Department of Emergency Medicine, New York University School of Medicine, 455 First Avenue, Room 123, New York, NY 10016, USA.
J Med Toxicol. 2012 Dec;8(4):335-40. doi: 10.1007/s13181-012-0263-x.
Nonmedical use of prescription opioid analgesics is associated with epidemic levels of morbidity and mortality. There are several factors that affect the abuse liability of the various opioids, including likability or the pleasurable subjective effects. Due to rising public health concerns over escalating prescription opioid abuse, we sought to examine the literature about abuse liability with a specific focus on likability studies.
A search of EMBASE and MEDLINE databases identified articles that described the comparative likeability and/or abuse potential of hydrocodone and oxycodone relative to each other and/or of either one to morphine. After an assessment of study quality using the Oxford/Jadad scale, relevant details such as demographics, study design, and outcome measures were compiled into an evidence table.
We identified nine studies that met inclusion criteria. All were double-blinded, randomized, placebo-controlled crossover studies and scored 5 out of 5 Jadad scale. There was no consistent clinically significant difference between abuse liability of morphine and hydrocodone. Oxycodone demonstrated high abuse liability on the basis of its high likability scores and a relative lack of negative subjective effects.
Oral oxycodone has an elevated abuse liability profile compared to oral morphine and hydrocodone.
处方类阿片类止痛药的非医疗用途与流行程度的发病率和死亡率有关。有几个因素会影响各种阿片类药物的滥用倾向，包括喜欢程度或令人愉悦的主观效果。由于公众对不断上升的处方类阿片类药物滥用问题的健康担忧日益加剧，我们试图研究关于滥用倾向的文献，特别是关于喜欢程度研究的文献。
通过对 EMBASE 和 MEDLINE 数据库的搜索，确定了描述氢可酮和羟考酮相对彼此以及其中任何一种药物相对于吗啡的可喜欢程度和/或滥用潜力的文章。使用牛津/贾达德量表评估研究质量后，将相关细节（如人口统计学、研究设计和结果测量）汇编到一个证据表中。
我们确定了九项符合纳入标准的研究。所有研究均为双盲、随机、安慰剂对照交叉研究，贾达德量表评分为 5 分。吗啡和氢可酮的滥用倾向之间没有一致的、临床上显著的差异。基于其高喜欢程度评分和相对缺乏负面主观影响，羟考酮表现出高滥用倾向。
与口服吗啡和氢可酮相比，口服羟考酮具有更高的滥用倾向特征。
