Barrett Sean P, Meisner Jessica R, Stewart Sherry H
Department of Psychology, Dalhousie University, Nova Scotia, Canada.
Curr Drug Abuse Rev. 2008 Nov;1(3):255-62. doi: 10.2174/1874473710801030255.
Many medications with sedative, anxiolytic, analgesic, or stimulant properties have the potential to be inappropriately used. However, because these substances have beneficial effects, many issues pertinent to understanding prescription drug misuse may differ from those associated with other misused substances. There is currently a lack of consensus about what constitutes prescription misuse and a wide range of operational criteria have been proposed. Inappropriate medication use is frequently defined on the basis of user characteristics (i.e. any non-prescribed use), the reason for use (i.e. use for recreational purposes), the presence of clinically significant symptoms (i.e. meeting diagnostic criteria for abuse and dependence) or on the presence of any of these factors. In cases where multiple criteria are used to define misuse there is often a lack of differentiation among them, while studies that use more specific criteria tend to exclude certain types of misuse from consideration altogether. In addition, in some cases there are a number of potential ways that a single operational criterion can be met and many of these may be associated with substantially different risks, harms, and predictors. Due to considerable variability in the classification of medication misuse both within and between studies, it is currently difficult to interpret the clinical significance of existing findings or to determine the true magnitude of problems associated with any particular form of misuse. In the present review many of the problems and challenges for adequately defining prescription drug misuse will be overviewed and recommendations will be made on how to better characterize this phenomenon.
许多具有镇静、抗焦虑、止痛或兴奋特性的药物都有可能被不恰当地使用。然而，由于这些物质具有有益作用，许多与理解处方药滥用相关的问题可能与其他滥用物质的问题有所不同。目前对于什么构成处方药物滥用缺乏共识，并且已经提出了广泛的操作标准。不适当的药物使用通常根据使用者特征（即任何非处方使用）、使用原因（即用于娱乐目的）、是否存在具有临床意义的症状（即符合滥用和依赖的诊断标准）或是否存在这些因素中的任何一个来定义。在使用多个标准来定义滥用的情况下，它们之间往往缺乏区分，而使用更具体标准的研究往往完全排除某些类型的滥用情况不予考虑。此外，在某些情况下，满足单一操作标准可能有多种潜在方式，其中许多可能与截然不同的风险、危害和预测因素相关。由于研究内部和研究之间在药物滥用分类方面存在相当大的差异，目前很难解释现有研究结果的临床意义，也难以确定与任何特定形式滥用相关问题的真实严重程度。在本综述中，将概述充分定义处方药滥用所面临的许多问题和挑战，并就如何更好地描述这一现象提出建议。
