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治疗慢性疼痛:对非阿片类药物选择的需求。

Treating chronic pain: the need for non-opioid options.

作者信息

Garland Eric L

机构信息

Integrative Medicine, Supportive Oncology Program, Huntsman Cancer Institute, 395 South, 1500 East, Salt Lake City, UT 84112, USA.

出版信息

Expert Rev Clin Pharmacol. 2014 Sep;7(5):545-50. doi: 10.1586/17512433.2014.928587. Epub 2014 Jun 11.

Abstract

Chronic pain is a prevalent problem that exacts a significant toll on society. The medical system has responded to this issue by implementing pain management services centered on opioid pharmacotherapy. However, for many chronic pain patients, the analgesic efficacy of long-term opioids is limited. Moreover, chronic exposure to opioids can result in opioid misuse, addiction, and risk of overdose. As such, non-opioid treatment options are needed. This article first provides a selective review of cognitive, affective, and psychophysiological mechanisms implicated in chronic pain to be targeted by novel non-opioid treatments. Next, it briefly details one such treatment approach, Mindfulness-Oriented Recovery Enhancement, and describes evidence suggesting that this intervention can disrupt the risk chain linking chronic pain to prescription opioid misuse.

摘要

慢性疼痛是一个普遍存在的问题,给社会带来了巨大损失。医疗系统通过实施以阿片类药物疗法为中心的疼痛管理服务来应对这一问题。然而,对于许多慢性疼痛患者来说,长期使用阿片类药物的镇痛效果有限。此外,长期接触阿片类药物会导致阿片类药物滥用、成瘾和过量用药风险。因此,需要非阿片类治疗选择。本文首先对新型非阿片类治疗所针对的慢性疼痛相关的认知、情感和心理生理机制进行了选择性综述。接下来,简要详细介绍了一种这样的治疗方法,即正念导向康复增强法,并描述了证据表明这种干预可以中断将慢性疼痛与处方阿片类药物滥用联系起来的风险链。

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