Ilgen Mark A, Trafton Jodie A, Humphreys Keith
Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD 152), Menlo Park, CA 94025, USA.
Drug Alcohol Depend. 2006 May 20;82(3):187-93. doi: 10.1016/j.drugalcdep.2005.09.005. Epub 2005 Oct 10.
Both clinicians and researchers have expressed doubt that opiate dependent patients with significant pain can be effectively treated in methadone maintenance treatment (MMT) programs; however, little research exists on this topic. Patients who report significant pain in the month preceding entry to MMT present with a distinct and more severe pattern of polysubstance use, medical and psychosocial problems than do those without pain. The present study investigated the 1-year treatment outcomes of MMT patients with opiate dependence and pain.
Analyses were based on a national sample of 200 patients presenting in MMT programs for treatment of opiate dependence. Substance use and related problems were measured at treatment entry and 12 months later. Patients reported pain severity over the month preceding treatment entry.
Compared to patients without significant pain, patients who reported significant pain at baseline (n = 103) showed similar substance-related functioning, but poorer psychosocial functioning at 1 year.
Patients with and without significant pain experience comparable reductions in substance use when provided with standard care in MMT programs. However, additional medical and/or mental health treatment is needed for their pain and other problems.
临床医生和研究人员都对阿片类药物依赖且伴有严重疼痛的患者能否在美沙酮维持治疗（MMT）项目中得到有效治疗表示怀疑；然而，关于这一主题的研究很少。与无疼痛的患者相比，在进入MMT治疗前一个月报告有严重疼痛的患者呈现出一种独特且更严重的多物质使用模式、医疗和心理社会问题。本研究调查了患有阿片类药物依赖和疼痛的MMT患者的1年治疗结果。
分析基于在MMT项目中接受阿片类药物依赖治疗的200名患者的全国样本。在治疗开始时和12个月后测量物质使用及相关问题。患者报告了治疗开始前一个月的疼痛严重程度。
与无严重疼痛的患者相比，在基线时报告有严重疼痛的患者（n = 103）在1年时显示出类似的物质相关功能，但心理社会功能较差。
在MMT项目中接受标准护理时，有严重疼痛和无严重疼痛的患者在物质使用方面的减少程度相当。然而，他们的疼痛和其他问题需要额外的医疗和/或心理健康治疗。
