Campbell Gabrielle, Nielsen Suzanne, Bruno Raimondo, Lintzeris Nicholas, Cohen Milton, Hall Wayne, Larance Briony, Mattick Richard P, Degenhardt Louisa
National Drug and Alcohol Research Centre, School of Medicine, University of New South Wales, Sydney, Australia The Langton Centre, South East Sydney Local Health District (SESLHD) Drug and Alcohol Services, Surry Hills, Australia School of Medicine, University of Tasmania, Sandy Bay Campus, Hobart, Australia University of Sydney, Addiction Medicine, Central Clinical School, Camperdown, Australia St Vincent's Clinical School, University of New South Wales, Darlinghurst, Australia Centre for Youth Substance Abuse Research, Royal Brisbane and Women's Hospital, University of Queensland, Herston, Australia School of Population and Global Health, The University of Melbourne, Melbourne, Australia Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Australia Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA.
Pain. 2015 Feb;156(2):231-242. doi: 10.1097/01.j.pain.0000460303.63948.8e.
There has been a recent increase in public and professional concern about the prescription of strong prescription opioids for pain. Despite this concern, research to date has been limited because of a number of factors such as small sample sizes, exclusion of people with complex comorbidities, and studies of short duration. The Pain and Opioids IN Treatment is a 2-year prospective cohort study of 1500 people prescribed with pharmaceutical opioids for their chronic pain. This article provides an overview of the demographic and clinical characteristics of the cohort using the baseline data of 1514 community-based people across Australia. Participants had been in pain for a period of 10 years and had been on prescription opioids for approximately 4 years. One in 10 was on a daily morphine equivalent dose of ≥200 mg. Employment and income levels were low, and two-thirds of the sample reported that their pain had impacted on their employment status. Approximately 50% screened positive for current moderate-to-severe depression, and 1 in 5 had made a lifetime suicide attempt. There were a number of age-related differences. The younger groups experienced higher levels of pain and pain interference, more mental health and substance use issues, and barriers to treatment, compared with the older group. This study found that the people who have been prescribed strong opioids for chronic pain have very complex demographic and clinical profiles. Major age-related differences in the experiences of pain, coping, mental health, and substance use suggest the necessity of differential approaches to treatment.
近期，公众和专业人士对强效处方阿片类药物用于止痛的处方开具愈发关注。尽管存在这种担忧，但由于诸多因素，如样本量小、排除患有复杂合并症的人群以及研究持续时间短等，迄今为止的研究一直有限。“疼痛与阿片类药物治疗研究”（Pain and Opioids IN Treatment）是一项针对1500名因慢性疼痛而开具了阿片类药物处方的人群开展的为期两年的前瞻性队列研究。本文利用澳大利亚各地1514名社区居民的基线数据，概述了该队列的人口统计学和临床特征。参与者疼痛持续了10年，服用处方阿片类药物约4年。十分之一的人每日吗啡当量剂量≥200毫克。就业和收入水平较低，三分之二的样本报告称他们的疼痛影响了其就业状况。约50%的人当前中度至重度抑郁筛查呈阳性，五分之一的人曾有过自杀未遂经历。存在一些与年龄相关的差异。与老年组相比，年轻组经历的疼痛和疼痛干扰程度更高，心理健康和物质使用问题更多，且存在治疗障碍。本研究发现，因慢性疼痛而开具了强效阿片类药物处方的人群具有非常复杂的人口统计学和临床特征。在疼痛体验、应对方式、心理健康和物质使用方面与年龄相关的主要差异表明，需要采用不同的治疗方法。
