Nicholls Lance, Bragaw Lisa, Ruetsch Charles
Lancer Solutions, LLC, New Milford, CT 06776, USA.
J Manag Care Pharm. 2010 Feb;16(1 Suppl B):S14-21. doi: 10.18553/jmcp.2010.16.S1-B.14.
In response to the growing incidence of opioid dependence, guidelines have been created, and new treatments are being developed to assist physicians in treating dependence and withdrawal of opioids.
To review treatment modalities and guidelines utilized in opioid dependence.
Guidelines for the treatment of opioid dependence have been developed by organizations such as the American Society of Interventional Pain Physicians (ASIPP) and the American Psychiatric Association (APA). Current guidelines recommend comprehensive treatment with pharmacological agents such as methadone, buprenorphine, or buprenorphine combined with naloxone as well as psychosocial therapy. These guidelines stress the need for an integrated approach to treatment. Office-based opioid treatment is currently being utilized to treat opioid dependent patients in a physician's office setting with buprenorphine/naloxone replacement therapy as an alternative to entering patients into a methadone clinic. These office-based programs offer a breakthrough in access to care for dependent patients.
Physicians need to be aware of and adhere to currently accepted guidelines and recommendations for treating opioid dependent patients, including integrating psychosocial treatments and behavior modification strategies for optimal results. Clinicians must be educated on the new treatment modalities and regulations surrounding the use of these therapies.
为应对阿片类药物依赖发病率的不断上升，已制定了相关指南，并正在研发新的治疗方法以帮助医生治疗阿片类药物依赖和戒断症状。
回顾阿片类药物依赖所采用的治疗方式和指南。
美国介入性疼痛医师协会（ASIPP）和美国精神病学协会（APA）等组织已制定了阿片类药物依赖的治疗指南。当前指南推荐采用美沙酮、丁丙诺啡或丁丙诺啡联合纳洛酮等药物以及心理社会治疗进行综合治疗。这些指南强调治疗需要采用综合方法。目前正在利用基于办公室的阿片类药物治疗，在医生办公室环境中用丁丙诺啡/纳洛酮替代疗法治疗阿片类药物依赖患者，作为让患者进入美沙酮诊所的一种替代方法。这些基于办公室的项目为依赖患者提供了获得治疗的突破。
医生需要了解并遵守当前公认的治疗阿片类药物依赖患者的指南和建议，包括整合心理社会治疗和行为矫正策略以取得最佳效果。必须对临床医生进行关于这些治疗方法的新治疗方式和使用规定的教育。
