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老年人群初级保健中的阿片类药物使用障碍的筛查和管理。

Screening for and Management of Opioid Use Disorder in Older Adults in Primary Care.

机构信息

Saint Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, USA.

Kolmac Outpatient Recovery Centers, 3919 National Drive, Suite 300, Burtonsville, MD 20866, USA.

出版信息

Clin Geriatr Med. 2022 Feb;38(1):23-38. doi: 10.1016/j.cger.2021.07.001.

Abstract

Opioid use disorder (OUD) is commonly seen in older adults in primary care offices. OUD when left untreated, often leads to overdose deaths, emergency department visits, and hospitalizations due to opioid-related adverse effects, especially respiratory and central nervous system depression. Primary care providers are on the front lines of efforts for its prevention, early detection, and treatment. This includes using the lowest doses of opioids for the shortest possible time for management of pain, routine screening, brief intervention, opioid withdrawal management, prescription of naloxone to prevent overdose death, and treatment with medications and psychosocial interventions for OUD. Referral to addiction treatment centers may be needed in complex cases. This review explores the epidemiology, screening, as well as management of OUD as it pertains to the elderly population.

摘要

阿片类药物使用障碍(OUD)在初级保健诊所的老年人中很常见。如果不加以治疗,OUD 通常会导致过量死亡、因阿片类药物相关不良反应而导致的急诊就诊和住院,特别是呼吸和中枢神经系统抑制。初级保健提供者是预防、早期发现和治疗 OUD 的第一线。这包括使用最低剂量的阿片类药物来管理疼痛,尽可能缩短时间,常规筛查,简短干预,阿片类药物戒断管理,开纳洛酮预防过量死亡,以及使用药物和心理社会干预治疗 OUD。在复杂的情况下,可能需要转介到成瘾治疗中心。这篇综述探讨了 OUD 的流行病学、筛查以及与老年人群相关的管理。

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