Division of Pain Medicine, Department of Anesthesiology, University of California, Davis School of Medicine, California 95817, USA.
Curr Opin Anaesthesiol. 2012 Oct;25(5):566-71. doi: 10.1097/ACO.0b013e328357a24a.
Approximately 100 million people suffer from chronic pain in the USA. Opioid medications are commonly prescribed to treat pain, but are becoming the most widely misused controlled substance nationally. Physicians who treat patients with chronic pain must be cognizant of the federal and state policies that govern the distribution of opioid medications as well as the current standards of medical practice for opioid prescribing.
The laws and policies regarding the standard medical practice for opioid prescribing are constantly subject to revision. The National Drug Control Policy announced its plan to fight prescription drug abuse in 2011 and unveiled the Risk Evaluation and Management Strategy initiative. Currently there is a Risk Evaluation and Management Strategy for Transmucosal Immediate-Release Fentanyl. Other resources, such as state-run prescription drug monitoring programs, are also available to many physicians. The level of participation in these programs by physicians and pharmacists varies by state, and funding for continuation of these programs is an ongoing issue.
The problems of undertreated pain and the epidemic of prescription drug abuse have coincided, creating a need for medical and social policy that protects society and access to appropriate care for those in pain. Federal and state laws are in evolution, and clinicians must remain aware of these changes as well as the issues behind them that will impact safe and appropriate care of patients in pain.
目的综述：美国约有 1 亿人患有慢性疼痛。阿片类药物通常被用于治疗疼痛，但已成为全国范围内使用最广泛的滥用受控物质。治疗慢性疼痛患者的医生必须了解管理阿片类药物分配的联邦和州政策以及阿片类药物处方的当前医学实践标准。
最新发现：关于阿片类药物处方标准医学实践的法律和政策不断修订。国家毒品管制政策于 2011 年宣布了打击处方药物滥用的计划，并公布了风险评估和管理策略倡议。目前，有一项 Transmucosal Immediate-Release Fentanyl 的风险评估和管理策略。许多医生还可以使用其他资源，例如州立处方药物监测计划。医生和药剂师对这些计划的参与程度因州而异，这些计划的持续资金是一个持续存在的问题。
总结：治疗不足的疼痛问题和处方药物滥用的流行同时出现，这需要医疗和社会政策来保护社会并为疼痛患者提供适当的护理。联邦和州法律正在不断演变，临床医生必须了解这些变化以及背后的问题，这些问题将影响疼痛患者的安全和适当护理。
