伤害前阿片类药物使用与工作伤害后阿片类药物使用模式之间的关联
Deborah Fulton-Kehoe1, John Haight1, Andrea Elmore1
1Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.
American journal of industrial medicine
|December 5, 2024
概括
在工作伤害之前使用阿片类药物显著增加了伤害后长期处方阿片类药物的可能性. 医疗保健提供者应监测伤害前的阿片类药物使用,以有效地管理伤害后的处方.
科学领域:
- 职业健康 职业健康 职业健康
- 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:
- 有限的研究存在于长期的阿片类药物处方后与工作有关的伤害.
- 了解受伤前的阿片类药物使用对于预测受伤后的处方模式至关重要.
研究的目的:
- 评估受伤后工人的长期阿片类药物处方模式.
- 调查伤害前阿片类药物使用与伤害后阿片类药物处方之间的关联.
主要方法:
- 使用了相关的工人赔偿和处方药监测计划 (PDMP) 数据.
- 在受伤前3个月和受伤后1年内分析了阿片类药物处方.
主要成果:
- 19%的受伤工人初次处方阿片类药物还在受伤前3个月内使用了阿片类药物.
- 在受伤前使用阿片类药物的工人在受伤后9-12个月内 (34%vs7%) 更有可能接受阿片类药物.
- 在受伤后9-12个月的慢性阿片类药物使用 (≥60天) 在那些先前有阿片类药物处方的人群中 (20%对0.4%) 显著更高.
结论:
- 在受伤前的阿片类药物使用和在工作相关伤害后的长期阿片类药物处方之间存在强烈的关联.
- 医疗保健提供者必须意识到这种关系,以告知临床实践和患者护理.
相关概念视频
Analgesia and Pain Management
504
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...
504
Opioid Analgesics: Synthetic and Semisynthetic Opioids
223
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...
223
Opioid Analgesics: Morphine and Other Natural Cogeners
183
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...
183
Opioid Receptors: Overview
521
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,...
521
Drug Abuse and Addiction: Pharmacological Phenomena
437
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
437


