Boureau F, Luu M, Koskas-Sergent A S, Doubrere J F
Centre d'Evaluation et de Traitement de la Douleur, Hôpital Saint-Antoine, Paris.
Therapie. 1992 Nov;47(6):513-8.
It is commonly recognized than opioids analgesics have an major place in the treatment of pain. In spite of guidelines, opioids drugs remain underutilized in chronic cancer pain and acute severe pain. Among the possible factors, involved in the insufficient use of opioids drugs, is the fear (opiophoby) of physicians, nurses, patients and family to induce or to maintain an addiction. This review examines the potential of iatrogenic addiction. We will examined the place of morphine-like drugs in the treatment of severe acute pain and chronic cancer pain, the definition of dependency in pain patients, the assessment of the dependency potential in patients treated for pain. Available studies indicate that iatrogenic addiction is quite scarce and that the risk for a major tolerance is very small. Further studies will be necessary, since opioids analgesics may also be useful in some non-cancer chronic pain.
人们普遍认为阿片类镇痛药在疼痛治疗中占有重要地位。尽管有相关指南，但阿片类药物在慢性癌痛和急性剧痛治疗中的使用仍未得到充分利用。在阿片类药物使用不足的可能因素中，医生、护士、患者及其家属对引发或维持成瘾的恐惧（阿片恐惧症）是其中之一。本综述探讨了医源性成瘾的可能性。我们将研究吗啡类药物在治疗严重急性疼痛和慢性癌痛中的地位、疼痛患者依赖的定义、接受疼痛治疗患者的依赖可能性评估。现有研究表明医源性成瘾相当罕见，产生显著耐受性的风险非常小。由于阿片类镇痛药在某些非癌性慢性疼痛中可能也有用，因此有必要进行进一步研究。
