Saffier Kenneth, Colombo Cynthia, Brown David, Mundt Marlon P, Fleming Michael F
Department of Family and Community Medicine, University of California Davis and Contra Costa Regional Medical Center, Martinez, CA 94552, USA.
J Subst Abuse Treat. 2007 Oct;33(3):303-11. doi: 10.1016/j.jsat.2006.12.011. Epub 2007 Mar 21.
The treatment of chronic pain with opioids remains controversial. Physicians are concerned about addiction and drug diversion, and there is limited empirical information on the use of opioids in patients with chronic pain. This report presents data on the Addiction Severity Index (ASI) collected in a sample of patients (N = 908) receiving opioids from their primary care physicians. The ASI provides clinically important information about patients receiving opioid therapy. The ASI consists of seven subscales, including medical, alcohol, drug, employment/support, legal, family/social, and psychiatric domains. Clinically relevant findings include high ASI medical score (0.87), high psychiatric severity score (0.27), lifetime treatment of alcohol problems (reported by 22% of men), prior delirium tremens (5.6%), prior treatment for drug problems (10.1%), prior drug overdose (12.1%), and drunk-driving citations (28%); 40.3% of women had serious suicidal thoughts, and 23.8% had suicide attempts. The ASI provides important information that can help primary care physicians manage patients with chronic pain who are receiving opioid therapy.
使用阿片类药物治疗慢性疼痛仍然存在争议。医生们担心成瘾和药物滥用问题,而且关于阿片类药物在慢性疼痛患者中的使用,实证信息有限。本报告呈现了在一个从初级保健医生处接受阿片类药物治疗的患者样本(N = 908)中收集到的成瘾严重程度指数(ASI)数据。ASI提供了有关接受阿片类药物治疗患者的重要临床信息。ASI由七个分量表组成,包括医疗、酒精、药物、就业/支持、法律、家庭/社会和精神领域。具有临床相关性的发现包括:ASI医疗得分较高(0.87)、精神严重程度得分较高(0.27)、有终身酒精问题治疗史(22%的男性报告有此情况)、既往有震颤谵妄(5.6%)、既往有药物问题治疗史(10.1%)、既往有药物过量情况(12.1%)以及有酒驾记录(28%);40.3%的女性有严重自杀念头,23.8%的女性有过自杀未遂经历。ASI提供了重要信息,可帮助初级保健医生管理接受阿片类药物治疗的慢性疼痛患者。