美国阿片类药物使用障碍的管理:现状和未来方向
Carlos Blanco1, Nora D Volkow1
1National Institute on Drug Abuse, Bethesda, MD, USA.
Lancet (London, England)
|March 18, 2019
概括
片使用障碍 (OUD) 是一个具有重大风险的严重疾病. 像甲和布普伦诺芬这样的药物可以改善治疗结果,
科学领域:
- 药物成
- 精神病学
- 公共卫生
背景情况:
- 阿片类药物使用障碍 (OUD) 是一种慢性复发性脑疾病,其特征是强迫性寻找和使用阿片类药物,尽管有有害的后果.
- OUD与严重的精神和医疗并发症,增加的死亡率和社会经济因素,如年龄较小,男性性别和收入/教育水平较低有关.
- 虽然遗传学起着作用,但环境和社会因素显著地影响了OUD的风险和进展.
研究的目的:
- 审查目前的阿片类药物使用障碍 (OUD) 治疗情况,重点关注药物有效性和护理层中的挑战.
- 强调扩大对OUD (MOUD) 基于证据的药物获取的迫切需要.
- 提倡加强医疗保健专业培训和创新的护理模式,以改善个性化的OUD干预.
主要方法:
- 综合了OUD流行病学,危险因素和治疗结果的最新研究.
- 分析阿片类药物使用障碍的治疗连锁,确定诊断,治疗入门和持续治疗的障碍.
- 检查目前用于阿片类药物使用障碍 (MOUD) 的药物的作用和有效性,包括甲,布普伦诺芬和纳尔德.
主要成果:
- 治疗阿片类药物使用障碍 (MOUD) 的药物明显改善了患者的治疗结果,减少了非法阿片类药物使用,过量服用死亡和传染性疾病的传播.
- 在OUD护理层面存在重大障碍,阻碍了诊断,治疗启动和持续参与MOUD.
- 尽管已证明有效,但由于系统性问题和医疗保健提供者的培训不足,MOUD的使用仍然不足.
结论:
- 扩大用于阿片类药物使用障碍 (MOUD) 的基于证据的药物的使用对于公共卫生至关重要.
- 解决系统性障碍和加强医疗专业教育对于优化MOUD的有效性至关重要.
- 需要开发新的药物疗法和灵活的护理模式,以个性化OUD治疗并改善长期康复.
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