Pharmacologically Assisted Treatment of Opioid-Dependent Youth
Pharmacologically Assisted Treatment of Opioid-Dependent Youth
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DOI：
10.1007/s40272-013-0041-5
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发表时间：
2013-12-01
期刊：
影响因子：
3.7
通讯作者：
Woody, George E.
中科院分区：
文献类型：
--
作者：
Pecoraro, Anna;Fishman, Marc;Woody, George E.
阿片类药物误用、滥用和依赖是全球性问题，其模式因文化而异。在美国，处方类阿片的非医疗使用已变得特别严重，因为它与成瘾和过量死亡有关。激动剂和拮抗剂药物已被证明对阿片类药物依赖的成年人有效，并且有越来越多的数据表明它们对青少年也有效。在这里，我们总结了单独戒毒导致高治疗辍学率和复发率的证据，但有限但不断增长的关于阿片类药物依赖青年延长使用药物辅助治疗的数据是积极的。实施药物辅助治疗作为一种标准做法是可行的，很容易与咨询或心理治疗相结合，并有可能大大改善结果。尽管对青少年的安全性和有效性的担忧需要更多的研究，我们不提倡无限期维持，但我们建议阿片类药物依赖的青少年应该被视为在全面的、适合发育的背景下进行药物辅助治疗的候选人，从第一次护理开始，随着每次护理的加强，推荐使用药物的力度增加。
Opioid misuse, abuse, and dependence are global problems whose patterns vary across cultures. In the USA, the non-medical use of prescription opioids has become particularly serious because of its association with addiction and overdose death. Agonist and antagonist medications have been shown to be effective for opioid-dependent adults, and there is a growing body of data that they are also effective for youth. Here, we summarize evidence that detoxification alone results in high rates of treatment dropout and relapse but that the limited but growing data on the extended use of medication-assisted treatment for opioid-dependent youth have been positive. The implementation of medication-assisted treatment as a standard practice is feasible, easily integrated with counseling or psychotherapy, and has potential to greatly improve outcomes. Although concerns about safety and efficacy with youth require more research, and we do not advocate indefinite maintenance, we suggest that opioiddependent youth should be considered as candidates for medication-assisted treatment delivered in a comprehensive, developmentally appropriate context, beginning at the first episode of care, with the strength of the recommendation to use medication increasing with each care episode.