Jan Saira A
Horizon Blue Cross Blue Shield of New Jersey, Newark, NJ 07105-2200, USA.
J Manag Care Pharm. 2010 Feb;16(1 Suppl B):S4-8. doi: 10.18553/jmcp.2010.16.S1-B.4.
The use of opioids for chronic noncancer pain increased 222% from 1992 to 2002. Opioid dependence has also increased significantly, leading to a burden on patients, employers, insurers, society, and the entire health care system. It is imperative that opioid dependence is addressed and treated properly, in order to return patients to being productive participants in the workplace and society.
To provide an overview of addiction, abuse, and dependence and identify risk factors for addiction.
Studies have shown that intensive use of opioids is associated with increased utilization of costly health care services, prolonged disability, and continued use of opioids, leading to abuse and dependence in many patients. While identifying patients at risk for developing opioid dependence is difficult, there are many risk stratification tools now available to practitioners, including the Opioid Risk Tool (ORT) or Screener and Opioid Assessment for Patients with Pain (SOAPP). Understanding the differences between dependence, addiction, and tolerance is essential to managing patients on opioids.
It is imperative that patients be properly managed when being treated for pain. Physicians and employers have to be able to identify patients at risk for opioid abuse or exhibiting symptoms of opioid abuse and know how to address their needs.
从1992年到2002年,用于慢性非癌性疼痛的阿片类药物使用量增加了222%。阿片类药物依赖也显著增加,给患者、雇主、保险公司、社会以及整个医疗保健系统带来了负担。必须妥善处理和治疗阿片类药物依赖,以使患者能够重新成为职场和社会中有生产力的参与者。
概述成瘾、滥用和依赖情况,并确定成瘾的风险因素。
研究表明,大量使用阿片类药物与昂贵的医疗保健服务利用率增加、残疾时间延长以及阿片类药物的持续使用有关,导致许多患者出现滥用和依赖。虽然识别有阿片类药物依赖风险的患者很困难,但现在从业者有许多风险分层工具可用,包括阿片类药物风险工具(ORT)或疼痛患者筛查与阿片类药物评估(SOAPP)。了解依赖、成瘾和耐受性之间的差异对于管理使用阿片类药物的患者至关重要。
在治疗疼痛患者时,必须对其进行妥善管理。医生和雇主必须能够识别有阿片类药物滥用风险或表现出阿片类药物滥用症状的患者,并知道如何满足他们的需求。