Division of Hospital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY 10029, USA.
Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY 10029, USA.
Med Clin North Am. 2020 Jul;104(4):695-708. doi: 10.1016/j.mcna.2020.03.003. Epub 2020 May 12.
The diagnosis of opioid use disorder (OUD) is often overlooked or inadequately managed during the inpatient admission. When recognized, a common strategy is opioid detoxification, an approach that is often ineffective and can be potentially dangerous because of loss of tolerance and subsequent risk for overdose. Medication for addiction treatment (MAT), including methadone and buprenorphine, is effective and can be dispensed in the hospital for both opioid withdrawal and initiation of maintenance treatment. Hospitalists should be knowledgeable about diagnosing and managing patients with OUD, including how to manage acute pain or MAT during the perioperative setting.
阿片类使用障碍（OUD）的诊断在住院期间经常被忽视或处理不当。当被识别出来时，一种常见的策略是阿片类药物脱毒，这种方法通常是无效的，而且由于耐受性丧失和随后的过量风险，可能是危险的。药物成瘾治疗（MAT），包括美沙酮和丁丙诺啡，是有效的，可以在医院开出，用于治疗阿片类药物戒断和启动维持治疗。医院医生应该了解如何诊断和治疗 OUD 患者，包括如何在围手术期管理急性疼痛或 MAT。
