Kamen Leonard B, Feeko Kristofer J
MossRehab Outpatient Center, Albert Einstein Healthcare Network, 9880 Bustleton Avenue, Suite 309, Philadelphia, PA 19115, USA; Department of Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, PA, USA.
Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Phys Med Rehabil Clin N Am. 2014 May;25(2):375-95. doi: 10.1016/j.pmr.2014.01.005.
Treatment of chronic noncancer pain (CNCP) with high-dose opioids (HDOs) has burgeoned over the past 2 decades in the United States. Characteristic domains and features of the failed CNCP management patient using long-term HDOs are described herein as the/an opioid syndrome (Schreiber AL, personal communication. 2013). Reversing or even modulating HDO use in patients with CNCP requires a paradigm shift on the part of physician, patient, and the societal "quick fix" medical culture. This review offers measures, agents, and strategies to consider in management of this pervasive, erosive medical and societal challenge.
在美国，过去20年来，使用高剂量阿片类药物（HDOs）治疗慢性非癌性疼痛（CNCP）的情况迅速增加。本文将长期使用HDOs但慢性非癌性疼痛管理失败的患者的特征领域和特点描述为阿片类药物综合征（施赖伯·艾尔，个人交流。2013年）。要扭转甚至调整慢性非癌性疼痛患者对HDOs的使用，医生、患者以及社会“快速解决”的医疗文化都需要转变思维模式。本综述提供了应对这一普遍存在、具有侵蚀性的医学和社会挑战时可考虑的措施、药物和策略。
