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16/07/10, 01:52:40 #1

9deltaVaporizar es salud

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Relato de un mdico ex adicto a la morfinaCARTA DE UN MDICO ADICTO

'Nada me ha anulado como el'mono''* Aos despus de rehabilitarse, un doctor relata su

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adiccin y el horror de la abstinencia

MADRID.- "Necesito actuar rpido para estar listo para el'subidn', para sentirlo completamente". Esta frase forma

parte del relato de un mdico ex adicto a la morfina, querecoge el ltimo nmero de la revista 'British MedicalJournal', dedicado a las drogas y a cmo la criminalizacinde su consumo aumenta la expansin del VIH.

El annimo testimonio relata el placer de recibir una dosis,la metdica preparacin de la parafernalia necesaria paraque la droga penetre en la vena, que "se yergue orgullosa ytentadora", y la desesperacin ante el sndrome deabstinencia: "Nada me ha anulado como el 'mono', nadame ha dejado tan asustado, tan falto de coraje yresistencia", describe el doctor.

Como l, muchos otros mdicos, dentistas y profesionalessanitarios han cado en la adiccin a la morfina u otrassustancias. Segn las estadsticas, un 12% de los galenosabusa del alcohol o del cannabis y el 7% de sedantes,estimulantes y opiceos. Los ms inclinados a estas

prcticas son los residentes, pero el acceso al frmaco y alinstrumental necesario, facilita su prctica en el entornohospitalario.

El placer del 'subidn'

"La jeringuilla est en la mesilla; la nueva y relucienteaguja naranja, expectante. Uno de los pequeos beneficiosde ser doctor y adicto es que las agujas limpias estn a tualcance, y el riesgo de VIH y hepatitis B o C es bajo",explica la carta. Coger bien la vena y saber esos pequeostrucos para que el pinchazo no deje seal y el vaso sigasiendo permeable, tambin son ventajas de los facultativos,

pero la adiccin es la misma que la de todos.

"Todo est en silencio, las puertas estn cerradas, lascortinas echadas, est todo a oscuras excepto por lalmpara de la mesilla. Estoy solo en casa; no hay glamourni drama ni 'heroin-chic' [look de heroinmano]. Es sloun egosta, sobornable, engaoso, srdido y solitario vicio.

[...] La aguja se desliza sin dolor; es como un beso, slo uninstante de resistencia hasta que penetra la pared de lavena. Tiro del mbolo para confirmar que estoy en la venay, ah, el alivio de ver la oscura espuma de sangre en la

jeringuilla, una bandera roja indicando que todo est listo.Ahora nada se interpone entra la droga y yo".

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Por fin llega el esperado momento, "cuando el placer de laanticipacin est casi agotado" y despus, el 'subidn',"una maravillosa, clida oleada acariciando todo micuerpo. Y tan rpido como llega, se va; eso es todo, hecho,

terminado. Ha merecido la pena?".Una condena de por vida

Muchos de los mdicos con problemas de adiccin logranrehabilitarse. Pero en esa batalla, su profesin no les

proporciona ventaja alguna. "Ya he pasado por el sndromede abstinencia antes y fue terrible. [...] No puedocalmarme, s lo que se avecina, se inclina sobre m comouna losa [...] S que no hay ningn riesgo mdicoimportante, y, uno a uno, los sntomas fsicos no son tanmalos [...] Pero la ansiedad, la ansiedad, es insoportable".

El 'mono', la reaccin del organismo ante la falta de lasustancia a la que es adicto, es inevitable. "No hay salida,no hay escape", seala la carta. "Salvo tomar otra dosis,que aliviara todos los sntomas al instante sera como unmilagro-", aade. Pero eso slo "pospondra la odisea. Hetenido el placer y ahora tengo que pagar el precio [...] Esuna transaccin que no tiene sentido, es una locura. Pero,me prometo a m mismo, sta es la ltima vez. No volvera hacerme pasar por esta odisea otra vez; esta vez,

permanecer limpio".

En aquella ocasin no lo logr, y sigui inyectndose hastaque busc ayuda. "Y la ayuda y la esperanza estn ahfuera", manifiesta aos despus. En su caso, la experienciade la rehabilitacin fue un xito, "aunque como todo adictoslo puedo afrontar un da tras otro", y la enseanzavaliosa: "Me ha hecho un mejor mdico, mejor conocedorde la debilidad humana porque mi propia debilidad es

profunda".

http://www.elmundo.es/elmundosalud/2...279034260.html

16/07/10, 01:53:23 #2

9deltaVaporizar es salud

Puntos: 113.166, Nivel:100Actividad: 0%

Respuesta: Relato de un mdico ex adicto a la

morfinaDejo por aki el articulo de la revista BMJ, la verdad q nose si esta entero el articulo....

Published 13 July 2010, doi:10.1136/bmj.c3725

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Cite this as: BMJ 2010;341:c3725Views & ReviewsPersonal View

Knowing the score: a doctoraddict tells his storyThe vein stands up, proud and inviting. The syringe sits onthe bedside table, the new orange needle gleamingexpectantly. One of the small benefits of being a doctorand an addict is that clean needles are easily available, andthe risk of HIV and hepatitis B or C infection is low. I hadused a green needle to draw up the drug, a needle that canreach right to the bottom of the ampoule, so that not onedrop will be missed. Beside the syringe lies the empty

packet of Cyclimorph; the red and blue packaging is sodistinctive to me that if it was lying on the road a mileaway I would spot it.

Everything is quiet, the doors are closed, the curtainspulled, it is all dark except for the bedside lamp. I amalone in the house; there is no glamour here, no drama, noheroin chicits just a selfish, venal, deceitful, squalid,solitary vice.

I tap the vein lightly with my forefinger, testing thebounce. The vein is engorged and will be easy to access,little chance of missing the vein and the drug leaking intothe subcutaneous tissues, which would leave a painful andvisible bruise and, even worse, would mean losing some ofthe drug.

I lift the syringe, flicking it and holding it up to the light toensure there are no air bubbles. The needle slips in

painlessly; it feels like a kiss, just a moments resistancetill the wall of the vein is penetrated. I draw back on the

syringe to confirm I am in the vein, and oh, the relief ofseeing the dark blood froth into the syringe, a red flagsignalling go. Now there is nothing between me and thedrug.

Everything is ready, the pleasure of the anticipation isalmost spent. I slip off the tourniquet and slowly press the

plunger fully in.

I need to act quickly now to prepare for the rush, toexperience it fully. I dont want any outside stimuli that

might interfere with the consummation. I whip out theneedle and press firmly on the site with a dark red paper

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tissue. A white tissue would show up the blood tooobviously and might turn up somewhere inconvenient. Thefirm pressure will restrict localised bruising and make theinjection site less easy to spot and also will help keep thevein patent for future use. I take off my glasses, switch off

the light, lie back, close my eyes, and wait.

Within seconds I feel the rush coming on, a wonderful,warm tidal wave stroking my whole body. And just asquickly it is gone; thats it, done, all over. Was it worth it?

I am slightly sedated but not overly so. I could walk downthe street and exchange greetings and partake inconversation, and only those who knew me well wouldthink something was wrong: my voice might be deeper,my pupils dilated, but nothing very obvious.

I should still feel relaxed but at once I am aware that thatwas my last dose. I have no more supplies of the drug, sowithdrawal effects are inevitable. Ive been throughwithdrawal before and it was terrible. I know that,theoretically, withdrawal effects should not begin untileight hours after the last dose, but such is my fear ofwithdrawal that I begin to feel uncomfortable after only afew hours.

I cant settle, I know what is to come, it hangs over me likea weight. I start to feel cold and sweaty, my skin pricklyand uncomfortable. Or maybe I just think I am starting tofeel that way, just my fear playing tricks.

As each hour passes the symptoms get worse. They arereal now and accompanied by muscle pains, abdominalcramps, and diarrhoea. I know that there is no significantmedical risk, and individually the physical symptomsarent that bad. Put me in a warm room with plenty offluids and theyd be tolerable.

But the anxiety, the anxiety, is overwhelming; I am like avibrating string. I cannot sit for even a moment withouthaving to get up. Once up I have to sit down again, and Iknow this will continue for the next 36 hourssomeonetake this cup away from me. Ive been ill before, Ive hadinjuries before, Ive had bad times before, but nothing hasever unmanned me like withdrawal, nothing has ever leftme so scared, so lacking in courage and resistance. Thereis no way out, no way to escape.

Except to take another dose, which would relieve all thesymptoms instantlyit would be like a miracle. But I

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dont have another dose, and if I did Id only bepostponing the ordeal. Ive had the pleasure, and now Ihave to pay the price. The preparation was elaborate andthe consequences prolonged and grim, yet the gratificationwas only fleeting. It is a transaction that makes no sense, a

kind of madness. But, I promise to myself, this is the lasttime. I wont put myself through this ordeal again; thistime Ill stay clean.

But I didnt, and I continued using until at last I went forhelp. And help, and hope, is out there: NarcoticsAnonymous, the doctors and dentists groups, addictionspecialists. Withdrawal can be managed and staying cleanencouraged; the vast majority of addicted doctors achieverecovery. The General Medical Council will need to beinformed, but my experience has been that they consideredaddiction a health issue and were sympathetic rather than

punitive. I received support from my wife and family andfriends and from my colleagues and staff. And most of allfrom my patients, as my addiction is now commonknowledge; their compassion and forgiveness has beenhumbling. It has made me a better doctor, moreunderstanding of human frailty because my own frailty isso stark.

I have been clean for some years now, though like every

addict I can only take one day at a time; I was clean today,and I will try to stay clean tomorrow.

Cite this as: BMJ 2010;341:c3725

http://www.bmj.com/cgi/content/full/...urcetype=HWCIT

por cierto, en este numero hay unos cuantos articulos qparecen muy interesantes sobre el tema de las drogas,habra q conseguirlo.

Saludos.

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