British Columbia Centre on Substance Use (VB, SN); Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada (SN).
J Addict Med. 2019 Jul/Aug;13(4):251-252. doi: 10.1097/ADM.0000000000000488.
: Substance use disorders account for a significant burden of disease and place an enormous strain on the health care system in the United States and beyond. Despite death tolls climbing, a myriad of evidence-based medications exist to effectively treat many substance use disorders including nicotine, alcohol, and opioid use disorders. To date, hospitals have largely been overlooked as a setting ripe for the delivery of specialized addiction care. This occurs despite a high lifetime prevalence of a substance use disorder (50%) occurring among hospitalized individuals. A potential barrier to this is the lack of addiction medicine training that currently exists in undergraduate and graduate medical education. Consequently, a paucity of existing physicians report feeling competent to adequately screen for, diagnose or treat substance use disorders. Given the prevalence, cost and potentially lethal consequences of substance use disorders, a critical need exists to improve its identification and evidence-based management in hospital settings.
物质使用障碍在美国乃至全球都给医疗系统带来了沉重的负担,是导致疾病的主要原因之一。尽管死亡人数不断攀升,但仍有许多基于证据的药物可有效治疗多种物质使用障碍,包括尼古丁、酒精和阿片类药物使用障碍。迄今为止,医院在提供专门的成瘾治疗方面基本上被忽视了。尽管在住院患者中,物质使用障碍的终身患病率(50%)很高,但这种情况仍在发生。一个潜在的障碍是本科和研究生医学教育中目前缺乏成瘾医学培训。因此,很少有医生报告说自己有能力充分筛查、诊断或治疗物质使用障碍。鉴于物质使用障碍的普遍性、成本和潜在致命后果,迫切需要提高在医院环境中识别和基于证据的管理能力。