Takasusuki Toshifumi, Hayashi Shinji, Koretaka Yuichi, Yamaguchi Shigeki
Department of Anesthesiology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan.
Integrated Disease Care Division, Shionogi & Co., Ltd., 1-8, Doshomachi 3-chome, Chuo-ku, Osaka, Japan.
Pain Ther. 2022 Sep;11(3):987-1009. doi: 10.1007/s40122-022-00409-6. Epub 2022 Jul 5.
Opioid use disorder is a global problem. Although opioid analgesics are prescribed less frequently in Japan than in many other countries, the rate of aberrant prescription opioid-taking behaviors in Japan is unknown.
An internet survey was conducted to estimate the prevalence of and risk factors for prescription opioid misuse, abuse, diversion and doctor shopping in Japanese subjects with chronic pain who had been prescribed opioid analgesics.
The proportion of respondents (n = 387) who reported opioid misuse was 45.5% (95% confidence interval [CI]: 40.4-50.6); rates were: 24.6% (95% CI: 20.3-29.2) for abuse; 15.0% (95% CI: 11.6-19.0) for diversion; and 10.6% (95% CI: 7.7-14.1) for doctor shopping. Aberrant prescription opioid-taking behaviors were higher in participants with chronic post-cancer treatment pain (misuse, 64.2%; abuse, 52.2%) or chronic cancer pain (misuse, 57.4%; abuse, 26.2%) than in those with chronic noncancer pain (misuse, 37.8%; abuse, 17.0%). Younger age, male sex, smoking, habitual drinking, diagnosis of psychiatric disease, use of opioids other than tramadol, and use of opioids for chronic post-cancer treatment pain and chronic cancer pain were identified as risk factors for aberrant prescription opioid-taking behaviors.
Even in Japan, which has not experienced the surge in opioid consumption documented in other countries, aberrant prescription opioid-taking behaviors were observed. When prescribing opioid analgesics, universal precautions should always be taken for both cancer and non-cancer patients.
UMIN000041788.
阿片类药物使用障碍是一个全球性问题。尽管在日本，阿片类镇痛药的处方开具频率低于许多其他国家，但日本异常处方阿片类药物服用行为的发生率尚不清楚。
开展了一项网络调查，以估计日本慢性疼痛患者中处方阿片类药物滥用、误用、转移和骗保购药行为的患病率及风险因素，这些患者已被开具阿片类镇痛药。
报告阿片类药物误用的受访者（n = 387）比例为45.5%（95%置信区间[CI]：40.4 - 50.6）；各行为发生率分别为：滥用24.6%（95% CI：20.3 - 29.2）；转移15.0%（95% CI：11.6 - 19.0）；骗保购药10.6%（95% CI：7.7 - 14.1）。癌症治疗后慢性疼痛患者（误用64.2%；滥用52.2%）或慢性癌症疼痛患者（误用57.4%；滥用26.2%）的异常处方阿片类药物服用行为高于慢性非癌症疼痛患者（误用37.8%；滥用17.0%）。年龄较小、男性、吸烟、习惯性饮酒、精神疾病诊断、使用曲马多以外的阿片类药物，以及用于癌症治疗后慢性疼痛和慢性癌症疼痛的阿片类药物使用被确定为异常处方阿片类药物服用行为的风险因素。
即使在未经历其他国家所记录的阿片类药物消费激增情况的日本，也观察到了异常处方阿片类药物服用行为。在开具阿片类镇痛药时，对于癌症和非癌症患者都应始终采取通用预防措施。
UMIN000041788。
