Opioid tolerance and dependence - do they matter?
Opioid tolerance and dependence - do they matter?
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DOI：
10.1016/j.ejpain.2004.11.009
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发表时间：
2005-04-01
影响因子：
3.6
通讯作者：
Jage, J
中科院分区：
文献类型：
--
作者：
Jage, J
长期以来，阿片类药物的使用一直被接受为癌症和急性疼痛患者的标准治疗。阿片类药物可以进一步有效地用于慢性非恶性疼痛状态患者的特定亚组。虽然阿片类药物在癌症和非癌症疼痛人群中的耐受性和身体依赖性的发展是已知的作用，但这些患者不能被视为成瘾。然而，长期短效阿片类药物治疗易产生耐受性和成瘾性，最近的研究证实了精神病理学和社会心理状况在相当数量的非癌症疼痛亚组中作为阿片类药物疗效失败的预测因子的重要作用。治疗失败的临床表现可能会因不依从、隐蔽消费精神药物和将处方阿片类药物转用于各种目的而变得复杂，例如，这篇文章讨论了阿片类药物治疗的影响，包括耐受性、身体依赖性、药物异常行为、药物史、精神病理学和躯体化。(c)2004年，国际疼痛研究协会欧洲分会联合会。由爱思唯尔有限公司出版。保留所有权利。
The use of opioids has long been accepted as the standard of care in patients with cancer and acute pain. Opioids can further be used effectively in specific subgroups of patients with chronic nonmalignant pain states. While the development of tolerance and physical dependence are known effects of opioids in cancer and noncancer pain populations, these patients can not be regarded as addicted. However, long-term therapy with short-acting opioids predisposes to tolerance and addiction.Recent research has confirmed the important role of psychopathologic and psychosocial conditions as predictors of failed opioid effectiveness in a significant number of noncancer pain subgroups. The clinical picture of failed therapy may be complicated by noncompliance, concealed consumption of psychotropic substances, and diversion of prescribed opioids for various purposes as, e.g., selling for profit, or sharing excess opioids with others.This article discusses the effects of opioid therapy, including tolerance, physical dependence, drug-aberrant behavior, drug history, psychopathology, and somatization. (c) 2004 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.