Gerra G, Maremmani I, Capovani B, Somaini L, Berterame S, Tomas-Rossello J, Saenz E, Busse A, Kleber H
Health and Human Development Section Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria.
Subst Use Misuse. 2009;44(5):663-71. doi: 10.1080/10826080902810251.
Many studies have documented the safety, efficacy, and effectiveness of long-acting opioids (L-AOs), such as methadone and buprenorphine, in the treatment of heroin addiction. This article reviews the pharmacological differences between L-AO medications and short-acting opioids (heroin) in terms of reinforcing properties, pharmacokinetics, effects on the endocrine and immune systems. Given their specific pharmacological profile, L-AOs contribute to control addictive behavior, reduce craving, and restore the balance of disrupted endocrine function. The use of the term "substitution," referring to the fact that methadone or buprenorphine replace heroin in binding to brain opioid receptors, has been generalized to consider L-AOs as simple replacement of street drugs, thus contributing to the widespread misunderstanding of this treatment approach.
许多研究记录了长效阿片类药物（如美沙酮和丁丙诺啡）在治疗海洛因成瘾方面的安全性、疗效和有效性。本文从强化特性、药代动力学、对内分泌和免疫系统的影响等方面综述了长效阿片类药物与短效阿片类药物（海洛因）之间的药理学差异。鉴于其特定的药理学特征，长效阿片类药物有助于控制成瘾行为、减少渴望并恢复内分泌功能紊乱的平衡。“替代”一词的使用，指的是美沙酮或丁丙诺啡在与脑阿片受体结合时取代海洛因这一事实，已被普遍化，将长效阿片类药物视为街头毒品的简单替代品，从而导致了对这种治疗方法的广泛误解。
