处方药滥用：流行病学、监管问题以及使用麻醉性镇痛药进行慢性疼痛管理
Prescription drug abuse: epidemiology, regulatory issues, chronic pain management with narcotic analgesics.
作者信息
Manubay Jeanne M, Muchow Carrie, Sullivan Maria A
机构信息
Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 66, New York, NY 10032, USA; Departments of Family Medicine and Psychiatry, Columbia University, 710 West 168th Street, New York, NY 10032, USA.
The Columbia University Buprenorphine Program, Department of Psychiatry, Columbia University, 710 West 168th Street, 12th Floor, New York, NY 10032, USA.
出版信息
Prim Care. 2011 Mar;38(1):71-90. doi: 10.1016/j.pop.2010.11.006.
The epidemic of prescription drug abuse has reached a critical level, which has received national attention. This article provides insight into the epidemiology of prescription drug abuse, explains regulatory issues, and provides guidelines for the assessment and management of pain, particularly with long-term opioid therapy. Using informed consent forms, treatment agreements, and risk documentation tools and regularly monitoring the 4 A's help to educate patients and guide management based on treatment goals. By using universal precautions, and being aware of aberrant behaviors, physicians may feel more confident in identifying and addressing problematic behaviors.
处方药滥用的流行已达到危急程度，这已引起全国关注。本文深入探讨了处方药滥用的流行病学，解释了监管问题，并提供了疼痛评估和管理指南，尤其是长期阿片类药物治疗方面的指南。使用知情同意书、治疗协议和风险记录工具，并定期监测“4A”有助于对患者进行教育，并根据治疗目标指导管理。通过采取普遍预防措施并留意异常行为，医生在识别和处理问题行为时可能会更有信心。
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