Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
Semin Neurol. 2024 Aug;44(4):441-451. doi: 10.1055/s-0044-1787571. Epub 2024 Jun 7.
The rates of opioid use and opioid related deaths are escalating in the United States. Despite this, evidence-based treatments for Opioid Use Disorder are underutilized. There are three medications FDA approved for treatment of Opioid Use Disorder: Methadone, Buprenorphine, and Naltrexone. This article reviews the history, criteria, and mechanisms associated with Opioid Use Disorder. Pertinent pharmacology considerations, treatment strategies, efficacy, safety, and challenges of Methadone, Buprenorphine, and Naltrexone are outlined. Lastly, a practical decision making algorithm is discussed to address pertinent psychiatric and medical comorbidities when prescribing pharmacology for Opioid Use Disorder.
在美国，阿片类药物的使用和与阿片类药物相关的死亡人数正在上升。尽管如此，基于证据的阿片类药物使用障碍治疗方法仍未得到充分利用。有三种药物获得了美国食品和药物管理局（FDA）批准用于治疗阿片类药物使用障碍：美沙酮、丁丙诺啡和纳曲酮。本文回顾了阿片类药物使用障碍的历史、标准和相关机制。概述了美沙酮、丁丙诺啡和纳曲酮的相关药理学考虑因素、治疗策略、疗效、安全性和挑战。最后，讨论了一种实用的决策算法，以解决在为阿片类药物使用障碍开具药物治疗时出现的相关精神和医学合并症。
