Brands Bruna, Blake Joan, Sproule Beth, Gourlay Douglas, Busto Usoa
Centre for Addiction and Mental Health, University of Toronto, 33 Russell St., Toronto, Ont., Canada M5S 2S1.
Drug Alcohol Depend. 2004 Feb 7;73(2):199-207. doi: 10.1016/j.drugalcdep.2003.10.012.
To characterize prescription opioid dependent patients in a methadone maintenance treatment (MMT) program, a detailed retrospective chart review of new admissions (1997-1999, n=178, mean age=34.5+/-0.7 years, 65% male) was conducted. At admission most patients (83%) had been using prescription opioids (+/-heroin). Four groups were identified: 24% had used prescription opioids only; 24% used prescription opioids initially and heroin later; 35% used heroin first and prescription opioids subsequently; and 17% had used heroin only (this group was significantly younger: mean age 26+/-1 years, P=0.0001). Subjects reported regular use of prescription opioids at higher than therapeutic dosages. For example, in the 'prescription opioid only' group the reported mean (+/-S.E.) number of codeine or oxycodone-containing tablets consumed daily was 23 (+/-6) tablets and 21 (+/-3) tablets, respectively. There were no significant differences found amongst the groups in measures of social stability. Those dependent on prescription opioids alone were less likely to use illicit non-opioid drugs or to be associated with injection drug use. Those that used prescription opioids only or initially were more likely to have ongoing pain problems and to be involved in psychiatric treatment. Further research is required to better elucidate the complex relationships between pain, mental health and addiction in order to develop optimal prevention and treatment strategies for prescription opioid dependence.
为了描述美沙酮维持治疗（MMT）项目中处方阿片类药物依赖患者的特征，我们对新入院患者（1997 - 1999年，n = 178，平均年龄 = 34.5±0.7岁，65%为男性）进行了详细的回顾性病历审查。入院时，大多数患者（83%）一直在使用处方阿片类药物（±海洛因）。确定了四组：24%仅使用处方阿片类药物；24%最初使用处方阿片类药物，后来使用海洛因；35%首先使用海洛因，随后使用处方阿片类药物；17%仅使用海洛因（该组明显更年轻：平均年龄26±1岁，P = 0.0001）。受试者报告经常以高于治疗剂量使用处方阿片类药物。例如，在“仅使用处方阿片类药物”组中，报告的每日服用含可待因或羟考酮片剂的平均（±标准误）数量分别为23（±6）片和21（±3）片。在社会稳定性指标方面，各组之间未发现显著差异。仅依赖处方阿片类药物的人使用非法非阿片类药物或与注射吸毒相关的可能性较小。仅使用或最初使用处方阿片类药物的人更有可能持续存在疼痛问题并接受精神科治疗。需要进一步研究以更好地阐明疼痛、心理健康和成瘾之间的复杂关系，从而制定针对处方阿片类药物依赖的最佳预防和治疗策略。
