新泽西州的新立法减少了创伤患者的阿片类药物使用
Renay Durling-Grover1, Louis T DiFazio1, John M Adams1
1Department of Surgery, Morristown Medical Center, Morristown, New Jersey.
Journal of opioid management
|June 3, 2023
概括
新泽西州的立法成功地将住院患者的阿片类药物消费量减少了近40%,而不会影响患者的疼痛管理. 这项研究评估了2017年法律限制急性疼痛处方后的阿片类药物使用情况.
科学领域:
- 创伤外科手术是什么
- 疼痛管理 疼痛管理
- 公共卫生政策 公共卫生政策
背景情况:
- 阿片类药物流行仍然是一个关键的公共卫生问题,需要立法干预.
- 2017年,新泽西州通过了参议院法案3,将阿片类药物处方限制从30天减少到急性疼痛的5天.
- "阿片类药物使用障碍带来重大风险,包括成和死亡率.
研究的目的:
- 评估新泽西州参议院法案3对住院患者阿片类药物消费的影响.
- 根据立法,在一级创伤中心评估阿片类止痛药使用的变化.
- 为了确定减少阿片类药物处方是否影响疼痛管理质量.
主要方法:
- 进行了对2016年和2018年患者的比较分析.
- 测量了住院患者每天平均的吗啡毫克相当量 (MME) 消耗量.
- 伤害严重程度评分 (ISS) 和患者平均疼痛评分进行了比较.
主要成果:
- 尽管2018年平均ISS较高,但阿片类药物消费显著下降 (p < 0.001).
- 住院患者的平均每日MME消费量从2016年的14.1 ± 0.5下降到2018年的8.8 ± 0.3.
- 减少阿片类药物使用发生在没有增加患者平均疼痛评级的情况下.
结论:
- 该立法有效地减少了住院患者的阿片类药物使用.
- 减少阿片类药物消费并没有对疼痛管理质量产生负面影响.
- 这些发现支持政策干预措施在制阿片类药物流行病方面的成功.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
349
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
349
Analgesia and Pain Management
669
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
669
Standards of Care I
731
Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
731
Opioid Analgesics: Morphine and Other Natural Cogeners
305
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
305
Opioid Receptors: Overview
1.1K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
1.1K
Drug Control Governance: Regulatory Bodies and Their Impact
196
Drug control governance involves the oversight and regulation of pharmaceuticals to ensure their safety and efficacy while preventing illegal drug use and trafficking. Regulatory bodies, including the US Food and Drug Administration (FDA) and the European Union's European Medicines Agency (EMA), play a central role in this process. These agencies evaluate the safety and efficacy of drugs before they can be marketed. They fund clinical trials and assess the benefits and risks associated with...
196


