Departments of Anesthesiology, Perioperative & Pain Medicine and Pediatrics, Stanford University, Stanford, CA.
Clin J Pain. 2019 Jun;35(6):468-472. doi: 10.1097/AJP.0000000000000700.
The increase in opioid-related deaths in the United States (and other countries) has prompted a national debate in medicine about the appropriateness of opioids for the treatment of acute and chronic pain, and specifically in children, if medical opioid use causes or increases the risk of opioid use disorder (OUD) later in life. Some in the medical community and in government advocate withholding opioids from children after an arbitrary number of days of treatment, regardless of diagnosis. Here, I argue that opioid experimentation and misuse is no more common in children and adolescents today than 2 or 3 decades ago, that there is no compelling evidence that appropriate medical use of opioids leads to OUD, and that the epidemic of inadequately treated pain in children remains the more compelling issue.
美国（和其他国家）阿片类药物相关死亡人数的增加促使医学界就阿片类药物治疗急性和慢性疼痛的适宜性展开了全国性辩论，特别是在儿童中，如果医疗阿片类药物的使用导致或增加了日后发生阿片类药物使用障碍（OUD）的风险。医学界和政府中的一些人主张，无论诊断如何，在经过任意天数的治疗后，不给儿童开阿片类药物。在这里，我认为，如今儿童和青少年中阿片类药物的实验性和滥用与 20 或 30 年前相比并没有更常见，没有令人信服的证据表明适当的医疗用阿片类药物会导致 OUD，而儿童中治疗不足的疼痛的流行仍然是更引人关注的问题。
