Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.
Curr Psychiatry Rep. 2011 Oct;13(5):374-81. doi: 10.1007/s11920-011-0222-2.
Substance use disorders are highly prevalent, debilitating conditions for which effective pharmacotherapies exist with a broad evidence base, yet pharmacotherapy for the treatment of addiction disorders is underutilized. The goals of this review are to describe the barriers that may contribute to poor adoption and utilization of pharmacotherapy for alcohol and opioid dependence at the system, provider, and patient level and to discuss ways to overcome those barriers. Multifaceted efforts directed at all three levels may be needed to speed pharmacotherapy adoption. More research is needed to help us better understand barriers from patients' perspectives. Strategies to promote adoption of pharmacotherapy for addiction disorders should be modified to fit the needs of the practice, system, and individual patients. Pharmacotherapy is a valuable tool in the clinical armamentarium of addiction treatment; thus, overcoming barriers to implementation may improve clinical and social outcomes.
物质使用障碍是高度流行的、使人衰弱的疾病,针对这些疾病已经有了有效的药物治疗方法,并具有广泛的证据基础,但药物治疗在治疗成瘾障碍方面的应用不足。本综述的目的是描述可能导致在系统、提供者和患者层面上对酒精和阿片类药物依赖的药物治疗采用率低的障碍,并讨论克服这些障碍的方法。可能需要针对这三个层面采取多方面的努力来加快药物治疗的采用。需要开展更多的研究,帮助我们从患者的角度更好地理解障碍。促进药物治疗成瘾障碍采用的策略应根据实践、系统和个体患者的需求进行调整。药物治疗是成瘾治疗临床手段的宝贵工具;因此,克服实施障碍可能会改善临床和社会结果。