Smith Meredith Y, Woody George
Purdue Pharma, L.P., One Stamford Forum, Stamford, CT 06901, USA.
Curr Psychiatry Rep. 2005 Oct;7(5):337-43. doi: 10.1007/s11920-005-0033-4.
The nonmedical use of scheduled medications commonly prescribed for pain, pain-related symptoms, and psychiatric disorders began rising in the mid-1990s. Physicians are confronted with the dilemma of how to minimize the abuse and diversion potential of these products without compromising access for patients with a legitimate medical need. Using data from the National Survey on Drug Use and Health, we describe the scope of nonmedical use of opioids, stimulants, and tranquilizers; characteristics of nonmedical users; and options available to reduce abuse liability. In 2003, lifetime prevalence estimates of nonmedical use were 31.2 million for opioids, 20.7 million for stimulants, and 20.2 million for tranquilizers. Nonmedical users of psychotherapeutics were more likely to be Caucasian; use alcohol, cocaine, or heroin; and to use needles to inject drugs than those who reported using illicit drugs only. Sources of diversion are enumerated, and options for minimizing the abuse liability associated with these medications are described.
常用于疼痛、疼痛相关症状及精神疾病的受管制药物的非医疗用途自20世纪90年代中期开始上升。医生面临着两难困境，即如何在不影响有合理医疗需求患者的药物可及性的情况下，尽量减少这些产品的滥用和转移风险。利用来自全国药物使用和健康调查的数据，我们描述了阿片类药物、兴奋剂和镇静剂的非医疗用途范围；非医疗使用者的特征；以及可用于降低滥用风险的选择。2003年，阿片类药物非医疗用途的终生患病率估计为3120万，兴奋剂为2070万，镇静剂为2020万。与仅报告使用非法药物的人相比，精神治疗药物的非医疗使用者更有可能是白人；使用酒精、可卡因或海洛因；以及使用针头注射毒品。文中列举了药物转移的来源，并描述了将这些药物的滥用风险降至最低的选择。
