Scurti Pietro, Nunzi Marco, Leonardi Claudio, Pierlorenzi Claudio, Marenzi Roberta, Lamartora Vincenzo
ASL Napoli 2 Nord, Napoli, Italy.
UOS Patologie da Dipendenza d9 ASL Roma 2, Roma, Italy.
Front Psychiatry. 2023 Aug 31;14:1205285. doi: 10.3389/fpsyt.2023.1205285. eCollection 2023.
This study used narrative medicine (NM) to assess the point of view of patients with opioid use disorder (OUD) and the impact that addiction and a new treatment approach via buprenorphine implant had on their daily lives as compared with previous oral Opioid Agonist Therapy (OAT).
Five patients with OUD undergoing treatment with a buprenorphine subcutaneous implant participated voluntarily and provided their anonymity by self-describing, in response to questions prompted by the clinician, their experience with this innovative therapy. The narratives were analyzed according to standard NM methodology. Citations of patients' positive or negative experiences with traditional OAT and buprenorphine implant were classified according to five categories-patient's determination toward complete opioid abstinence, emotional impact, impact on life, smoothness of therapy, and therapy dependency-and quantified to obtain a picture of the overall therapy experience.
The analysis revealed the extent of the burden not only of addiction but also of the traditional OAT on patients' life, including relationships with family, job management, and free time. Conversely, the therapy with buprenorphine implant revealed a significant improvement in the quality of life of the patients, who also largely reported a positive emotional outcome during this therapy, as well as a solid determination to achieve complete recovery.
This study illustrates the complex problems of living with OUD and provides insights into the added value of an innovative buprenorphine implant therapy that, due to its administration route and prolonged duration, allows patients to take an additional step toward total opioid abstinence and complete recovery of daily life.
本研究采用叙事医学（NM）来评估阿片类药物使用障碍（OUD）患者的观点，以及成瘾和通过丁丙诺啡植入剂的新治疗方法与之前的口服阿片类激动剂疗法（OAT）相比对其日常生活的影响。
五名接受丁丙诺啡皮下植入治疗的OUD患者自愿参与，并通过在临床医生提问的引导下自我描述这种创新疗法的经历来保持匿名。根据标准的叙事医学方法对这些叙述进行分析。根据患者对传统OAT和丁丙诺啡植入剂的积极或消极体验的引用，分为五类——患者对完全戒除阿片类药物的决心、情感影响、对生活的影响、治疗的顺畅程度以及治疗依赖性——并进行量化，以了解整体治疗体验。
分析揭示了成瘾以及传统OAT给患者生活带来的负担程度，包括与家人的关系、工作管理和空闲时间。相反，丁丙诺啡植入剂治疗显示患者的生活质量有显著改善，他们在治疗期间也大多报告了积极的情绪结果，以及实现完全康复的坚定决心。
本研究阐述了患有OUD的复杂问题，并深入了解了一种创新的丁丙诺啡植入剂治疗的附加价值，由于其给药途径和延长的持续时间，使患者朝着完全戒除阿片类药物和完全恢复日常生活又迈进了一步。
