Department of Medicine, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Avenue, Box 359780, Seattle, WA 98104, USA.
Department of Psychiatry & Behavioral Sciences, University of Washington, 1959 Northeast Pacific Street, Box 356560, Seattle, WA 98195-6560, USA.
Med Clin North Am. 2014 Sep;98(5):1097-122. doi: 10.1016/j.mcna.2014.06.008.
Substance use disorders are common in primary care settings, but detection, assessment, and management are seldom undertaken. Substantial evidence supports alcohol screening and brief intervention for risky drinking, and pharmacotherapy is effective for alcohol use disorders. Substance use disorders can complicate the management of chronic noncancer pain, making routine monitoring and assessment for substance use disorders an important aspect of long-term opioid prescribing. Patients with opioid use disorders can be effectively treated with methadone in opioid treatment programs or with buprenorphine in the primary care setting.
物质使用障碍在初级保健环境中很常见，但很少进行检测、评估和管理。大量证据支持对危险饮酒进行酒精筛查和简短干预，药物治疗对酒精使用障碍有效。物质使用障碍会使慢性非癌症疼痛的管理变得复杂，因此对物质使用障碍进行常规监测和评估是长期阿片类药物处方的一个重要方面。阿片类药物使用障碍患者可以在阿片类药物治疗项目中接受美沙酮治疗，也可以在初级保健环境中接受丁丙诺啡治疗。
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