オピオイド鎮痛剤の医学的使用と乱用の傾向
D E Joranson1, K M Ryan, A M Gilson
1Pain and Policy Studies Group, Comprehensive Cancer Center, University of Wisconsin Medical School, Madison, USA. joranson@facstaff.wisc.edu
JAMA
|February 7, 2001
まとめ
オピオイド鎮痛剤の医学的使用は1990年から1996年まで増加したが,ほとんどの薬物の乱用に関する言及は減少した. これは,鎮痛剤の処方量の増加が,より多くの虐待の結果をもたらさなかったことを示唆しています.
科学分野:
- 薬理学 薬理学とは
- 公共衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
背景:
- オピオイド鎮痛剤は,痛みの管理に不可欠ですが,虐待の懸念のため,躊躇しています.
- オピオイド鎮痛剤の乱用に関連した健康への影響に関するデータは限られている.
研究 の 目的:
- オピオイド鎮痛剤に関連した薬物乱用の割合を評価する.
- 重度の痛みに対する5つの主要なオピオイド鎮痛剤 (フェンタニル,ヒドロモルフォン,メペリジン,モルヒン,オキシコドン) の医学的使用および乱用の傾向を分析する.
主な方法:
- 1990年から1996年の医療記録を遡及的に分析した.
- 薬物乱用警報ネットワーク (乱用データ) と報告自動化および統合注文システム (医療用データ) から得られたデータ.
- 薬物乱用による病院の緊急治療室入院の全国的な評価.
主要な成果:
- モルヒン,フェンタニル,オキシコドン,およびヒドロモルフォンに対する医療使用量は増加し,メペリジンに対する使用量は減少した.
- オピオイド鎮痛剤の乱用に関する報告の年間総数はわずかに増加した (6.6%),しかし,薬物乱用に関する報告の総数に対するそれらの割合は減少した (5.1%から3.8%).
- 虐待の報告はメペリジン,オキシコドン,フェンタニル,ヒドロモルフォンで減少し,モルヒネではわずかに増加した.
結論:
- 痛みを和らげるためのオピオイド鎮痛剤の医療利用の増加は,虐待に関連する健康上の影響の増加と相関していない.
- この研究は,これらの特定の鎮痛剤の乱用問題へのエスカレートによる処方箋率の増加の潜在的な分離を示しています.
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