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青少年和青年阿片类药物使用障碍患者的药物治疗。

Medication for Adolescents and Young Adults With Opioid Use Disorder.

出版信息

J Adolesc Health. 2021 Mar;68(3):632-636. doi: 10.1016/j.jadohealth.2020.12.129. Epub 2021 Jan 21.

Abstract

Opioid-related morbidity and mortality have risen in many settings globally. It is critical that practitioners who work with adolescents and young adults (AYAs) provide timely, evidence-based treatment for opioid use disorder (OUD). Such treatment should include medications for opioid use disorder (MOUD), including buprenorphine, naltrexone, and methadone. Medication treatment is associated with reduced mortality, fewer relapses to opioid use, and enhanced recovery and retention in addiction care, among other positive health outcomes. Unfortunately, the vast majority of AYAs with OUD do not receive medication. The Society for Adolescent Health and Medicine recommends that AYAs be offered MOUD as a critical component of an integrated treatment approach. Barriers to receipt of medications are widespread; many are common to high-, middle-, and low-income countries alike, whereas others differ. Such barriers should be minimized to ensure equitable access to youth-friendly, affirming, and confidential addiction treatment that includes MOUD. Robust education on OUD and medication treatment should be provided to all practitioners who work with AYAs. Strategies to reduce stigma surrounding medication-and stigma experienced by individuals with substance use disorders more generally-should be widely implemented. A broad research agenda is proposed with the goal of expanding the evidence base for the use and delivery of MOUD for AYAs.

摘要

全球许多地方的阿片类药物相关发病率和死亡率都有所上升。与青少年和年轻人(AYAs)一起工作的从业者为阿片类药物使用障碍(OUD)提供及时、基于证据的治疗至关重要。这种治疗应该包括治疗阿片类药物使用障碍的药物(MOUD),包括丁丙诺啡、纳曲酮和美沙酮。药物治疗与降低死亡率、减少阿片类药物使用复发以及促进成瘾治疗中的康复和保留等其他积极的健康结果相关。不幸的是,绝大多数患有 OUD 的 AYAs 并未接受药物治疗。青少年健康与医学学会建议将 MOUD 作为综合治疗方法的重要组成部分提供给 AYAs。获得药物的障碍普遍存在;其中许多障碍在高、中、低收入国家都很常见,而其他障碍则不同。应尽量减少这些障碍,以确保青少年友好、肯定和保密的成瘾治疗(包括 MOUD)能够平等获得。应该向所有与 AYAs 一起工作的从业者提供关于 OUD 和药物治疗的强化教育。应广泛实施减少与药物相关的污名和与物质使用障碍相关的个人经历的污名的策略。提出了广泛的研究议程,旨在扩大为 AYAs 使用和提供 MOUD 的证据基础。

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