Donaher Paul A, Welsh Christopher
Whitsett Center, Chestertown, MD, USA.
Am Fam Physician. 2006 May 1;73(9):1573-8.
Legislation has enabled physicians to treat opioid-dependent patients with an office-based maintenance program using buprenorphine, a partial mu-opioid receptor agonist. Clinical studies indicate buprenorphine effectively manages opioid addiction. Buprenorphine is more effective than placebo for managing opioid addiction but may not be superior to methadone if high doses are needed. It is comparable to lower doses of methadone, however. Treatment phases include induction, stabilization, and maintenance. Buprenorphine therapy should be initiated at the onset of withdrawal symptoms and adjusted to address withdrawal symptoms and cravings. Advantages of buprenorphine include low abuse potential and high availability for office use. Disadvantages include high cost and possible lack of effectiveness in patients who require high methadone doses. Most family physicians are required to complete eight hours of training before they can prescribe buprenorphine for opioid addiction.
立法已使医生能够使用丁丙诺啡（一种部分μ-阿片受体激动剂），通过基于办公室的维持治疗方案来治疗阿片类药物依赖患者。临床研究表明，丁丙诺啡能有效治疗阿片类药物成瘾。在治疗阿片类药物成瘾方面，丁丙诺啡比安慰剂更有效，但如果需要高剂量，则可能并不优于美沙酮。不过，它与低剂量美沙酮效果相当。治疗阶段包括诱导期、稳定期和维持期。丁丙诺啡治疗应在戒断症状出现时开始，并进行调整以应对戒断症状和渴望。丁丙诺啡的优点包括滥用潜力低以及便于在办公室使用。缺点包括成本高以及对于需要高剂量美沙酮的患者可能缺乏疗效。大多数家庭医生在能够开具丁丙诺啡用于治疗阿片类药物成瘾之前，需要完成八小时的培训。
