Dartmouth College, 7764 Parker House, Hanover, NH 03755, USA.
Curr Psychiatry Rep. 2009 Oct;11(5):377-84. doi: 10.1007/s11920-009-0057-2.
When prescribed appropriately and used as prescribed, opioid medications can safely and effectively treat pain. Best practices with respect to their use in chronic non-cancer-related pain (CNCP) are evolving. Opioids may be subject to misuse for a variety of purposes, including self-medication, use for reward, compulsive use because of addiction, and diversion for profit. Individuals with chronic pain and co-occurring substance use, mental health disorders, and other conditions may be at increased risk for misuse of prescribed opioids. Interdisciplinary pain management, the use of universal precautions in all patients, and special attention to the structure of care in those at higher risk for opioid misuse may improve outcomes in opioid treatment of CNCP. This article discusses evolving research and clinical literature related to the care of individuals with CNCP at a higher risk for opioid misuse.
当合理处方和按规定使用时，阿片类药物可以安全有效地治疗疼痛。关于在慢性非癌症相关疼痛（CNCP）中使用的最佳实践正在不断发展。阿片类药物可能会被滥用，其目的包括自我治疗、为了奖励而使用、因为成瘾而强迫使用以及为了盈利而转移。患有慢性疼痛和同时存在物质使用、心理健康障碍和其他疾病的人可能更容易滥用处方阿片类药物。跨学科疼痛管理、在所有患者中使用通用预防措施以及特别关注那些有更高阿片类药物滥用风险的患者的护理结构，可能会改善 CNCP 中阿片类药物治疗的效果。本文讨论了与治疗 CNCP 中具有更高阿片类药物滥用风险的个体相关的不断发展的研究和临床文献。
