Department of Anesthesia & Critical Care, The University of Chicago, Chicago, IL 60637, USA.
Drug Alcohol Depend. 2012 Aug 1;124(3):274-82. doi: 10.1016/j.drugalcdep.2012.01.023. Epub 2012 Feb 25.
There are epidemiological data indicating that medical and/or nonmedical use of prescription opioids oftentimes involves concurrent use of other substances. One of those substances is benzodiazepines. It would be of relevance to characterize the effects of an opioid and a benzodiazepine when taken together to determine if measures related to abuse liability-related effects and psychomotor performance impairment are increased compared to when the drugs are taken alone.
Twenty volunteers participated in a crossover, randomized, double-blind study in which they received placebo, 0.5mg alprazolam, 10mg oxycodone, and 0.5mg alprazolam combined with 10 mg oxycodone, all p.o. Subjective, psychomotor, and physiological measures were assessed during each of the four sessions.
Oxycodone by itself increased drug liking and "take again" ratings relative to placebo, but these ratings were not increased when oxycodone was taken with alprazolam, which by itself did not increase either of these ratings. The two drugs in combination produced stronger effects (larger in magnitude or longer lasting) than when either was taken alone on a number of measures, including psychomotor performance impairment.
In healthy volunteers, abuse liability-related subjective effects of oxycodone were not enhanced by alprazolam. There was enhanced behavioral toxicity when the drugs were taken together, and thus, this is of significant concern from a public safety standpoint.
有流行病学数据表明,医疗和/或非医疗用途的处方类阿片类药物经常同时使用其他物质。其中一种物质是苯二氮䓬类药物。当同时使用阿片类药物和苯二氮䓬类药物时,描述它们的效果将非常重要,以确定与滥用倾向相关的效果和精神运动表现受损的相关措施是否比单独使用这些药物时增加。
二十名志愿者参加了一项交叉、随机、双盲研究,他们分别接受安慰剂、0.5mg 阿普唑仑、10mg 羟考酮和 0.5mg 阿普唑仑联合 10mg 羟考酮,均为口服。在每次四个疗程中,评估主观、精神运动和生理测量。
与安慰剂相比,单独使用羟考酮会增加药物的喜好和“再次使用”的评分,但当羟考酮与阿普唑仑一起使用时,这些评分并没有增加,而阿普唑仑本身并没有增加这两种评分。与单独使用相比,这两种药物联合使用在许多方面产生了更强的效果(更大的幅度或更长的持续时间),包括精神运动表现受损。
在健康志愿者中,阿普唑仑不会增强羟考酮与滥用倾向相关的主观效果。当这些药物一起服用时,会产生增强的行为毒性,因此,从公共安全的角度来看,这是一个非常值得关注的问题。