美国国家公共电台 NPR Without Medical Support, DIY Detox Often Fails

 

RACHEL MARTIN, HOST:

People struggling with opioid addiction¹ can get help. But waiting lists are long, and treatment is expensive. So some people try to detox all on their own. Addiction specialists say this is not a good idea. WHYY's Elana Gordon explains.

ELANA GORDON, BYLINE²: Elvis Rosado grew up in North Philly in the Badlands. It's an area well-known for drugs. He was in his teens when he developed a deep affinity³ for what was then called pancakes and syrup⁴.

ELVIS ROSADO: I actually had - and I'm going to have to say it - a relationship, a love relationship with codeine.

GORDON: He quickly became addicted⁵. Soon he was selling drugs to support his habit. By the time he was 25, he'd hit rock bottom. He was in jail.

ROSADO: I was like, I have to kick this. I have to break this.

GORDON: This was 25 years ago. But Rosado didn't ask for help from the jail's clinic staff, who could have given him medication to help with the symptoms. For him, if he took anything...

ROSADO: In my head, I was like, I'm still using.

GORDON: So began the most intense physical and mental experience he could have imagined.

ROSADO: The first day is gradual. It's like the onset⁶ of the flu.

GORDON: But then that flu went on steroids.

ROSADO: By 12 hours, I literally⁷ felt like not only did I have the flu, but I had a stomach virus and God knows what else. It was a difficult night.

GORDON: Full of shakes, racing⁸ heartbeat.

ROSADO: The sweats, the throwing up. It just gets really, really bad. The physical pain, it's like having Freddy Krueger inside you trying to rip his way out.

GORDON: Did you worry that it was going to kill you?

ROSADO: No, I don't think I ever worried about that. I had days where I felt like I wish I was dead.

GORDON: But is it dangerous to detox from opioids on your own? I asked Dr. Kyle Kampman, a psychiatrist⁹ at the University of Pennsylvania.

KYLE KAMPMAN: It's certainly uncomfortable, and most people can't tolerate it.

GORDON: But...

KAMPMAN: For people who are healthy, it's generally not a life-threatening condition.

GORDON: The diarrhea and vomiting¹⁰ from withdrawing can make you dehydrated. That can lead to severe complications, even deaths. But what Kampman really worries about is patients trying to avoid the side effects or cravings by getting drugs on their own without the understanding of potential adverse¹¹ drug reactions or knowing how to safely monitor dosages. And beyond that...

KAMPMAN: What bothers me most about thinking that detox is adequate treatment is that we know that it just doesn't work.

GORDON: Some studies show the relapse rate is upwards¹² of 90 percent without prescribed meds and monitoring to control the drug cravings after that initial withdrawal¹³.

FREDERIC BAURER: So this is a detox unit. Their medications are controlled. The environment is controlled.

GORDON: Dr. Frederic Baurer is medical director of Kirkbride. It's a big recovery center in Philadelphia, where he's been treating people with addiction for 30 years. Baurer wants to throw out the old notion of detox.

BAURER: Back then, detox was thought of more as a treatment. Like, you go to detox, and then you're supposed to be well. And that's a really pernicious myth.

GORDON: Baurer says treatment is a lot more than getting the drugs out of your system. You can't just flush out the addiction. It's about counseling and perhaps, most important, medication like suboxone or methadone to manage the cravings. More and more evidence backs this.

BAURER: We have to really consider all the tools that are out there to support someone in getting well.

GORDON: And that can be a lifelong process.

ROSADO: There was this constant, like, there's something missing; there's something missing.

GORDON: For Elvis Rosado, drug cravings haunted him long after he detoxed on his own in jail. They even consumed his dreams.

ROSADO: Even though I wasn't using, my thoughts were still corrupted¹⁴.

GORDON: Over the last few decades, he's found counseling and support. But researchers would say success with detox is the exception. Rosado, in fact, says his cellmate back in jail tried kicking the habit, too. But within months of being released, he'd relapsed and died of an overdose. For NPR News, I'm Elana Gordon in Philadelphia.

MARTIN: That story was part of the reporting partnership¹⁵ with NPR, WHYY's health show The Pulse and Kaiser Health News.

1 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 affinity   

n.亲和力，密切关系

参考例句：

• I felt a great affinity with the people of the Highlands.我被苏格兰高地人民深深地吸引。
• It's important that you share an affinity with your husband.和丈夫有共同的爱好是十分重要的。

4 syrup   

n.糖浆，糖水

参考例句：

• I skimmed the foam from the boiling syrup.我撇去了煮沸糖浆上的泡沫。
• Tinned fruit usually has a lot of syrup with it.罐头水果通常都有许多糖浆。

5 addicted   

adj.沉溺于....的，对...上瘾的

参考例句：

• He was addicted to heroin at the age of 17.他17岁的时候对海洛因上了瘾。
• She's become addicted to love stories.她迷上了爱情小说。

6 onset   

n.进攻，袭击，开始，突然开始

参考例句：

• The drug must be taken from the onset of the infection.这种药必须在感染的最初期就开始服用。
• Our troops withstood the onset of the enemy.我们的部队抵挡住了敌人的进攻。

7 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

8 racing   

n.竞赛，赛马；adj.竞赛用的，赛马用的

参考例句：

• I was watching the racing on television last night.昨晚我在电视上看赛马。
• The two racing drivers fenced for a chance to gain the lead.两个赛车手伺机竞相领先。

9 psychiatrist   

n.精神病专家；精神病医师

参考例句：

• He went to a psychiatrist about his compulsive gambling.他去看精神科医生治疗不能自拔的赌瘾。
• The psychiatrist corrected him gently.精神病医师彬彬有礼地纠正他。

10 vomiting   

吐

参考例句：

• Symptoms include diarrhoea and vomiting. 症状有腹泻和呕吐。
• Especially when I feel seasick, I can't stand watching someone else vomiting." 尤其晕船的时候，看不得人家呕。”

11 adverse   

adj.不利的；有害的；敌对的，不友好的

参考例句：

• He is adverse to going abroad.他反对出国。
• The improper use of medicine could lead to severe adverse reactions.用药不当会产生严重的不良反应。

12 upwards   

adv.向上，在更高处...以上

参考例句：

• The trend of prices is still upwards.物价的趋向是仍在上涨。
• The smoke rose straight upwards.烟一直向上升。

13 withdrawal   

n.取回，提款；撤退，撤军；收回，撤销

参考例句：

• The police were forced to make a tactical withdrawal.警方被迫进行战术撤退。
• They insisted upon a withdrawal of the statement and a public apology.他们坚持要收回那些话并公开道歉。

14 corrupted   

（使）败坏( corrupt的过去式和过去分词 )； （使）腐化； 引起（计算机文件等的）错误； 破坏

参考例句：

• The body corrupted quite quickly. 尸体很快腐烂了。
• The text was corrupted by careless copyists. 原文因抄写员粗心而有讹误。

15 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。