在长期服用阿片类药物治疗慢性疼痛的患者中,使用兴奋剂和与阿片类药物相关的危害
Ayesha Appa1, Vanessa M McMahan2, Kyna Long2
1University of California, San Francisco (UCSF), Division of HIV, Infectious Diseases & Global Medicine, Department of Medicine, 995 Potrero Ave, Box 0874, San Francisco, CA 94110, USA.
Drug and alcohol dependence
|January 21, 2024
概括
对兴奋剂的阳性尿液药物测试 (UDT) 并没有增加与阿片类药物相关的危害,但与停止长期阿片类药物治疗 (LTOT) 有关. 医疗保健提供者应该讨论物质使用,而不是立即停止LTOT.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 在治疗长期阿片类药物治疗 (LTOT) 疼痛的患者中,对兴奋剂使用的影响缺乏清晰度.
- 在这个人群中,对兴奋剂使用的最佳临床反应还没有得到很好的定义.
研究的目的:
- 调查积极的刺激剂尿液药物测试 (UDTs) 与随后的阿片类药物相关伤害之间的关联.
- 为了确定兴奋剂阳性UDT是否与停止LTOT相关.
主要方法:
- 一项回顾性队列研究,涉及600名接受慢性非癌症疼痛LTOT的患者.
- 对2012-2019年UDT结果的分析,以评估与阿片类药物相关的急诊室访问或死亡以及在90天内停止使用LTOT.
- 使用后勤回归来评估关联,控制相关因素.
主要成果:
- 在兴奋剂阳性UDT后的90天内没有发生过量阿片类药物死亡.
- 兴奋剂阳性UDT与与阿片类药物相关的急诊室访问增加没有显著的关联 (aOR1.39;95%CI=0.88-2.21).
- 刺激剂阳性UDT与在90天内停止LTOT独立相关 (aOR2.96;95%CI=2.13 - 4.12).
结论:
- 虽然UDT检测到的兴奋剂使用与阿片类药物相关伤害增加无关,但与LTOT停药有关.
- 调查结果表明,兴奋剂检测需要讨论物质使用和风险,而不是自动停止LTOT.
- 携带艾滋病毒的生活与停止LTOT治疗的可能性较低有关.
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