Luquiens Amandine, Aubin Henri-Jean
INSERM U669, Université Paris Sud, Hôpital Paul Brousse, Assistance Publique - Hôpitaux de Paris (AP-HP), Villejuif, France.
Patient Prefer Adherence. 2014 Sep 29;8:1347-52. doi: 10.2147/PPA.S57358. eCollection 2014.
Alcohol use disorder is a major public health issue. The absolute mortality burden of alcohol-attributable death has increased over the last 20 years. However, access to care remains very poor and many people with alcohol use disorder are untreated. The main limiting factor for access to care in alcohol use disorder appears to be the reluctance to engage in abstinence. Risk reduction is a developing approach in the treatment of alcohol use disorders, drawing its inspiration, with quite a delay, from the decades-long dominant approach in other substance use disorders. A paradigm shift has recently occurred that places more of an emphasis on reducing alcohol as a therapeutic strategy for patients with alcohol use disorder, to better meet the patients' preferences and needs. The development and recent approval of nalmefene, in alcohol-dependent adults with a high drinking risk level, contributes to enlarging the therapeutic arsenal for alcohol dependence, strengthening the legitimacy of alcohol reduction strategies.
酒精使用障碍是一个重大的公共卫生问题。在过去20年里,酒精所致死亡的绝对死亡率负担有所增加。然而,获得治疗的机会仍然非常有限,许多患有酒精使用障碍的人未得到治疗。酒精使用障碍患者获得治疗的主要限制因素似乎是不愿戒酒。降低风险是治疗酒精使用障碍的一种新兴方法,它在相当长的延迟之后,从其他物质使用障碍长达数十年的主导方法中汲取了灵感。最近发生了一种范式转变,更加重视将减少饮酒作为酒精使用障碍患者的一种治疗策略,以更好地满足患者的偏好和需求。纳美芬在饮酒风险水平高的酒精依赖成年人中的研发及近期获批,有助于扩大酒精依赖的治疗手段,增强减少饮酒策略的合理性。