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美沙酮治疗阿片类药物使用障碍和 2019 年冠状病毒病感染患者安全吗?

Is Methadone Safe for Patients With Opioid Use Disorder and Coronavirus Disease 2019 Infection?

机构信息

John Arianda Owiti, RMN, BSc (Hons), MSc, H.E. Dip (Nursing), PhD, Molli Benson, RGN, BSc, Mandisa Maplanka, BSc, Lasekan Oluseye, MD, and Debora Carvalho, BSc, Substance Misuse Service, Oxleas NHS Foundation Trust, HMP Thameside, London, England.

出版信息

J Addict Nurs. 2022;33(2):86-94. doi: 10.1097/JAN.0000000000000457.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has led to not only increase in substance misuse, substance use disorder, and risk of overdose but also lack of access to treatment services. Due to lack of knowledge of the course and impact of COVID-19 and outcomes of it's interactions with existing treatments, the Substance Misuse Service Team initiated a safety improvement project to review the safety of opioid substitution treatment, particularly the safety of methadone. This preliminary retrospective cross-sectional audit of safety improvement intiative underscores the importance of providing treatment services to those with opioid use disorders and that methadone is safe among this population with a high burden of comorbidity, most of which leads to negative outcomes from COVID-19. The outcomes show that patients who have COVID-19 should continue with opioid substitution treatment with methadone. Although treatment with methadone is safe, symptomatic patients should be monitored. In addition, patients who take methadone at home should be educated on the risk of overdose due to, and adverse outcomes from, COVID-19 infection. Patients should monitor themselves using pulse oximeter for any signs of hypoxia.

摘要

2019 年冠状病毒病(COVID-19)大流行不仅导致了物质滥用、物质使用障碍和过量风险的增加,还导致了治疗服务的缺乏。由于缺乏对 COVID-19 的过程和影响以及其与现有治疗方法相互作用的结果的了解,物质滥用服务团队启动了一项安全改进项目,以审查阿片类药物替代治疗的安全性,特别是美沙酮的安全性。这项安全改进倡议的初步回顾性横断面审计强调了向患有阿片类药物使用障碍的人提供治疗服务的重要性,并且美沙酮在患有高共病负担的人群中是安全的,其中大多数导致 COVID-19 的负面结果。结果表明,患有 COVID-19 的患者应继续接受美沙酮替代治疗。尽管美沙酮治疗是安全的,但应监测有症状的患者。此外,应向在家中服用美沙酮的患者进行有关 COVID-19 感染导致的过量风险和不良后果的教育。患者应使用脉搏血氧仪自行监测是否有缺氧迹象。

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本文引用的文献

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Substance use and related harms in the context of COVID-19: a conceptual model.在 COVID-19 背景下的物质使用及相关危害:概念模型。
Health Promot Chronic Dis Prev Can. 2020 Dec 9;40(11-12):342-349. doi: 10.24095/hpcdp.40.11/12.03. Epub 2020 Sep 16.

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