Jones Mark R, Viswanath Omar, Peck Jacquelin, Kaye Alan D, Gill Jatinder S, Simopoulos Thomas T
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Johns Hopkins Medical Center, All Children's Hospital, St. Petersburg, FL, USA.
Pain Ther. 2018 Jun;7(1):13-21. doi: 10.1007/s40122-018-0097-6. Epub 2018 Apr 24.
The opioid epidemic has resulted from myriad causes and will not be solved by any simple solution. Consequent to a staggering increase in opioid-related deaths in the USA, various governmental inputs and stakeholder strategies have been proposed and implemented with varying success. This article summarizes the history of opioid use and explores the causes for the present day epidemic. Recent trends in opioid-related data demonstrate an almost fourfold increase in overdose deaths from 1999 to 2008. Tragically, opioids claimed over 64,000 lives just last year. Some solutions have undergone legislation, including the limitation of numbers of opioids postsurgery, as well as growing national prevalence of enhanced recovery after surgery protocols which focus on reduced postoperative opioid consumption and shortened hospital stays. Stricter prescribing practices and prescription monitoring programs have been instituted in the recent past. Improvement in abuse deterrent strategies which is a major focus of the Food and Drug Administration (FDA) for all opioid preparations will likely play an important role by increasing the safety of these medications. Future potential strategies such as additional legislative policies, public awareness, and physician education are also detailed in this review.
阿片类药物泛滥是由多种原因造成的，没有任何简单的解决方案能将其解决。在美国，与阿片类药物相关的死亡人数惊人地增加之后，政府采取了各种措施，并实施了不同利益相关方的策略，取得了不同程度的成功。本文总结了阿片类药物的使用历史，并探讨了当今泛滥的原因。与阿片类药物相关的数据的近期趋势表明，从1999年到2008年，过量用药死亡人数几乎增加了四倍。可悲的是，仅去年阿片类药物就夺走了64000多人的生命。一些解决方案已通过立法实施，包括限制术后阿片类药物的使用数量，以及全国范围内越来越普遍的术后强化康复方案，该方案侧重于减少术后阿片类药物的使用量和缩短住院时间。最近已经制定了更严格的处方规范和处方监测计划。改进阿片类药物的滥用预防策略是美国食品药品监督管理局（FDA）对所有阿片类制剂的主要关注点，这可能会通过提高这些药物的安全性发挥重要作用。本综述还详细介绍了未来可能的策略，如额外的立法政策、公众意识和医生教育。
