Colameco Stephen, Coren Joshua S, Ciervo Carman A
Department of Family Medicine, University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine, Stratford, NJ, USA.
Postgrad Med. 2009 Jul;121(4):61-6. doi: 10.3810/pgm.2009.07.2032.
Physicians have embraced the concept of long-term opioid treatment for chronic noncancer pain (CNCP), as evidenced by increased prescribing. Many patients have benefited from more liberal opioid prescribing, but many have not, and prescription opioid abuse has risen significantly coincident with increased prescribing. Because of the potentially serious adverse effects of opioids, physicians must balance potential benefits against risks, especially in individuals at risk for opioid misuse, abuse, or dependence. This article reviews long-term, continuous opioid treatment of CNCP, current treatment guidelines, addiction risk stratification, opioid-induced hyperalgesia, and endocrine dysfunction.
医生们已经接受了长期使用阿片类药物治疗慢性非癌性疼痛（CNCP）的概念，开药量的增加就是证明。许多患者从更宽松的阿片类药物处方中受益，但也有许多患者没有受益，而且处方阿片类药物滥用现象随着开药量的增加而显著上升。由于阿片类药物可能产生严重的不良反应，医生必须权衡潜在益处与风险，尤其是在有阿片类药物滥用、误用或成瘾风险的个体中。本文综述了CNCP的长期、持续阿片类药物治疗、当前治疗指南、成瘾风险分层、阿片类药物诱导的痛觉过敏和内分泌功能障碍。
