酒精使用障碍和慢性疼痛:一个被忽视的流行病
Joao P De Aquino1, Matthew E Sloan1, Julio C Nunes1
1Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (DeAquino, Nunes, Ra, Petrakis); Clinical Neuroscience Research Unit, Connecticut Mental Health Center, New Haven, Conn. (De Aquino, Ra); VA Connecticut Healthcare System, West Haven, Conn. (De Aquino, Petrakis); Addictions Division, Centre for Addiction and Mental Health, Toronto (Sloan, Katz, Tang); Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto (Sloan); Department of Pharmacology & Toxicology, University of Toronto (Sloan); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Sloan); Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto (Sloan); Institute of Medical Science, University of Toronto (Sloan, Tang); Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto (Sloan, Tang); University of Ribeirao Preto, Ribeirao Preto, São Paulo, Brazil (Costa); St. Elizabeth's Hospital, Washington, D.C. (De Oliveira).
酒精使用障碍 (AUD) 和慢性疼痛往往同时发生,酒精使用加剧疼痛和慢性疼痛增加AUD风险. 同时管理对于更好的结果至关重要.
科学领域:
- 神经科学是一个神经科学.
- 成 药物 药物 药物 药物
- 疼痛管理 疼痛管理
背景情况:
- 酒精使用障碍 (AUD) 和慢性疼痛是普遍存在的疾病.
- 它们频繁的同时发生往往在临床上被忽视.
- 患有AUD的人报告慢性疼痛的比率更高,慢性疼痛患者可能会使用酒精来缓解,冒着AUD发展的风险.
研究的目的:
- 为了回顾AUD和慢性疼痛之间的复杂关系.
- 介绍它们相互相互作用的理论模型.
- 讨论评估方法,治疗方法以及同时进行管理的必要性.
主要方法:
- 现有文献的叙述性审查.
- 开发AUD和慢性疼痛相互作用的理论模型.
- 对疼痛评估方法的审查 (自我报告,心理物理).
- 对药物治疗和心理治疗的讨论.
主要成果:
- 一个理论模型说明了中毒和戒断阶段的双向关系.
- 酒精的止痛作用导致耐受性和增加消费.
- 戒断会引发戒断过敏症,增加复发风险.
- 慢性神经生物学变化使疼痛和酒精渴望延续.
结论:
- 有效的管理需要同时治疗AUD和慢性疼痛.
- 在AUD研究中需要改进疼痛评估.
- 药物治疗和心理治疗可以提供双重好处.
- 解决这些相互交织的疾病在临床上具有重要意义.
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