Gordon Alan L, Snyder Amy F
Chief of Clinical Addiction Services, Butler Hospital; Clinical Associate Professor of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI.
Butler Hospital, Providence, RI.
R I Med J (2013). 2017 Oct 2;100(10):45-47.
New Rhode Island regulations require physicians and other licensed practitioners to make significant adjustments to comply with new requirements for prescribing narcotics for chronic pain. Responding to the opioid epidemic, the new rules are intended to improve patient safety by changing physicians' prescribing patterns. However, the new rules may overlook the importance of treatment-access problems and the importance of buprenorphine products for treating pain and opioid dependence. Empirical data have demonstrated the safety and efficacy of buprenorphine in treating opioid-dependent patients with chronic pain, including those with and without substance abuse histories, but access to buprenorphine treatment remains limited throughout the state. The new regulations call upon physicians to make use of consultation services, which are also of limited availability. Although well intentioned, the new rules may contribute to treatment-access problems, and patients with chronic pain may resort to higher-risk "street" drugs when they are unable to access safe but effective medical treatment. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
罗德岛州的新规定要求医生和其他持牌从业者做出重大调整，以符合开具慢性疼痛麻醉药品的新要求。为应对阿片类药物泛滥问题，新规定旨在通过改变医生的处方模式来提高患者安全性。然而，新规定可能忽视了治疗可及性问题的重要性以及丁丙诺啡产品在治疗疼痛和阿片类药物依赖方面的重要性。实证数据已证明丁丙诺啡在治疗患有慢性疼痛的阿片类药物依赖患者方面的安全性和有效性，包括有和没有药物滥用史的患者，但在该州，丁丙诺啡治疗的可及性仍然有限。新规定要求医生利用咨询服务，而咨询服务的可用性也很有限。尽管出发点是好的，但新规定可能会导致治疗可及性问题，当慢性疼痛患者无法获得安全有效的医疗治疗时，他们可能会求助于风险更高的“街头”毒品。[全文可在http://rimed.org/rimedicaljournal-2017-10.asp获取]
