Copenhaver David J, Karvelas Nicolas B, Fishman Scott M
From the Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, Center for Advancing Pain Relief, University of California, Davis School of Medicine, UC Davis Medical Center, Ellison Ambulatory Care Center, Sacramento, California.
Anesth Analg. 2017 Nov;125(5):1610-1615. doi: 10.1213/ANE.0000000000002463.
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public. Moreover, palliative care and hospice programs appear poorly prepared for assessing or managing patients with aberrant behaviors or evidence of drug abuse. Further research and professional consensus are needed to help address the challenges associated with misuse, abuse, and addiction in patients with cancer and terminal illness.
随着美国处方药滥用情况的泛滥，专业组织和政府机构随后出台了慢性疼痛患者阿片类药物处方安全操作指南，但针对治疗癌症或绝症患者疼痛的阿片类药物处方医生，可用的指导却很有限。患有活动性癌症或绝症的患者经常会疼痛，也经常被开阿片类药物和其他管制药品。当前研究表明，癌症患者滥用、误用和成瘾的风险率与普通大众相似。此外，姑息治疗和临终关怀项目在评估或管理有异常行为或药物滥用迹象的患者方面，似乎准备不足。需要进一步的研究和专业共识，以帮助应对癌症和绝症患者中与药物误用、滥用和成瘾相关的挑战。
