Peck Kelly R, Ehrentraut Jennifer Harman, Anghelescu Doralina L
Department of Psychology, University of Mississippi, University, Mississippi.
Department of Psychology, St Jude Children's Research Hospital, Memphis, Tennessee.
J Opioid Manag. 2016 May-Jun;12(3):205-16. doi: 10.5055/jom.2016.0333.
Prescription opioid use has increased in recent decades. Although opioids provide effective pain control, their use may be associated with the risk of misuse. Opioid misuse (OM) is prevalent among adolescents and young adults (AYAs). Opioids are necessary to treat cancer-related pain; however, oncology patients are not immune to medication misuse. Research examining OM among AYAs with cancer is scarce. This article examines the risk factors described in the general adult and adolescent medication abuse literature and aims to provide recommendations for practice in the AYA oncology population. The following risk factors should be examined in AYA oncology patients to determine their relevance: age, sex, behavioral and academic problems, psychological conditions, and a history of illicit drug use/abuse. To maintain the delicate balance of providing adequate pain relief while protecting patients from the risk of OM, clinicians must consider potential risk factors, motivating factors, and individual behaviors. Placing these challenges in perspective, this review provides clinical considerations, recommendations, and intervention strategies for OM prevention in AYA oncology patients.
近几十年来,处方阿片类药物的使用有所增加。虽然阿片类药物能有效控制疼痛,但其使用可能与滥用风险相关。阿片类药物滥用(OM)在青少年和青年成年人(AYA)中很普遍。阿片类药物对于治疗癌症相关疼痛是必要的;然而,肿瘤患者也不能免于药物滥用。针对患有癌症的AYA中阿片类药物滥用的研究很少。本文探讨了一般成人和青少年药物滥用文献中描述的风险因素,旨在为AYA肿瘤患者群体的实践提供建议。对于AYA肿瘤患者,应检查以下风险因素以确定其相关性:年龄、性别、行为和学业问题、心理状况以及非法药物使用/滥用史。为了在提供充分疼痛缓解的同时保护患者免受阿片类药物滥用风险,临床医生必须考虑潜在风险因素、促动因素和个体行为。从这个角度看待这些挑战,本综述为预防AYA肿瘤患者的阿片类药物滥用提供了临床考量、建议和干预策略。