Department of Psychiatry and Human Behavior-Division of Substance Abuse, The Sidney Kimmel Medical College at Thomas Jefferson University, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Department of Psychiatry, Rowan University School of Osteopathic Medicine, Mount Laurel, NJ, USA.
Intern Emerg Med. 2022 Oct;17(7):2159-2165. doi: 10.1007/s11739-022-02936-8. Epub 2022 Feb 9.
The number of patients with opioid use disorder (OUD) has increased dramatically. Substance use disorders in general are thought to occur in one in five patients in primary care. However, despite this prevalence, there is a dearth of training in undergraduate and continuing medical education to manage OUDs, and internal medicine doctors need to have an understanding of the basic physiology and treatment options for this illness. Expanding knowledge of OUD treatments will allow internists to use their skills and strong patient-doctor relationships to ensure the trust of their patients with OUD, leading to better outcomes and increased chances of recovery. It will also allow clinicians to appropriately refer their patients for lifesaving specialized care and help them prevent dangerous medical complications often seen as a result of addiction. There are three FDA-approved medications to treat OUD disorder, known collectively as medication-assisted treatment (MAT). In this paper, the three medications-methadone, naltrexone, and buprenorphine-are presented, compared, contrasted, and clinically reviewed.
阿片类药物使用障碍（OUD）患者的数量急剧增加。一般来说，人们认为在初级保健中，每五个患者中就有一个患有物质使用障碍。然而，尽管这种情况很普遍，但在本科和继续医学教育中，治疗 OUD 的培训却很少，内科医生需要了解这种疾病的基本生理学和治疗选择。扩大对 OUD 治疗的了解将使内科医生能够利用他们的技能和与患者的牢固关系来确保信任他们的 OUD 患者，从而带来更好的结果和增加康复的机会。它还将使临床医生能够适当地将他们的患者转介到救生的专门护理，并帮助他们预防因成瘾而经常出现的危险的医疗并发症。有三种经美国食品和药物管理局批准的治疗 OUD 障碍的药物，统称为药物辅助治疗（MAT）。在本文中，介绍、比较、对比和临床审查了三种药物——美沙酮、纳曲酮和丁丙诺啡。
