British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Subst Abus. 2019;40(4):473-475. doi: 10.1080/08897077.2019.1576086. Epub 2019 Mar 4.
Overdose deaths as a result of untreated opioid use disorder (OUD) pose a major public health concern across North America. Although slow-release oral morphine (SROM) is increasingly used as an alternative option for the treatment of OUD, research on its efficacy among individuals exposed to illicit fentanyl or those with previous unsuccessful attempts with other opioid agonist therapies (OATs) is limited and controversial. We present a case of a 48-year-old male with severe OUD seeking treatment following a near-fatal fentanyl overdose. His previous treatment attempts with methadone and buprenorphine/naloxone-based OAT had been unsuccessful. As per local guidelines, he was started on SROM with subsequent cessation of opioid cravings and illicit drug use. This case report describes a patient entering early remission for OUD when treated with SROM following unsuccessful past treatment attempts on first-line oral medications. Future studies should seek to evaluate SROM-based OAT as a potential second-line treatment alternative for OUD.
由于未治疗的阿片类药物使用障碍（OUD）导致的过量死亡是整个北美地区主要的公共卫生关注点。尽管缓释口服吗啡（SROM）越来越多地被用作治疗 OUD 的替代选择，但在接触非法芬太尼或以前使用其他阿片类激动剂治疗（OAT）失败的个体中，关于其疗效的研究有限且存在争议。我们报告了一例 48 岁男性患者，他因芬太尼过量险些致命，随后寻求治疗 OUD。他以前尝试使用美沙酮和丁丙诺啡/纳洛酮为基础的 OAT 治疗，但均未成功。根据当地指南，他开始使用 SROM，随后停止了阿片类药物渴求和非法药物使用。本病例报告描述了一名患者在一线口服药物治疗失败后，使用 SROM 治疗 OUD 进入早期缓解期。未来的研究应评估 SROM 为 OUD 的潜在二线治疗选择。
