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在终末期疾病背景下管理阿片类物质使用障碍:机遇与挑战

Managing Opioid Use Disorder in the Setting of a Terminal Disease: Opportunities and Challenges.

作者信息

Sager Zachary S, Buss Mary K, Hill Kevin P, Driver Jane A, Skarf Lara M

机构信息

VA New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.

Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts.

出版信息

J Palliat Med. 2020 Feb;23(2):296-299. doi: 10.1089/jpm.2019.0101. Epub 2019 Jul 11.

Abstract

Opioids have long been a mainstay of symptom management in palliative care (PC), allowing patients with terminal illnesses to have an improved quality of life. Unfortunately, these same medications have contributed to the explosion of the opioid epidemic. This article explores the case of a patient with opioid use disorder (OUD) and pancreatic cancer. We share our experience of managing his symptoms and treating OUD in the setting of an outpatient PC clinic. We explore the challenges and joys of this case while reflecting on the need for more research investigating best practices for individuals where opioids serve as both a pain reliever and contributor to further suffering from their OUD.

摘要

长期以来,阿片类药物一直是姑息治疗(PC)中症状管理的主要手段,使绝症患者的生活质量得到改善。不幸的是,这些药物也导致了阿片类药物流行的激增。本文探讨了一名患有阿片类药物使用障碍(OUD)和胰腺癌患者的病例。我们分享了在门诊姑息治疗诊所环境中管理他的症状和治疗阿片类药物使用障碍的经验。我们探讨了这个病例的挑战和喜悦,同时反思了对于阿片类药物既是止痛剂又会导致其阿片类药物使用障碍进一步痛苦的个体,需要进行更多研究以调查最佳实践方法。

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