The Impact of Misuse and Diversion of Opioid Substitution Treatment Medicines: Evidence Review and Expert Consensus
The Impact of Misuse and Diversion of Opioid Substitution Treatment Medicines: Evidence Review and Expert Consensus
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DOI：
10.1159/000438988
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发表时间：
2016-01-01
影响因子：
3.9
通讯作者：
D'Agnone, Oscar
中科院分区：
文献类型：
--
作者：
Reimer, Jens;Wright, Nat;D'Agnone, Oscar
背景/目标：阿片类药物替代治疗 (OST) 可改善阿片类药物依赖的结果。然而，治疗中使用的受控药物可能会被滥用或挪用，从而导致负面的治疗结果。本次审查定义了一个评估滥用和转移影响的框架。方法：完成了对已发表的 OST 药物滥用和转移研究的系统回顾；这些证据与专家的现实经验相结合，以更好地了解滥用和转移对个人和社会的影响。结果：对个人的直接影响包括康复失败和对健康的负面影响（用药过量、与注射行为相关的健康风险）。 OST 的转移对社区的影响超出了预期 OST 接收者的范围。直接影响包括对他人的风险（无人监督的使用；儿童无意中接触转移的药物）和与毒品有关的犯罪行为。间接影响包括未经治疗的阿片类药物依赖、犯罪和生产力损失的经济成本。结论：虽然阿片类药物依赖的治疗至关重要且必须得到支持，但在确保提供最佳护理的同时减少滥用和转移也至关重要。了解 OST 滥用和转移的影响是制定解决这些问题的策略的关键。 (C) 2015 S. Karger AG，巴塞尔
Background/Aims: Opioid substitution treatment (OST) improves outcomes in opioid dependence. However, controlled drugs used in treatment may be misused or diverted, resulting in negative treatment outcomes. This review defines a framework to assess the impact of misuse and diversion. Methods: A systematic review of published studies of misuse and diversion of OST medicines was completed; this evidence was paired with expert real-world experience to better understand the impact of misuse and diversion on the individual and on society. Results: Direct impact to the individual includes failure to progress in recovery and negative effects on health (overdose, health risks associated with injecting behaviour). Diversion of OST has impacts on a community that is beyond the intended OST recipient. The direct impact includes risk to others (unsupervised use; unintended exposure of children to diverted medication) and drug-related criminal behavior. The indirect impact includes the economic costs of untreated opioid dependence, crime and loss of productivity. Conclusion: While treatment for opioid dependence is essential and must be supported, it is vital to reduce misuse and diversion while ensuring the best possible care. Understanding the impact of OST misuse and diversion is key to defining strategies to address these issues. (C) 2015 S. Karger AG, Basel