Dematteis Maurice, Auriacombe Marc, D'Agnone Oscar, Somaini Lorenzo, Szerman Néstor, Littlewood Richard, Alam Farrukh, Alho Hannu, Benyamina Amine, Bobes Julio, Daulouede Jean Pierre, Leonardi Claudio, Maremmani Icro, Torrens Marta, Walcher Stephan, Soyka Michael
a Department of Addiction Medicine , Grenoble Alpes University Hospital , Grenoble , France.
b Faculty of Medicine , Grenoble Alpes University , Grenoble , France.
Expert Opin Pharmacother. 2017 Dec;18(18):1987-1999. doi: 10.1080/14656566.2017.1409722. Epub 2017 Dec 3.
Management of patients with opioid use disorder (OUD) commonly includes opioid agonist therapy (OAT) as a part of an integrated treatment plan. These interventions are associated with proven benefits to the individual and society. Areas covered: The use of methadone and buprenorphine within an integrated treatment plan in the management of patients with OUD: this work provides consensus recommendation on pharmacotherapy in OUD to assist clinicians with practical decision making in this field. Expert opinion: Pharmacotherapy is recommended as part of an integrated OUD treatment approach with psychosocial interventions, with the goal of reducing risks of illicit opioid use, overdose mortality, infection with HIV or HCV, improving health, psychological and social outcomes. Access to OAT should be prioritised in the treatment of OUD. Treatment choices in OUD pharmacotherapy should be based on the needs of the individual and characteristics of medications. Recommendations for choices of OAT are based on clinical efficacy, safety, patient preference, side effects, pharmacological interactions, quality of life, dose titration potential and outcomes (control craving, ongoing opioids consumption or other drugs, and potentially psychiatric comorbidities). Special groups, pregnant women, prisoners, patients with mental health problems have specific needs which must be addressed with expert input.
阿片类物质使用障碍（OUD）患者的管理通常包括将阿片类激动剂疗法（OAT）作为综合治疗计划的一部分。这些干预措施对个人和社会都有已证实的益处。涵盖领域：在OUD患者管理的综合治疗计划中使用美沙酮和丁丙诺啡：这项工作就OUD的药物治疗提供了共识性建议，以协助临床医生在该领域做出实际决策。专家意见：推荐将药物治疗作为OUD综合治疗方法的一部分，并结合心理社会干预措施，目标是降低非法使用阿片类物质的风险、过量用药死亡率、感染艾滋病毒或丙型肝炎病毒的风险，改善健康、心理和社会结局。在OUD治疗中应优先提供OAT。OUD药物治疗的选择应基于个体需求和药物特性。OAT选择的建议基于临床疗效、安全性、患者偏好、副作用、药物相互作用、生活质量、剂量滴定潜力和结局（控制渴望、持续使用阿片类物质或其他药物以及潜在的精神疾病合并症）。特殊群体，如孕妇、囚犯、有心理健康问题的患者有特定需求，必须在专家的参与下加以解决。
