Ternes J W, O'Brien C P
Department of Psychiatry, University of Pennsylvania School of Medicine.
Adv Alcohol Subst Abuse. 1990;9(1-2):27-45. doi: 10.1300/J251v09n01_03.
The opioids vary greatly in addictive potential, from the highly addictive such as heroin to the opioid antagonists such as naltrexone, which can be used to treat opioid dependence and overdose. The various opioid compounds have different euphorigenic properties and also produce withdrawal syndromes of distinct patterns of duration and intensity. Dependence liability is affected by both the pleasure-seeking motives for initiating drug use and the painful consequences of abstinence or withdrawal. Detoxification, which takes 7-10 days for the short-acting opioids, is usually the first stage in treatment. Methadone is often used as a preliminary stage in detoxification, but some patients are maintained on methadone for years, since it allows them to lead relatively normal lives. Non-opioid drugs used to control withdrawal symptoms include clonidine. After detoxification, naltrexone, a long-acting opioid antagonist, can be administered orally to prevent relapse.
阿片类药物的成瘾潜力差异很大，从极易成瘾的海洛因到可用于治疗阿片类药物依赖和过量的阿片类拮抗剂纳曲酮。各种阿片类化合物具有不同的致欣快特性，还会产生持续时间和强度各异的戒断综合征。药物依赖倾向既受开始使用药物时追求愉悦的动机影响，也受禁欲或戒断带来的痛苦后果影响。对于短效阿片类药物，脱毒通常需要7至10天，这通常是治疗的第一阶段。美沙酮常被用作脱毒的初始阶段，但有些患者会服用美沙酮数年，因为这能让他们过上相对正常的生活。用于控制戒断症状的非阿片类药物包括可乐定。脱毒后，可口服长效阿片类拮抗剂纳曲酮以防止复发。
