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专家答疑:在慢性疼痛管理背景下,我们对处方阿片类药物滥用了解(以及不了解)多少?

Ask the Experts: What do we know (and not know) about prescription opioid misuse in the context of chronic pain management?

作者信息

Zacny James

机构信息

Department of Anesthesia & Critical Care, University of Chicago, MC4028, 5841 S Maryland Avenue, Chicago, IL 60637, USA.

出版信息

Pain Manag. 2011 Sep;1(5):395-8. doi: 10.2217/pmt.11.40.

DOI:10.2217/pmt.11.40
PMID:24645705
Abstract

James Zacny received his PhD in Psychology at West Virginia University (WV, USA) in 1984. From 1984 to 1986 he did a postdoctoral fellowship at The Johns Hopkins University School of Medicine (MD, USA) in the Behavioral Pharmacology Research Unit of the Department of Psychiatry and Behavioral Sciences. He then became Research Associate in the Department of Psychiatry at the University of Chicago (IL, USA) and conducted both preclinical and human psychopharmacology studies. In 1992 he joined the faculty in the Department of Anesthesia & Critical Care at the University where he is currently Professor. His two primary research interests have been in studying the psychopharmacological effects of drugs used in anesthesiology, chiefly inhaled and intravenous general anesthetics at subanesthestic doses, and opioid analgesics, in healthy nondrug-abusing volunteers. The unique research environment he is in fostered a large body of research that systematically characterized the subjective, psychomotor and reinforcing (rewarding) effects of a number of different anesthetic and analgesic agents. Dr Zacny's primary source of funding is through the National Institute on Drug Abuse and in 1999 was presented with a MERIT award for his research on opioids. In 2001 he focused his efforts on prescription opioids at about the same time that warning signs started to emerge indicating that prescription opioid abuse was on the rise. He has characterized the psychopharmacological effects of a number of prescription opioids, as well as investigated possible factors that might modulate their positive (as well as negative) subjective effects including gender, sensation seeking and alcohol. He has also written guest editorials on the psychomotor effects of opioids in relation to the ability of chronic pain patients on long-term opioid therapy to drive. He is an elected member of the College on Problems of Drug Dependence and of the Association of University Anesthesiologists, and served as President of the Division of Psychopharmacology and Substance Abuse of the American Psychological Association, and the International Study Group Investigating Drugs as Reinforcers.

摘要

詹姆斯·扎克尼于1984年在美国西弗吉尼亚大学获得心理学博士学位。1984年至1986年,他在美国约翰·霍普金斯大学医学院(美国马里兰州)精神病学与行为科学系的行为药理学研究室做博士后。随后,他成为美国芝加哥大学(美国伊利诺伊州)精神病学系的研究助理,开展临床前和人体精神药理学研究。1992年,他加入该校麻醉与重症监护系任教,目前是该系教授。他的两个主要研究兴趣在于研究麻醉学中使用的药物的精神药理学效应,主要是在健康、不滥用药物的志愿者中研究亚麻醉剂量的吸入式和静脉注射全身麻醉药,以及阿片类镇痛药。他所处的独特研究环境促成了大量研究,系统地描述了多种不同麻醉药和镇痛药的主观、精神运动和强化(奖赏)效应。扎克尼博士的主要资金来源是美国国立药物滥用研究所,1999年,他因在阿片类药物方面的研究获得了杰出研究者奖。2001年,在警示迹象开始出现表明处方阿片类药物滥用呈上升趋势的大约同一时间,他将研究重点放在了处方阿片类药物上。他描述了多种处方阿片类药物的精神药理学效应,还研究了可能调节其积极(以及消极)主观效应的因素,包括性别、寻求刺激和酒精。他还就阿片类药物的精神运动效应撰写了特邀社论,涉及长期接受阿片类药物治疗的慢性疼痛患者的驾驶能力。他是药物依赖问题学会和大学麻醉医师协会的当选成员,曾担任美国心理学会精神药理学与药物滥用分会以及研究药物作为强化剂的国际研究小组的主席。

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