Extracorporeal detoxication is a large group of efferent methods of treatment, implying use of special equipment for blood purification from toxic substances out of the body. There are such procedures as hemosorption, plasmapheresis and liquorsorption used in drug treatment.
Extracorporeal methods of detoxication find a use in situations, when traditional methods appear to be not very effective, for example – in case of acute psychosis, caused by using different drugs; by excessive intoxication caused by narcotic substances and pharmaceuticals; severe abstinence syndrome; high resistance to conducted therapy; co-existing pathology – toxic and viral hepatitis.
Hemosorption (from Greek haema – the blood + Lat. sorbere - to absorb) — is a way of treatment, directed at moving off different toxic products from the blood and hemostasis regulation, when the blood contacts with the sorbent outside the body. By this type of sorption the particles of absorbed substance and absorbents get into chemical reaction. Hemosorption is a method of extrarenal blood purification from toxic substances by toxin adsorption on sorbent’s surface. Activated carbon (charcoal hemoperfusion) or ion-exchange resin (for blood purification from some groups of chemical substances) are used as sorbents.
Plasmapheresis — plasm (blood plasma) + aphairesis (removal or deletion). Depending on the method of plasma production, there are instrumental, centrifugal, membranous and sedimentation plasmapheresis. In the process of plasmapheresis a portion of blood is taken from the organism and placed into a bottle in hemocontainer. Then the blood, depending on the method, is divided into plasm and blood corpuscles (erythrocytes (red blood cells), leukocytes (white blood cells), thrombocytes (cells, taking part in blood coagulation). The blood cells return to the organism, while the plasm, depending on the type of plasmapheresis – therapeutical or donor, is utilized, used for transfusion or used for preparing components or blood products. If the plasm is affected to other methods of influence, such as the cold, and returns then, this procedure is called cryopheresis.
Liquorsorption – is an operation of extracorporal fractional or continous liquor processing with hemosorbent usage. Extracorporal liquor correction, consisting in sorption and filtration of pathologic bioactive compounds from cerebrospinal fluid of a human, finds use for drug treatment. Liquor detoxication allows to interrupt the pathological process and activates the own mechanisms of functioning of central nervous system.
The duration of procedures is from half an hour and more. The procedures cause certain injury of skin cover, and liquorsorption causes injury of dura mater of spinal cord with the following penetration into internal environment of human organism, therefore they are considered to be surgical interferences with ensuing consequences. The procedures of this kind should be performed in conditions of absolute sterility; there exist a probability of possible complications by using them.
There is an opinion among drug users, that after such procedures their blood will be totally purified from toxins, which form after using narcotic substances, and this will contribute to good health. Addicts, who use homemade narcotics, ask for appointment cards to these procedures and think this will help their blood to get purified from all the dirt, containing in the drugs they use. They consider the dirt to be those small particles of herbal raw material, which are impossible to purify in home conditions, and which paints drugs in dark and non-transparent colors.
Such particles get into the blood by intravenous injection. But they don’t stay in the circulatory system for long. Within several hours they are captured by special cells called phagocytes, which always contain in the blood. The phagocytes partially destroy the particles, and those, which are left, concentrate in the cells of reticulo-endothelial system (RES). Reticuloendothelium covers the internal surface of blood vessels. The particles concentrate in hepatic vessels mostly; the great amount of them remains there forever, and they can’t be removed from there even with the assistance of the existing methods of drug treatment.
There is a certain risk in applying such procedures, as by any surgical interference (although the risk is far less in case of hemosorption and plasmapheresis). Degree of risk increases by liquorsorption. It is connected not only with skin cover injury, but also with maters of spinal cord violation. The penetration into the space common for the brain and the spinal cord may bring to serious complications. Of course, when such treatment is performed by experienced physicians, the risk is minimal, but still it exists.
The optimal method for narcology today is noticed to be plasmapheresis. It differs from labor-intensive, expensive, not always effective and highly traumatic sorption methods by sufficient effectiveness, relative safety and commercial availability.
Extracorporeal detoxication alone is not enough for drug treatment. We shouldn’t forget about psychological dependence from narcotics. If not taking into account this fact, the addict will most likely begin taking drugs again.
