Basu Sanjay, Bruce R Douglas, Barry Declan T, Altice Frederick L
Yale University AIDS Program, Yale University School of Medicine, New Haven, CT 06511, USA.
J Subst Abuse Treat. 2007 Jun;32(4):399-409. doi: 10.1016/j.jsat.2006.10.005. Epub 2007 Jan 9.
Clinicians treating human immunodeficiency virus (HIV)-infected patients with substance use disorders often face the challenge of managing patients' acute or chronic pain conditions while keeping in mind the potential dangers of prescription opiate dependence. In this clinical review, we critically appraise the existing data concerning barriers to appropriate treatment of pain among HIV-infected patients with substance use disorders. We then analyze published studies concerning the choice of pharmacological pain control regimens for acute and chronic pain conditions in HIV-infected patients, keeping in mind HIV-specific issues related to drug interactions and substance use disorders. We summarize this information in the form of flowcharts for physicians approaching HIV-infected patients who present with complaints of pain, providing evidence-based guidance for the structuring of pain management services and for addressing aberrant drug-taking behaviors.
治疗患有物质使用障碍的人类免疫缺陷病毒（HIV）感染患者的临床医生，在管理患者的急性或慢性疼痛状况时，常常面临挑战，同时要牢记处方阿片类药物依赖的潜在危险。在本临床综述中，我们批判性地评估了有关患有物质使用障碍的HIV感染患者在适当疼痛治疗方面存在的障碍的现有数据。然后，我们分析了已发表的关于HIV感染患者急性和慢性疼痛状况的药理学疼痛控制方案选择的研究，同时牢记与药物相互作用和物质使用障碍相关的HIV特异性问题。我们以流程图的形式为处理有疼痛主诉的HIV感染患者的医生总结了这些信息，为疼痛管理服务的构建以及处理异常用药行为提供基于证据的指导。
