Integrated treatment for opioid addiction complicated with neuroophthalmic pathology due to codeine and levomycetin abuse narcoassociated phenomenon

• Published in: European psychiatry Vol. 33; p. S774
• Main Authors: Sosin, I, Chuev, Y, Goncharova, O
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01-03-2016
• Subjects: Internal Medicine; Psychiatry
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2016.01.2319

Introduction Among drug addicts cohort in Ukrainian population, the phenomenon of codeine narcotic effect intensification and prolongation with antibiotic levomycetin simultaneous combined dose was identified. Current narcology encounters the insufficiently studied problem of drug addicts who lost vision due to levomycetin abuse at chronic codeine intoxication. Continuous levomycetin abuse was proved to cause optic nerve neuritis followed with eyesight loss. This is connected with discrete loss of eyesight pathogenesis in opioidaddicts. Aims and objectives To elaborate integrated method of treatment considering main pathogenic links of this narcotic addiction. Method It is based on combined therapy at traditional detoxication and includes membrane plasmapheresis 2–5 times at once every 3 days. Everyday 2.0 mL pyridoxin hydrochloride 5% solution for 15 days. Capillary stabilizer l -lysine aescinat in drops once in 24 h for 5–8 days. Transorbital medicinal electrophoresis (thiamine bromide 2.5% solution), 15–20 min exposure, daily, 10–12 procedures. Peroral retinol acetate, 1 capsule 3–4 times daily, for 7–10 days. Enterosorbent atoxil, 10–12 g daily, for 3–5 days. Results Five codeine addicts with neuro-ophtalmic disorders due to levomycetin abuse as a narco-associated phenomenon were examined. The addicts explained additional levomycetin composition in individual narcotization schemes by the aim to intensify and prolong codeine effects maintaining its stable dose. Combined comprehensive therapy restored the eyesight partially; renewed capacity to move independently, the patients’ disability was ceased. Conclusions Membrane plasmapheresis in the proposed method integrates in therapy the prescribed pharmaceuticals and corresponds numerous tasks of detoxication at continuous combined codein and levomycetin abuse.