Raymond G. Murphy New Mexico Veterans' Affairs Health Care System, Albuquerque, NM 87108, USA.
J Subst Abuse Treat. 2012 Dec;43(4):446-50. doi: 10.1016/j.jsat.2012.08.010. Epub 2012 Sep 11.
Abuse of opioids has become a public health crisis. The historic separation between the addiction and pain communities and a lack of training in medical education have made treatment difficult to provide, especially in primary care. The Co-occurring Disorders Clinic (COD) was established to treat patients with co-morbid chronic pain and addiction. This retrospective chart review reports results of a quality improvement project using buprenorphine/naloxone to treat co-occurring chronic non-cancer pain (CNCP) and opioid dependence in a primary care setting. Data were collected for 143 patients who were induced with buprenorphine/naloxone (BUP/NLX) between June 2009 and November 2011. Ninety-three patients (65%) continued to be maintained on the medication and seven completed treatment and were no longer taking any opioid (5%). Pain scores showed a modest, but statistically significant improvement on BUP/NLX, which was contrary to our expectations and may be an important factor in treatment retention for this challenging population.
阿片类药物滥用已成为公共健康危机。成瘾和疼痛领域之间历史性的分离以及医学教育中缺乏相关培训，使得治疗变得困难，尤其是在初级保健中。共病障碍诊所（COD）的建立是为了治疗同时患有慢性疼痛和成瘾的患者。本回顾性图表研究报告了使用丁丙诺啡/纳洛酮治疗初级保健环境中同时发生的慢性非癌症疼痛（CNCP）和阿片类药物依赖的质量改进项目的结果。数据收集自 2009 年 6 月至 2011 年 11 月期间接受丁丙诺啡/纳洛酮诱导治疗的 143 名患者。93 名患者（65%）继续使用该药物维持治疗，7 名患者完成治疗后不再服用任何阿片类药物（5%）。疼痛评分显示在 BUP/NLX 治疗下有适度但具有统计学意义的改善，这与我们的预期相反，可能是治疗这一具有挑战性人群的重要因素。
