Murphy Debra A
Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of Psychiatry, University of California, 11075 Santa Monica Boulevard, Suite 200, Los Angeles, CA 90025-7539, USA.
Oral Maxillofac Surg Clin North Am. 2010 May;22(2):231-8. doi: 10.1016/j.coms.2010.01.005.
Substance use is a major contributing factor to the interpersonal violence that accounts for a significant proportion of facial injuries among adults and adolescents; thus, violence is the main "pathway" through which substance use and injuries are linked. Beyond causality, substance use continues to influence recovery from the injury through its impact on the healing process (eg, patient noncompliance, suppression of T-cell counts, susceptibility to bacterial colonization, and protein production). Further exacerbating this issue are significant rates of injury recidivism and the lack of motivation to seek treatment for underlying substance-use problems. As a frontline care provider, the oral and maxillofacial surgeon has a responsibility to screen and refer patients for any needed specialty treatment (including substance-use treatment, violence reduction, and posttraumatic stress reduction). Recognizing and addressing these issues requires a paradigm shift that involves integration of multidisciplinary expertise.
物质使用是人际暴力的一个主要促成因素，人际暴力在成人和青少年面部损伤中占很大比例；因此，暴力是物质使用与损伤相联系的主要“途径”。除了因果关系外，物质使用还通过其对愈合过程的影响（如患者不依从、T细胞计数抑制、细菌定植易感性和蛋白质生成）继续影响损伤的恢复。损伤再发率高以及缺乏针对潜在物质使用问题寻求治疗的动力，进一步加剧了这一问题。作为一线护理提供者，口腔颌面外科医生有责任对患者进行筛查，并将其转介至任何所需的专科治疗（包括物质使用治疗、减少暴力和减轻创伤后应激）。认识并解决这些问题需要一种范式转变，即整合多学科专业知识。
