ÖZEL GRUPLARDA ALKOL VE MADDE KULLANIM BOZUKLUKLARI VE TEDAVİSİ

Ozel_Gruplarda_Alkol_ve_Madde_Kullanimi_Bozukluklari_ve_Tedavisi_kapak

KADINLARDA, GEBELERDE VE EMZİRENLERDE ALKOL VE MADDE KULLANIM BOZUKLUKLARI

Kübra Sezer Katar

Ankara Eğitim ve Araştırma Hastanesi, Ruh Sağlığı ve Hastalıkları Kliniği, Ankara, Türkiye

Sezer Katar K. Kadınlarda, Gebelerde ve Emzirenlerde Alkol ve Madde Kullanım Bozuklukları. Doğan Bulut S, editör. Özel Gruplarda Alkol ve Madde Kullanım Bozuklukları ve Tedavisi. 1. Baskı. Ankara: Türkiye Klinikleri; 2025. p.43-55.

ÖZET

Alkol ve Madde Kullanım Bozuklukları (AMKB) kadınlar arasında da giderek artan önemli bir psikiyatrik sorun haline gelmiştir. Kadınlarda AMKB gelişiminde biyolojik, çevresel, sosyokültürel ve genetik faktörler önemli rol oynamaktadır. Erkeklerle kıyaslandığında kadınlarda maddeye erişim ve bağımlılık süreçleri farklı seyretmekte, kadınlar daha hızlı bağımlılık geliştirme eğilimi göstermektedir. Ayrıca, kadınlarda AMKB’ye eşlik eden istismar, aile işlev bozuklukları ve sosyal roller gibi çevresel faktörler daha belirgindir. Epidemiyoloji çalışmalarında, kadınlarda alkol ve tütün ürünlerinin kullanımı en yaygın maddeler arasında yer alırken, gebelerde ve emziren kadınlarda alkol ve madde kullanım oranlarının artış gösterdiği belirtilmiştir. Gebelik ve emzirme dönemlerinde kullanılan maddelerin fetüs ve yenidoğan üzerinde olumsuz etkileri olduğu gibi, bu durum annenin sağlık durumunu da tehlikeye atmaktadır. Nörobiyolojik faktörler, kadınlarda bağımlılığın farklı gelişim evrelerinde erkeklerden ayrıştığını göstermektedir. Hormonların (östrojen ve progesteron) bağımlılık süreçlerindeki etkileri, metabolizma farklılıkları ve beyin yapılarındaki farklılıklar bu süreçte belirleyici rol oynamaktadır. Gebelik ve emzirme dönemlerinde AMKB, hem anne hem de fetüs/yenidoğan açısından ciddi riskler taşımaktadır. Fetal alkol sendromu, nikotin maruziyeti ve opioidlerin yol açtığı neonatal yoksunluk sendromu gibi sorunlar bu dönemde sıkça karşılaşılan durumlardır. Gebelikte ve emzirme sürecinde kullanılan farmakolojik tedaviler sınırlı veriler nedeniyle dikkatli bir şekilde uygulanmalıdır. Tedavi ve öneriler arasında, kadınlar için özel bir yaklaşım geliştirilmesi, sosyal destek sistemlerinin güçlendirilmesi, stigma ve ayrımcılıkla mücadele edilmesi önemlidir. Gebelik ve emzirme döneminde bütüncül bir yaklaşım benimsenmeli, hem annenin hem de bebeğin sağlığı gözetilerek tedavi süreçleri planlanmalıdır. Sonuç olarak, AMKB kadınlar, gebeler ve emziren anneler için biyolojik, psikososyal ve kültürel boyutlarıyla ele alınması gereken karmaşık bir sorundur. Toplumun her bireyini etkileyen bu durum, sağlık çalışanlarının multidisipliner bir yaklaşımla ele alması gereken bir alan olarak öne çıkmaktadır.

Anahtar Kelimeler: Bağımlılık; Gebelik; Emzirme; Kadın sağlığı; Madde kullanımına bağlı bozukluklar

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