Sanz Yagüez F, López Corbalán J C
Hospital comarcal Marina Baixa, Villajoyosa, Alicante.
Rev Esp Anestesiol Reanim. 1999 Oct;46(8):354-8.
Health care givers suffer problems of abuse of and addiction to substances at a rate similar to or perhaps higher than that of the general population according to available studies, most of which were done in the United States. Anesthesiologists tend to have the highest incidence of addiction. Among the risk factors identified are self-medication, stress at work and easy access to drugs. After alcohol, opiates and benzodiazepines are the drugs most favored. No data are available for Spain on this problem. One recently opened treatment program exists, implemented by the Department of Health of the autonomous government of Catalonia (Spain) in collaboration with the Official College of Physicians of Barcelona. Although the problem is probably not great in Spain, prevention programs should be put in place to identify and act on known risk factors, by controlling and limiting access to drugs, raising awareness among health-care givers of the risks of self-medication, and improving working conditions. The main obstacle to treating such patients is denial, which makes identification of abusers and their adherence to a program difficult. The therapeutic phases are identification, intervention, treatment, return to work and follow-up. Addicts are chronic patients who require follow-up for many years, given that the risk of relapse is always present.
根据现有研究,医护人员遭受药物滥用和成瘾问题的比例与普通人群相似,甚至可能更高,其中大部分研究是在美国进行的。麻醉医生的成瘾发生率往往最高。已确定的风险因素包括自我用药、工作压力和容易获得药物。除酒精外,阿片类药物和苯二氮䓬类药物是最常被滥用的药物。西班牙尚无关于此问题的数据。西班牙加泰罗尼亚自治区政府卫生部与巴塞罗那医师公会合作实施了一个最近开设的治疗项目。尽管在西班牙这个问题可能并不严重,但应制定预防计划,通过控制和限制药物获取、提高医护人员对自我用药风险的认识以及改善工作条件,来识别已知风险因素并采取行动。治疗这类患者的主要障碍是患者否认问题,这使得识别滥用者及其坚持治疗计划变得困难。治疗阶段包括识别、干预、治疗、重返工作岗位和随访。成瘾者是慢性病患者,鉴于复发风险始终存在,需要多年的随访。