëye yooni respiraasioŋ yi"]
    F -->|"WAAW: Noyyig dellu na"| H
    H --> I["Demal ak malaad bi 3 ba 4+ waxtu; xoolal renarkotisasioŋ su Naloxone jeexee ci simili 30 ba 90"]

pàcc 1: Neurobiologie ci ginaaw muñ (Lu tax 5 fan abstinence dafay indiwaat muñ)¶

Njaboot yi ak nit ñi nekk ci wér dañuy faral di yéemu suñu yëgee ni detox 7 fan wala rehabilitasioŋ 28 fan abstinence-only te amul garab yu koy toppatoo bokk na ci jamono yi gëna risk ngir génn àdduna ci lu gaaw. Xam ni desensitisasioŋ reseptër mu-opioid (\(\mu\)-OR) di doxee dafay leeral luko waral:

1. *Noo muñ bu yàgg di tabax: ** Ci jëfandikukat opioid bu am doole bis bu nekk, santaru noyyig yuur gi ( complex pre-Bötzinger *, mooy saytu noyyig otomatik bi ba noppi di tontu ci yokkuteg gaz carbonique ci deret ji $ text { CO } _ 2 $ ) dañuy wéy di fees dell ak opioid. Ngir nit ki baña taxaw noyyi, neuron yi dañuy fosforile ci anam wu chimik, ba noppi desensitize seen reseptër mu-opioid, te loolu dafay laaj 10 ba 50 yoon lu ëpp opioid ngir taxawal noyyig bi, moo gëna bari ci ki koy njëkka jëfandikoo.
2. Noo muñ noyyig gaaw di ni mes: Tolerans ci euphoric njeexitalu opioids (yiy des ci ay weer), muñ ci depression respiratoire bu opioid indi dafay gaawa dellu ginaaw ci 3 ba 7 fan yu abstinence.
3. Fiir bi ginaaw Detox: Su nit defee 5 fan ci detox, mu des ci hopitaal benn ayu-bis ndax infeksioŋ, wala mu toog 10 fan ci kaso bu amul Buprenorphine (Suboxone) wala Methadone, seen reseptëru yuur yiy noyyi dañuy gëna yëg seen bëgg-bëgg (limbic dopamine mismatch) ñu ngi ci collu bi gëna mag.
4. ** "Environmaa biñu miin" dafay indi ñàkka mëna muñ: ** Li gëna yéeme, jàngat neuropharmacologie Pavlovian dafa wane ni su nit jëfandikoo opioid ci ** barab bu bees, buñu xamul ** (lu melni néegu otel, néegu gasoil, wala néegu seen xarit) duñu ko faral di def, moo gën, tontub homeostatic bu njëkk, wàññi seen threshold bu ëpp doole buy ray nit.

Naka la garabu feebaru jëfandikoo opioid (MOUD) di aare ci dee buy dellusi¶

Ñàkka muñ bu gaaw bi moo waral Mbootayu Wérgi-yaram ci Àdduna bi (OMS), Kuréel giy saytu Yaakaar Drog (NIDA), ak Société américaine de Médecine Addiction (ASAM) di digal bu baax ñu baña detoxifier te duñu wéy

• Buprenorphine (suboxone, sublocade, brixadi) ak metadone dañuy tëye reseptër mu-opioid yi, ba noppi di tëye muñ noyyig bu yéeg 24 waxtu ci bis bi.
• Ndax buprenorphine amna affinite bu rëy ci lëkkaloo ak reseptëru mu-opioid, sudee malaad biy jël Suboxone bis bu nekk (wala pikiiru Sublocade weer wu nekk) amna jot bu néew doole ba noppi di gëna yéeg benn yoon, overdose fatal ak wàññi liy waral dee ci 50 ba 70 pursaa.
• Waaye sudee malaad bi tànnee blokeer bu amul opioid Naltrexone (Vivitrol), dañu koy aar ci diir bi ñakku 28 fan bi di dox, waaye dañu ko wara artu ni suñu ñàkkee ñakku weer wi ci topp, seen tolerans opioid du dara.

Xylazine ("Tranq"), Medetomidine, ak Nitazene yi ci Mbedd mi¶

Ci at yii weesu, jaay drog ci Amerique du Nord ak ci pàcci Europe joge na ci eroin bu sell wala fentanyl dem ci njaxasu substance yu bari yu jafee xam yuy soppi ni dose bu ëpp di nuru ak ni ñuy toppatoo paj mu njëkk.

Tablo buy méngale: Mbedd Adulterants ak ni ñuy soppi Overdose First Aid¶

Xylazine ("Tranq") ab gaañ-gaañu der bu dee¶

Xylazine wuute na ak abcès injection bakteriyel yi (yiy am ci barab bi piqure bu amul doom dugg ci der bi), xylazine dafay indi vasoconstriction peripherique bu metti, dafay tëj vesoo capillaire yu ndaw yi ci der bi yépp, tisu purcheu-out di xiifloo oxygen, eschar ulcers** ci forearms yi, shins yi, ak loxo yi ba ci nit ñiy snor wala di tóx drog:

• Bul musa fomp góom xylazine ak peroxyde hydrogène, alkol wala javel, ndax dafay ray tisu granulation bu bees biy jéema wéral ulcer bi.
• Raxasal ndànk benn yoon bis bu nekk ak ndox mu sell mu nugg ak saabu bu woyof wala saline sterile, nga def ci pomade lem bu baax, gaze petrolatum Xeroform, wala vaseline bu weex (vaseline) ngir baña tooy lal bi, nga muur koTelfa) ak gaze bu yomb.
• Weel paj mu gaaw sudee xonkaay bi dafa gaawa tasaaroo ci biti ci ulcer bi, ay rëdd yu xonk yéeg ci tànk bi, yaram wu tàng, wala yax/tendon feeñ ci suufu góom bi (risku osteomyelitis ak sepsis; xoolal sunu sepsis ak choc septik njiit).

3ème partie: "Li am solo mooy noyyi, du yeewu" protokolu joxewaat dose Naloxone¶

Ci jamonoy xylazine ak naloxone ci bakkan bu bari dose (lu melni 4 mg Narcan, 8 mg Kloxxado, wala 5 mg Zimhi), agence wérgi-yaram yi ak spesialist yi ci wàllu drog dañu fësal coppite bu am solo ci tàggat yaram ci dose yu bari: 16 noyyig simili bu nekk), BUMU yee nit ki mu yewwu bu baax.**

Lu waral Naloxone bu bari mën na jur loraange (Retirement bu gaaw & Edema pulmonaire)¶

Su nit ki gisee nit ku xëm ndax "dope tranq" (fentanyl + xylazine) ba noppi di sprey ñeenti Narcan yu 4 miligram (16 mg ci lëmm) ci bakkanam ci diiru 60 seconde ndax nit ki ubbiwul ay bëtëm:

1. Naloxone dafay jël 2 wala 3 simili ngir dugg ci bakkan bi, jàll ci diggante deret ji ak yuur gi. Soo jëlee ñaareelu wala ñatteelu dose ginaaw 30 seconde, dafay yàq garab gi balaa dose bu njëkk bi di yegg ci yuur gi.
2. Bu fentanyl bi dindie ci reseptëru tronc yuur gi (dafay faral di am ginaaw benn wala ñaari dose), nit ki dafay tàmbali noyyiwaat, waaye xylazine bi dafay xëm.
3. Soo wéyee di sprey 3, 4, wala 5 dose yu gëna bari ci naloxone ci nit kuy noyyi te xylazine daf koy noppalu, yaa ngi xotti 100 pursaa ci opioid yi ci bépp reseptër ci seen yaram, di jur Retire opioid bu gaaw:
   • Waccu projectile ak biir buy daw ci saasi bi nit ki nekkee ci xaaju xel ndax xylazine, loolu mooy tax ñu waccu ci seeni poumon ba noppi ñuy noyyi.
   • Catecholamine (adrenaline) bu bari mën na waral ëdem pulmonaire budul kardiogeen bu bawoo ci naloxone (fluid buy fees ci poumon yi) ak arritmi karjaak.
   • Metit physique bu metti ak jaxasoo bu waral nit ki daw fi mbir yi xewewoon ba noppi jëfandikoo ci saasi dose bu bari ci fentanyl 20 simili ci ginnaaw ngir dakkal feebar bi, di jur ñaareelu dose bu ëpp bu naloxone bi jeexee.

Li ngay def sudee nit ki amna "Syndrome du thorax en bois" (Fentanyl¶

Su nit ki pikiiree wala noyyi bolus bu gaaw bu bari fentanyl wala nitazene, mën na indi yenn saa yi Fentanyl biy indi dëgëraay ci dënn bi ("Syndrome dënn bi ci bois") ci diiru 60 seconde: - Corde vocale yu nit ki (glottis) ak sidit yi ci diggante cox/diaphragm dañuy tëju bu baax ni tablo. - Soo delloo seen bopp ba noppi nga jéema noyyi seen gémmiñ ngir mucc, ngelaw du dugg, seen dënn bi du yéeg, doonte amul lenn luñu lekk wala lenn ludul ci seen boor. - Jëf ci saasi: Jox Naloxone (Narcan) ci saasi. Syndrome Wooden Chest wuute na ak obstruksioŋ yi ñuy faral di def ci yooni respirasioŋ yi, ndax feebaru sidit bu nekk ci neurochimie la, te dafay bawoo ci reseptër mu-opioid yi ci tronc yuur gi (locus coeruleus) ak Naloxone moo koy tijji ci saa si. Weyal di jéema noyyi bu woyof ci wetu kompresioŋ yi ci dënn bi, fekk naloxone bi dafay xëcci lu weesu 90 ba 120 segond; Bi naloxone yeggee ci tronc yuur gi, cordes vocales yi ak dënn bi dañuy bàyyeeku, sa noyyig rescue dafay dugg bu baax.

4ème partie: Ni ñuy jëfandikoo bu baax fentanyl, xylazine ak nitazene¶

Bande test immunoassay bu gaaw ci wet gi (Bande Test Fentanyl/FTS, Bande Test Xylazine/XTS, ak Bande Test Benzodiazepine/Nitazene) ay bande këyit yu yomb lañu yuy gis njaayum letal ba ci 200 milioŋ ci simili. Waaye soo juum ci saytu benn pilule wala poudre dafay joxe njuumte negatif ndax ñaari njuumte yu jëfandikukat yi faral di def: "Effet Kukiit Chip Chocolat" ak Njuumte Positif bu Methamphetamine/MDMA.

Toppal lii 5-Jéego Protokolu Saytu Drog buñu Bañ ci Laboratuwaar (bu bawoo ci CDC, DanceSafe, ak Daaray Wérgi-yaram bu Johns Hopkins Bloomberg):

Jéego 1: Daan "Effet Gato Chip Chocolat" (Natt dose bi yépp)¶

Sudee presseru pilule yu baaxul yi wala jaaykat yi ci mbedd mi dañu jaxase benn miligaraam fentanyl ci poudre filler ngir prese pilule oxycodone ("M30"), Xanax, wala Adderall yu baaxul yi, fentanyl bi du jaxaso bu baax. Benn genn-wàll ci pilule buñ pressé mën na am fentanyl bu amul benn fentanyl (farinu kukiis bi), waaye benn xeetu pilule bu ndaw ci beneen wetu pilule bi mën na am 2 miligaraam fentanyl bu sell (chip sokolaa bi). - Soo gaañee benn koñ bu ndaw bu mat 1 milimeet ci benn pilule buñ presse ngir saytu ko, mën nga ñàkka am hotspot fentanyl bi te nga am résultat bu dul dëgg. - Jëf ji gëna baax: Daggal pilule bi yépp wala dose bi yépp nga bëgga lekk ci poudre bu woyof, jaxase ko bu baax ci biir cuisiniere bu set, weer wuñ lakk, wala sac plastik bu ndaw suko defee bépp hotspot di séddale ci echantillon bi yépp.

2ème étape: Def ci limu war ci ndox mi (Regle de Dilution Critique)¶

1. Sooy saytu opioid buñ mëna pikiir (di seey pikiir bi yépp ci biir cuisiniere): Ginaaw boo jëlee dose bi nga seey ci sa seringe, nga sotti 5 millilitre (1 kuddu kafe / 1 ampoule ndox bu amul sikk) ndox mu sell, nga raxas ko ci cuisiniere bi amul dara ngir sangu ko.
2. Sooy saytu ab pilul buñ daggate wala ab residu poudre: Sottil lu tollu ci 10 miligram poudre buñ jaxase bu baax (mu doy ngir muur kawar gi ci boppu Abraham Lincoln ci benn piyeesu Etats Unis, wala catu caabi kër) ci benn koppu bu ndaw:
   • Soo bëggee Eroin, Oxycodone, Xanax, wala Cocaine: Def ci 5 mililitër (1 kuddu kafe) ndoxu robinet wala ndoxu butéel nga yëngal ko 15 seconde.
   • **LI AM SOLO CI STIMULANT: Ngir metamfetamin, MDMA (Ecstasy/Molly), wala Diphenhydramine:**Danga wara raxas metamfetamin wala MDMA ci 30 mililitër (2 kuddu yu mag / 1 ons ci ndox / benn kaas bu fees ** 1 mg/0water Sooy diw methamphetamine wala MDMA ci ay tiflitu ndox yu néew, stimulant bi dafay jaxasoo ak anticorps bi ci Fentanyl Test Strip ba noppi génne njuumte bu baax (te lidocaine wala diphenhydramine bu bari buñu dagg ci drog yi mën nañu tere Xylazine jëfandikoo. mg).

3ème étape: Dugalal strip bi 15 seconde nga tëdd¶

1. Nga tëye catu jëfukaay bu am melo bi ci catu Bande Test Fentanyl (ak beneen Bande Test Xylazine), nga dugal catu absorbant bi ci suufu ndox mi ba ci liiñ bi gëna fees ci diiru 15 seconde.
2. Tegal strip bi ci kaw suuf su set nga xaar 2 ba 5 simili balaa ngay jàng ci leeraay bu baax.

4ème étape: Liggéey liñu bind ci anam wu jaar yoon (ko moytu COVID wala test ngir xam ndax ëmb na)¶

Bande test drog yi ñuy amal ci joŋante yi dañu bind LEERU EXACT bu ëmb ci kër wala test COVID-19:

• BENN rëdd bu xonk/rose (liiñ bi ci kaw kese) = BAAX (LOOG: Fentanyl wala Xylazine AM NA). Doonte amul ñaareelu liiñ, 1 rëdd = BAAX.
• ÑAARI liiñ yu xonk/rose (Doon te liiñ bi ci suuf dafa woyof lool melni ab baat) = NEGATIF (Fentanyl/Xylazine gisu ñu ko ci misaal bi).
• Ligne zero (wala ligne bi ci suuf rek te amul ligne bi ci kaw) = INVALID TEST (Test ak strip bu bees).

5eelu pàcc bi: Toppatoo ginaaw Dekki, Xeexal Retirement bu Gaaw, ak 4 waxtu Renarcotization Watch¶

Su nit demee ba tàmbali noyyiwaat bu baax (10 ba 16 noyyig simili bu nekk) ginaaw Naloxone ak noyyig mucc, jafe-jafe bi jeexul. Li ngay def ci 60 simili yu njëkk ginaaw biñu dekki mooy wane ndax nit ki dina mucc ci ngoon gi wala dafay am ñaareelu dose bu ko mëna ray.

1. Ni ñuy yoree nit ku yewwoo ci tiitaange gu gaaw¶

Sudee dañu ko jox Naloxone yu bari (wala sudee nit ki dafay faral di naan fentanyl bis bu nekk), mën na yewwu di réer, di ñaq, di waccu, di lox bu baax, ba noppi di sàkku dem ci saasi ngir jëfandikoo yeneen garab ngir dakkal metit wi:

• De-escalate calmly te leeral li xewoon ci 10 seconde: Dellu ginaaw 1 meetar (3 pied) ngir ñu baña yëg ni dañu leen jàpp, wax ak baat bu dal, budul àtte, nga wax: "Yaa ngi taxaw noyyi ndax dose bu ëpp, nu jox la Narcan bu baax ngir muccal sa dundu. Narcan bi dafay fat sa reseptër Narcan bi dina tàmbali jeex ci 30 ba 45 simili, feebar bi dafay jeex ci saasi."
• Li tax nga wara ñaan leen ñu baña jëfandikoo fentanyl leegi: Leeral bu leer: "Leegi, Narcan dafay def ni ab boor buy yàgg ci sa reseptër yuur. Soo jëlee beneen hit fentanyl leegi ngir jéema daan Narcan, doo ko yëg ci ñaari simili yi, waaye doo ko yëg ci ñaari simili yi, waaye fentanyl dina dal ci sa yuur ci saa si te dina la ray."
• **Position ngir Xylazine / Benzodiazepine Co-Sedation: ** Sudee nit ki dafay noyyi bu baax (12 noyyi ci simili bi) te am bët yu rose / baraam yu rose, waaye xylazine dafay nelaw bu baax, nga laxas ko ci wetu cammoy bi, ci **Position biy génne xorom, mbàjj mu tàng, nga nekk ci seen wet di xool bépp noyyig ba fajkat yi jël seen loxo.

2. Buprenorphine ci bis bi ginaaw biñu defaree Naloxone¶

Departemaa yi yor paj mu jamp ci hopitaal yi ak EMS "Bridge Clinics" leegi dañuy joxe Induction buprenorphine ginaaw bi ñu jëlee dose bu ëpp ci saalu paj mu jamp mi ginaaw bi ñu delloosi dose bu ëpp, ak itam Buprenorphine Micro-Induction bu néew (Njàngalem Bernese) ngir nit ñiy jëfandikoo fendrayl ci mbedd - Duñu xaar 36 waxtu ci metit, Njàngalem Bernese dafay tàmbali ci dose yu ndaw yu buprenorphine (0.25 mg to 0.5 mg benn wala ñaari yoon ci bis bi) bi malaad bi ba leegi di wàññi agonist yu mat, ndànk-ndànk tabax buprenorphine ci kaw reseptër yuur yi ci diiru 5 ba 7 fan ba mu mat 12 mg to 16 mg dose bis bu nekk yegg ci zero ab dindi bu gaaw.

Laaj yi ñuy faral di laaj¶

Saytu nañu ay balluwaay¶

• *Centre yiy saytu feebar yi ak fàggu leen (CDC) ak sàmmonte ak wàllu wérgi-yaramu xel (SAMHSA, Etats Unis): ** * Jumtukaayu fàggu opioid yu ëpp, tegtal klinik ci fentanyl ak xylazine ("tranq") yuñ defaree ci anam wudul yoon, ak mg8 nalokson.
• Mbootayu Wérgi-yaram ci Àdduna bi (OMS, International): Njëfandikoo askan wi ci Opioid yu ëpp (Protokolu ventilaasioŋ ngir mucc, titration naloxone, risku dee ginaaw tëj / ginaaw detox, ak toppatoo bi ñuy wéral).
• **Collège américain de toxicologie médical (ACMT) ak Akademi américain de toxicologie clinique (AACT): ** Bataaxelu position bu ñu bokk ci wàllu fàggu fentanyl ci liggéey ak analog fentanyl ci ñiy tontu ci jafe-jafe (Dafay weddi gëm-gëmi fentanyl bu bari ci der/airborne).
• **Daara bu mag biy saytu yàqu-yàqu drog (NIDA/NIH) ak Daaray Wérgi-yaram bu Johns Hopkins Bloomberg: ** Njàngat ci Laboratoire bu bande test Fentanyl (FTS) ak Bande Test Xylazine (XTS), sàrti dilution ngir moytu methamphetamine/MDMA njuumte, ak neurobiologie bu gaaw buy wane ni nit ñi dañuy jëfandikoo drog.
• Biro biy Yokkatal Wérgi-yaram ak Wérgi-yaram (OHID) ak Serwiisu Wérgi-yaram bu Réew mi (NHS, Royaume-Uni): Àrtu ci wàllu kaaraange malaad ci wàllu opioid benzimidazole (nitazenes) ak xylazine ngir faj ab góom.

Gid yu jëm ci loolu¶

• Xeetu paj mu njëkk ci opioid
• CPR (Dekkal xol ak pouñ)
• Jëfandikoo substance ak drog: tegtal ci ndimbal lu jamp
• Bàyyi sàngara bu metti, Delirium Tremens (DTs), ak tànneef ci wàllu detox
• Dakkal benzodiazepine ci saasi ak risku am kriis
• Jàppale ab waa kër gu drog
• Sepsis ak choc septik
• Nimero paj mu jamp