Addiction Disorders and Therapy

Therapeutic Apheresis in Drug Addiction Treatment

*Valerii A Voinov
Therapeutic Apheresis Department, I.P.Pavlov First Saint-Petersburg State Medical University, Russian Federation

*Corresponding Author:
Valerii A Voinov
Therapeutic Apheresis Department, I.P.Pavlov First Saint-Petersburg State Medical University, Russian Federation
Email:voinof@mail.ru

Published on: 2019-07-24

Abstract

In recent years, the number of patients taking opioid drugs associated with development of an unavoidable craving for them has increased. Often it results in lethal outcomes due to overdose and on the background of withdrawal syndrome, when trying to stop taking such drugs. There are a growing number of women, abusing drugs during pregnancy, which causes serious complications for the fetus and the newborn. All this is a consequence of severe intoxication, which cannot be relieved with help of medicines. The use of extracorporeal therapeutic apheresis methods is pathogenetically justified in such cases, and our experience shows the validity of this approach in the treatment of drug dependence.

Keywords

Opioids; drug addiction; withdrawal syndrome; delirium; intoxication; therapeutic apheresis; plasmapheresis

Introduction

More than 2 million of Americans have criteria for disorders associated with opioids consumption [1]. The number of deaths from them is increasing. In 2016 alone 63,632 people died in the United States from opioids overdose [2, 3]. Heroin and fentanyl are the main (up to 84%) causes of death. Fentanyl, however, appears to be the most deadly opioid [4]. One of the reasons for such an epidemic is the prescription of opioid drugs (legally or illegally) for pain syndromes, and the number of such patients in the United States is approximately 1,000,000 [5, 6]. The incidence of opioids addiction is 4.7% in cases of opioid prescription for therapeutic purposes (iatrogenic dependence) [7].
Moreover, women represent the fastest growing population of drug addicts in the United States [8]. Continuing opioid intake during pregnancy is the risk for severe withdrawal syndrome after giving birth to the child with a higher morbidity and mortality rate, as well as development of serious central nervous system lesions to over 700 per 10,000 births [9]. This is also accompanied by a higher maternal mortality rate [10], and among newborns the mortality rate reaches 6
2
per 1000 births [11]. The frequency of neonatal abstinence syndrome in the United States ranges from 7 to 27 cases per 1,000 births and it can be said that one such child is born every 15 minutes [12, 13].