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台湾慢性非癌痛重度吸烟者对阿片类药物的注意偏向。

Attentional Bias for Opioids in Taiwanese Heavy Smokers with Chronic Noncancer Pain.

机构信息

Department of Anesthesiology, Changhua Christian Hospital, Changhua 500, Taiwan.

Department of Statistics, Tunghai University, Taichung 407, Taiwan.

出版信息

Medicina (Kaunas). 2024 Jul 8;60(7):1107. doi: 10.3390/medicina60071107.

Abstract

Attentional bias (AB) for addictive substances is a feature of attention found in individuals with substance misuse or diagnosed with substance use disorders. When AB exists, the attention of the addicted individual may be quickly oriented to cues related to the addictive substance or be maintained on these cues for a longer time. AB toward opioids was found in Western samples of smokers with chronic noncancer pain. The level of AB was dose-responsive. However, similar studies in the Taiwanese population are lacking. This study compared the patterns of AB for opioid analgesics in Taiwanese participants with chronic noncancer pain to that of individuals without pain. This study aimed to investigate if AB toward opioids is presented in Taiwanese heavy smokers who are on long-term opioid therapy for pain control. Participants were grouped into chronic noncancer pain smokers, chronic pain nonsmokers, and smokers without pain, according to smoking habits and whether or not on long-term opioid therapy for pain control. Each participant completed demographic questionnaires, mood scales, and the opioid-related visual probe task. Differences in AB among the groups were compared using a three-way analysis of covariance controlling for daily cigarette consumption. Chronic noncancer pain smokers ( = 17) and chronic pain nonsmokers ( = 16) displayed more severe levels of depression, anxiety, and pain, compared to smokers without pain ( = 28). Only did chronic pain nonsmokers show significant AB for opioid cues that were displayed for a short time. Analysis on reaction time found that smokers without pain consistently responded faster to the tasks. No difference in reaction time was found between the pain groups. The current study did not fully replicate findings from studies that were based in Western countries. Formulary availability and regulatory limitations might have affected patient's perception of prescription opioids in Taiwan. However, chronic pain nonsmokers exhibited initial orientation toward opioid-related cues when daily cigarette consumption was accounted for. According to previous research, this AB for shortly displayed opioid cues can be associated with the expectation of pain relief. The current finding also indicated general psychomotor retardation in individuals who were on long-term use of opioids.

摘要

注意偏向(AB)是指对成瘾物质的注意特征,存在于物质滥用或物质使用障碍个体中。当 AB 存在时,成瘾个体的注意力可能会迅速指向与成瘾物质相关的线索,或者更长时间地维持在这些线索上。在西方慢性非癌痛吸烟者的样本中发现了对阿片类药物的 AB。AB 的水平与剂量呈反应关系。然而,在台湾人群中缺乏类似的研究。本研究比较了台湾慢性非癌痛吸烟者与无疼痛个体对阿片类镇痛药的 AB 模式。本研究旨在探讨长期接受阿片类药物治疗以控制疼痛的台湾重度吸烟者是否存在对阿片类药物的 AB。参与者根据吸烟习惯和是否长期接受阿片类药物治疗以控制疼痛,分为慢性非癌痛吸烟者、慢性疼痛不吸烟者和无疼痛吸烟者。每位参与者完成人口统计学问卷、情绪量表和阿片类药物相关视觉探测任务。使用三因素协方差分析比较组间 AB 的差异,控制每日吸烟量。与无疼痛吸烟者相比,慢性非癌痛吸烟者(n=17)和慢性疼痛不吸烟者(n=16)表现出更严重的抑郁、焦虑和疼痛程度。只有慢性疼痛不吸烟者在短时间内显示出对阿片类药物线索的显著 AB。反应时间分析发现,无疼痛吸烟者对任务的反应始终较快。疼痛组之间的反应时间没有差异。本研究没有完全复制基于西方国家的研究结果。处方可用性和监管限制可能影响了台湾患者对处方阿片类药物的看法。然而,当考虑到每日吸烟量时,慢性疼痛不吸烟者表现出对阿片类药物相关线索的初步定向。根据以往的研究,这种对短时间显示的阿片类药物线索的 AB 可以与对疼痛缓解的期望相关。目前的发现还表明,长期使用阿片类药物的个体存在一般的精神运动迟缓。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5096/11279384/2372c15e9a5b/medicina-60-01107-g001.jpg

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