医疗使用和滥用阿片类止痛药的趋势
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
概括
从1990年到1996年,阿片类止痛药的医疗使用增加了,但对大多数药物的滥用提及减少了. 这表明,增加的止痛药处方并没有导致更多的滥用后果.
科学领域:
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 阿片类止痛药对于疼痛管理至关重要,但由于滥用问题而面临不情愿.
- 有限的数据存在与阿片类止痛药滥用相关的健康后果.
研究的目的:
- 评估与阿片类止痛药相关的药物滥用比例.
- 分析医疗使用和滥用五种关键阿片类止痛药 (芬太尼,水墨,美佩里丁,吗啡, oxycodone) 治疗严重疼痛的趋势.
主要方法:
- 对1990-1996年的医疗记录进行了回顾性分析.
- 数据来源于药物滥用警告网络 (滥用数据) 和报告自动化和合并订单系统 (医疗使用数据).
- 评估全国代表性的医院急诊室因药物滥用而入院的情况.
主要成果:
- 吗啡,芬太尼,氧可和水利摩尔的医疗用量增加; 梅佩里丁的医疗用量减少.
- 报告中提到的阿片类止痛药滥用的年总数略有上升 (6.6%),但它们相对于所有滥用药物的比例下降了 (5.1%至3.8%).
- 滥用报告下降了梅佩里丁,氧化,芬太尼和水利摩尔;对吗啡略有增加.
结论:
- 增加用于缓解疼痛的阿片类止痛药的医疗利用与滥用相关健康后果的增加没有相关性.
- 这项研究表明,增加的处方率与这些特定止痛药的滥用问题不断升级的潜在脱.
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