阿片类药物使用障碍和同时使用二:临床风险和管理策略
Adam Fakhri1, Alexis Ritvo2, Jennifer Casarella1,3
1Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA.
Journal of addictive diseases
|December 9, 2025
概括
同时使用二胺 (BZD) 和阿片类药物使用障碍 (OUD) 的管理至关重要. 本综述强调了OUD患者在OUD (MOUD) 药物中的高BZD联合使用率,强调了风险和更安全的患者护理框架.
科学领域:
- 临床医学 临床医学
- 药理学 药理学是指药理学的学科.
- 成精神病学成精神病学
背景情况:
- 同时使用二 (BZD) 和阿片类药物使用障碍 (OUD) 是常见的,并且在临床上具有挑战性.
- 这种联合使用增加了过量服用,急诊室访问和治疗中断的风险.
- 接受OUD (MOUD) 药物治疗的患者,如布普伦诺芬和美沙,经常参与其中.
研究的目的:
- 综合当前关于OUD患者BZD联合使用的患病率,风险和管理的证据.
- 专注于接受MOUD治疗的患者.
- 提出一个以证据为基础的管理框架.
主要方法:
- 关于BZD和OUD共同使用的现有数据的文献综合.
- 对服用布普伦诺芬和美沙的患者患病率的分析.
- 在这个人群中对非医疗BZD使用相关风险的审查.
主要成果:
- BZD使用影响了16-21%的布普伦诺芬患者和40-47%的甲患者.
- 非医疗用途的BZD使用显著增加了与过量服用有关的紧急诊所和死亡率.
- 报告了增加死亡风险的95%置信区间 (7.8-13.2).
结论:
- 提出了一个基于证据的框架,用于管理OUD中的BZD共用.
- 关键组成部分包括OUD稳定,监测,降低危害,BZD逐渐缩小和心理社会干预.
- 这种方法平衡了以患者为中心的护理的安全性和有效性.
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