Bi-Mohammed Zanib, Wright Nat M, Hearty Philippa, King Nigel, Gavin Helen
University of Leeds, School of Healthcare Baines Wing, LS2 9UT, United Kingdom.
Spectrum Community Health CIC, Hebble Wharf, Wakefield, WF1 5RH, United Kingdom.
Drug Alcohol Depend. 2017 Feb 1;171:122-131. doi: 10.1016/j.drugalcdep.2016.11.032. Epub 2016 Dec 14.
To systematically review the quantitative and qualitative evidence base pertaining to the prevalence, practice of, and treatment response to the diversion of prescribed opiates in the prison setting.
Medline, Embase, CINAHL, PsycINFO, Google Scholar, ASSIA and Science Direct databases were searched for papers from 1995 to the present relevant to the abuse of prescribed opiate medication. Identified journals and their reference lists were hand searched for other relevant articles. Of the abstracts identified as relevant, full text papers were retrieved and critiqued against the inclusion criteria for the review.
Three hundred and fifty-five abstracts were identified, leading to 42 full-text articles being retrieved. Of those, 10 papers were included in the review. Significant differences in abuse behaviours between different countries were reported. However, a key theme emerged from the data regarding a culture of nasal administration of prescribed sublingual buprenorphine within some prisons due to both reduced prevalence of injection within prison and reduced supplies of illicit drugs within prison. The buprenorphine/naloxone preparation appears to be less amenable to abuse. The review highlighted a paucity of empirical research pertaining to both prevalence of the phenomenon and treatment responses.
Healthcare providers within prisons need to prescribe opioids in the least abuseable preparation since the risk of abuse is significant, despite widespread processes of supervised dispensing. Prescription medication abuse is not limited to opioids and the predominant drug of abuse in an individual prison can rapidly change according to availability.
系统评价与监狱环境中处方阿片类药物转移的患病率、行为及治疗反应相关的定量和定性证据。
检索Medline、Embase、CINAHL、PsycINFO、谷歌学术、ASSIA和科学Direct数据库，查找1995年至今与处方阿片类药物滥用相关的论文。对已识别的期刊及其参考文献列表进行手工检索，以查找其他相关文章。从识别出的相关摘要中检索全文论文，并根据综述的纳入标准进行评判。
共识别出355篇摘要，并检索到42篇全文文章。其中，10篇论文被纳入综述。报告了不同国家之间滥用行为的显著差异。然而，数据中出现了一个关键主题，即在一些监狱中，由于监狱内注射率降低和非法药物供应减少，出现了对处方舌下含服丁丙诺啡进行鼻内给药的文化现象。丁丙诺啡/纳洛酮制剂似乎较不易被滥用。该综述强调了关于该现象的患病率和治疗反应的实证研究匮乏。
监狱内的医疗服务提供者在开具阿片类药物处方时，应选择最不易被滥用的制剂，因为尽管有广泛的监督配药流程，但滥用风险依然很大。处方药滥用不仅限于阿片类药物，而且单个监狱中主要的滥用药物会根据可得性迅速变化。
