治疗阿片类药物使用障碍的药物,阿片类药物戒断和阿片类药物过量服用:一篇评论
Miriam T H Harris1, Zoe M Weinstein1, Alexander Y Walley1
1Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
JAMA
|February 11, 2026
概括
治疗阿片类药物使用障碍 (MOUD) 的药物显著降低死亡率和阿片类药物使用. 获得MOUD,包括甲和布普伦诺芬,以及用纳洛逆转过量,对于管理阿片类药物使用障碍 (OUD) 至关重要.
科学领域:
- 成 药物 药物 药物 药物
- 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:
- 阿片类药物使用障碍 (OUD) 是一个普遍存在的全球问题,影响着数以百万计的人,并导致显著的死亡率.
- OUD是全球第三个最常见的物质使用障碍,美国成年人患病率很高,最近的死亡率数据也很高.
- 对阿片类药物使用障碍 (MOUD) 的药物对于减少OUD相关的发病率和死亡率至关重要,包括治疗戒断和逆转过量.
研究的目的:
- 审查药物在管理阿片类药物使用障碍 (OUD) 中的作用.
- 突出像甲,布普伦诺芬和纳尔特雷克松等批准药物的有效性,减少阿片类药物使用和死亡率.
- 强调可访问的MOUD和纳洛对于OUD治疗和过量逆转的重要性.
主要方法:
- 对FDA批准的OUD药物的审查,包括美沙,布普伦诺芬和纳尔德.
- 对用于阿片类药物戒断症状和阿片类药物过量逆转的药物的检查.
- 分析治疗可访问性和以患者为中心的决策,以选择MOUD.
主要成果:
- 甲和布普伦诺芬有效地降低了OUD患者的过量服用风险和全因死亡率.
- 在2022年,只有25.1%的美国OUD成年人接受了MOUD,这表明治疗缺口.
- 药物用于阿片类药物戒断 (激动剂,α2受体激动剂) 和过量逆转 (纳洛) 是OUD护理的重要组成部分.
- 社区纳洛的分发与过量服用率的显著降低有关.
结论:
- 所有患有OUD的人都应该提供MOUD,以减少阿片类药物使用和死亡率.
- 有效的OUD管理包括MOUD,戒断症状的治疗,以及随时可用的纳洛用于过量逆转.
- 共享决策是根据患者需求和治疗可用性选择合适的MOUD的关键.
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