James Dominika Lipowska, Jowza Maryam
Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina.
Clin Obstet Gynecol. 2019 Mar;62(1):87-97. doi: 10.1097/GRF.0000000000000422.
Inappropriate and excessive opioid prescribing practices for treatment of chronic nonmalignant pain contributed to rising rates of opioid related mortality. Effective and widely available opioid addiction treatment resources are needed to ensure successful resolution of the "opioid epidemic". This chapter outlines the basic pathophysiology of addiction as well as principles of opioid addiction management focusing on the pharmacological and nonpharmacological aspects of care. Pharmacological treatment focuses on opioid substitution therapy, with aim at prevention of opioid cravings and opioid withdrawal symptoms. Nonpharmacological treatment involves psychological and supportive approaches to addiction such as group meetings, psychological counseling, and mindfulness training.
用于治疗慢性非恶性疼痛的不恰当且过度的阿片类药物处方行为导致了阿片类药物相关死亡率的上升。需要有效且广泛可得的阿片类药物成瘾治疗资源，以确保成功解决“阿片类药物流行”问题。本章概述了成瘾的基本病理生理学以及阿片类药物成瘾管理原则，重点关注护理的药理学和非药理学方面。药理学治疗侧重于阿片类药物替代疗法，旨在预防阿片类药物渴望和阿片类药物戒断症状。非药理学治疗涉及针对成瘾的心理和支持性方法，如小组会议、心理咨询和正念训练。
