Debono David J, Hoeksema Laura J, Hobbs Raymond D
Michigan Hematology Oncology, Rochester Hills, Michigan , USA.
J Am Osteopath Assoc. 2013 Aug;113(8):620-7. doi: 10.7556/jaoa.2013.023.
Chronic, nonmalignant pain is a substantial public health problem in the United States. Research over the past 2 decades has defined chronic pain by using a "biopsychosocial model" that considers a patient's biology and psychological makeup in the context of his or her social and cultural milieu. Whereas this model addresses the pathology of chronic pain, it also places many demands on the physician, who is expected to assess and manage chronic pain safely and successfully. There is a growing body of evidence suggesting that opioids can be effective in the management of chronic pain, but there has also been a rise in opioid-related overdoses and deaths. Clinicians should be aware of assessment tools that may be used to evaluate the risk of opioid abuse. A basic understanding of chronic pain pathophysiology and a uniform approach to patient care can satisfy the needs of both patients and physicians.
慢性非恶性疼痛在美国是一个重大的公共卫生问题。过去20年的研究通过使用“生物心理社会模型”来定义慢性疼痛，该模型在患者的社会和文化背景下考虑其生物学和心理构成。虽然这个模型解决了慢性疼痛的病理学问题，但它也对医生提出了许多要求，医生需要安全且成功地评估和管理慢性疼痛。越来越多的证据表明，阿片类药物在慢性疼痛管理中可能有效，但与阿片类药物相关的过量用药和死亡情况也有所增加。临床医生应了解可用于评估阿片类药物滥用风险的评估工具。对慢性疼痛病理生理学的基本了解和统一的患者护理方法可以满足患者和医生双方的需求。
