Department of Psychiatry and Behavioral Neurosciences, University of Chicago, IL 60615, USA.
Am J Addict. 2013 May-Jun;22(3):184-7. doi: 10.1111/j.1521-0391.2012.00335.x.
Physicians are challenged to effectively treat opioid dependent patients while minimizing diversion of potentially abusable medications, such as buprenorphine. The present study was designed to obtain information on steps physicians report taking to reduce diversion of buprenorphine.
National quarterly surveys from 2008 to 2009 of qualified physicians who have prescribed buprenorphine were analyzed (N = 2,330). One part of the survey queried physicians about what steps they had taken to reduce abuse and diversion of buprenorphine from a pre-specified list of 12 steps. Other parts of the survey included questions on the physicians' training and experience.
Physicians reported taking a mean of 4.4 steps. Longer experience prescribing buprenorphine, more buprenorphine-related educational training, and concern about diversion as a limitation on using buprenorphine for maintenance were associated with higher number of steps taken.
Physicians are currently taking multiple steps to reduce diversion. Future research needs to verify if these steps are effective or are instead reducing access to treatment.
医生在有效治疗阿片类药物依赖患者的同时，还需尽量减少潜在滥用药物（如丁丙诺啡）的转用。本研究旨在获取医生为减少丁丙诺啡转用而采取措施的相关信息。
对 2008 年至 2009 年期间开具丁丙诺啡处方的合格医生进行了全国季度调查（n=2330）。调查的一部分询问医生从预先确定的 12 个步骤中采取了哪些措施来减少丁丙诺啡的滥用和转用。调查的其他部分包括有关医生培训和经验的问题。
医生报告平均采取了 4.4 个步骤。开丁丙诺啡处方的经验更丰富、与丁丙诺啡相关的教育培训更多、以及对转用作为使用丁丙诺啡进行维持治疗的限制的关注，与采取的步骤数量更多有关。
医生目前正在采取多项措施来减少转用。未来的研究需要验证这些措施是否有效，或者是否反而会减少治疗的可及性。
