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美国酒精滥用与药物依赖协会/美国成瘾医师协会临床实践指南:兴奋剂使用障碍管理

The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder.

出版信息

J Addict Med. 2024;18(1S Suppl 1):1-56. doi: 10.1097/ADM.0000000000001299.

DOI:10.1097/ADM.0000000000001299
PMID:38669101
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11105801/
Abstract

The American Society of Addiction Medicine/American Academy of Addiction Psychiatry (ASAM/AAAP) Clinical Practice Guideline on the Management of Stimulant Use Disorder provides guidance on evidence-based strategies for the treatment of stimulant use disorders (StUDs), stimulant intoxication, and stimulant withdrawal, as well as secondary and tertiary prevention of harms associated with stimulant use. The Clinical Guideline Committee (CGC) comprised experts from ASAM and AAAP representing a range of clinical settings and patient populations. The guideline was developed following modified GRADE methodology. The process included a systematic literature review as well as several targeted supplemental searches. The CGC utilized Evidence to Decision tables to review available evidence and rate the strength of each recommendation. The clinical practice guideline was revised based on external stakeholder review. Key takeaways included: Contingency management represents the current standard of care for treatment of StUDs; Pharmacotherapies may be utilized off-label to treat StUDs; Acute stimulant intoxication can result in life-threatening complications that should be addressed in an appropriate level of care; Secondary and tertiary prevention strategies should be used to reduce harms related to risky stimulant use.

摘要

美国成瘾医学学会/美国成瘾精神病学学院(ASAM/AAAP)《兴奋剂使用障碍管理临床实践指南》为兴奋剂使用障碍(StUD)、兴奋剂中毒和兴奋剂戒断的治疗提供了循证策略指导,以及与兴奋剂使用相关的危害的二级和三级预防。临床指南委员会(CGC)由来自 ASAM 和 AAAP 的专家组成,代表了一系列临床环境和患者群体。该指南是按照改良的 GRADE 方法制定的。该过程包括系统文献回顾和几次有针对性的补充搜索。CGC 使用证据决策表来审查现有证据,并对每项建议的强度进行评分。临床实践指南根据外部利益相关者的审查进行了修订。主要内容包括:

  • 条件性管理代表了治疗 StUD 的当前护理标准;

  • 药物治疗可以标签外用于治疗 StUD;

  • 急性兴奋剂中毒可导致危及生命的并发症,应在适当的护理水平上进行治疗;

  • 应使用二级和三级预防策略来减少与冒险使用兴奋剂相关的危害。