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处方类兴奋剂作为减少冰毒使用障碍和治疗干预的手段,及其对护理临床实践的影响:文献的范围综述。

Prescription psychostimulants as a harm reduction and treatment intervention for methamphetamine use disorder and the implications for nursing clinical practice: A scoping review of the literature.

机构信息

College of Nursing, University of Saskatchewan, Saskatoon, Canada.

出版信息

Int J Ment Health Nurs. 2023 Oct;32(5):1225-1242. doi: 10.1111/inm.13144. Epub 2023 Mar 28.

Abstract

The global rise in methamphetamine use and its negative effects warrants the need for research exploring harm reduction and treatment interventions for individuals with methamphetamine use disorder. Agonist medications have been utilized for years for the treatment of heroin and opioid addiction, but have yet to be incorporated into mainstream Canadian practice for methamphetamine dependence. This review aims to provide an overview of the current trends of prescription psychostimulant usage for individuals with methamphetamine use disorder from a Canadian perspective, identifies the barriers to accessing prescription psychostimulants for methamphetamine use disorder and highlights the nursing clinical practice implications in caring for individuals with the disorder. Discourse on the sustained abstinence and harm reduction debate is presented from the perspective of methamphetamine abuse is provided along with the neuropsychiatric complications of chronic methamphetamine use. The impacts of specific prescription psychostimulants on cognition are discussed as is the use of neuroimaging techniques to assess neuronal damage in methamphetamine users. Sign of toxicity, overdose and the contraindications for use of these prescription psychostimulants is also presented. The implications to nursing clinical practice in caring for this population is provided, touching on the clinical presentation of methamphetamine use, completing thorough assessment and screening and patient education. The findings of this review indicate the need for further research in this area exploring the benefits of prescription psychostimulants as a harm reduction and treatment intervention for the global problem of methamphetamine dependence.

摘要

全球范围内甲基苯丙胺使用量的增加及其带来的负面影响,促使我们需要研究探索针对甲基苯丙胺使用障碍患者的减少伤害和治疗干预措施。多年来,激动剂药物一直被用于治疗海洛因和阿片类药物成瘾,但尚未纳入加拿大主流的甲基苯丙胺依赖治疗实践中。本综述旨在从加拿大的角度概述当前用于治疗甲基苯丙胺使用障碍患者的处方兴奋剂使用趋势,确定获得用于治疗甲基苯丙胺使用障碍的处方兴奋剂的障碍,并强调护理实践中对该障碍患者的护理的临床意义。本文从甲基苯丙胺滥用的角度讨论了持续禁欲和减少伤害的争论,并介绍了慢性使用甲基苯丙胺引起的神经精神并发症。讨论了特定处方兴奋剂对认知的影响,以及使用神经影像学技术评估甲基苯丙胺使用者的神经元损伤。还介绍了这些处方兴奋剂的毒性、过量和使用禁忌的迹象。本文还提供了对护理临床实践的启示,涉及到该人群的临床表现、进行全面评估和筛查以及患者教育。本综述的研究结果表明,需要在这一领域进行进一步的研究,探索将处方兴奋剂作为减少伤害和治疗干预措施,以解决全球范围内的甲基苯丙胺依赖问题。

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