Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Oncologist. 2019 Nov;24(11):1410-1415. doi: 10.1634/theoncologist.2019-0242. Epub 2019 May 16.
Opioids are required by a majority of patients with advanced cancer. Oncologists and palliative care clinicians are faced with the challenge of safely prescribing opioids in the current environment of an opioid crisis. Many patients with cancer use opioids unsafely, store them in unsecure locations, and do not dispose of unused opioids, leading to increased availability of these opioids for others to misuse. More than 50% of people who misuse opioids obtain the drugs from a friend or relative with or without their consent. Patient and provider education has been shown to improve safe opioid use, promote secure storage, and also increase disposal of unused opioids safely in drug take-back programs that are now widely available. This article highlights the importance of patient education and cautious opioid prescribing in patients with cancer. IMPLICATIONS FOR PRACTICE: The current opioid crisis makes it challenging to effectively manage cancer pain. Providers play a prominent role in minimizing opioid misuse. Cautious prescribing with limits enforced on the quantity of opioids prescribed, close follow-up, and consistent and frequent provision of opioid education are a must. Evidence points to the impact of patient education in promoting safety around opioid use. Most people who misuse prescription opioids obtain them from family or friends. Storing opioids in the open or not disposing of unused opioids increases the availability of these opioids for misuse by others. The importance of not sharing, always locking up, and disposing of unused and expired opioids must be highlighted as part of the opioid education that must be delivered every time that opioids are prescribed. Information about local drug take-back programs may also help increase disposal of unused opioids.
阿片类药物是大多数晚期癌症患者所必需的。肿瘤学家和姑息治疗临床医生面临着在当前阿片类药物危机环境下安全开具阿片类药物的挑战。许多癌症患者不安全地使用阿片类药物,将其存放在不安全的地方,并且不处理未使用的阿片类药物,导致这些阿片类药物更容易被他人滥用。超过 50%的阿片类药物滥用者未经其同意或同意从朋友或亲戚那里获得药物。已经证明,患者和提供者的教育可以改善安全使用阿片类药物,促进安全储存,并且还可以通过现在广泛可用的药物回收计划安全处理未使用的阿片类药物。本文强调了对癌症患者进行患者教育和谨慎开具阿片类药物处方的重要性。
当前的阿片类药物危机使得有效管理癌症疼痛变得具有挑战性。提供者在最大限度地减少阿片类药物滥用方面发挥着重要作用。谨慎开具处方,限制开具的阿片类药物数量,密切随访,以及持续和频繁地提供阿片类药物教育是必须的。证据表明,患者教育在促进阿片类药物使用安全方面具有重要影响。大多数滥用处方阿片类药物的人都是从家人或朋友那里获得的。将阿片类药物存放在开放的地方或不处理未使用的阿片类药物会增加这些药物被他人滥用的可用性。必须强调不共享、始终上锁以及处理未使用和过期阿片类药物的重要性,这是每次开具阿片类药物处方时都必须提供的阿片类药物教育的一部分。有关当地药物回收计划的信息也可能有助于增加未使用的阿片类药物的处理。