Post-marketing Surveillance of Methadone and Buprenorphine in the United States
Post-marketing Surveillance of Methadone and Buprenorphine in the United States
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DOI：
10.1111/j.1526-4637.2010.00877.x
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发表时间：
2010-01-01
期刊：
影响因子：
3.1
通讯作者：
Dart, Richard C.
中科院分区：
文献类型：
--
作者：
Dasgupta, Nabarun;Bailey, Elise J.;Dart, Richard C.
简介：最近美国美沙酮和丁丙诺啡的使用有所增加。美沙酮越来越多地用于疼痛管理，丁丙诺啡的使用范围已扩大到包括阿片类药物成瘾的治疗，导致新人群接触这些药物。关于这两种药物在常规门诊医疗使用中的相对安全性存在争议。方法。来自研究滥用、转移和成瘾相关监测 (RADARS (R)) 系统计划的数据用于分析 2003-2007 年药物转移、关键信息提供者、中毒中心和阿片类药物治疗计划的滥用、误用和转移率。全国比率和比率比率是使用人口和人时暴露分母计算的。提供了有关医疗结果和药物配方的严重程度的详细数据。结果。2003 年至 2007 年期间，美沙酮和丁丙诺啡的滥用、误用和转移率稳步上升。美沙酮的滥用、误用和转移比率（每季度每 100,000 人）始终高于丁丙诺啡。 RADARS 系统中毒中心接到 7,476 起美沙酮求助电话和 1,117 起丁丙诺啡求助电话。考虑到可用性后，在四个项目中的三个中，美沙酮误用、滥用和转移的比例高于丁丙诺啡。需要就医的接触美沙酮和丁丙诺啡的数量分别占所有呼叫的 46.8% 和 25.8%。最常见的美沙酮转移形式是固体口服片剂（通常在药房配发，而不是阿片类药物治疗项目），占病例的 73%。结论。在常规门诊医疗使用过程中，丁丙诺啡似乎比美沙酮具有更好的安全性。然而，这两种药物在治疗疼痛和阿片类药物成瘾方面都有作用，应该对它们各自的益处和风险进行进一步研究。
Introduction.There have been recent increases in the use of methadone and buprenorphine in the United States. Methadone is increasingly being used for pain management, and buprenorphine use has expanded to include treatment for opioid addiction, leading to exposures of these drugs in new populations. There is a debate about the relative safety of these two drugs in routine outpatient medical use.Methods.Data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS (R)) System Programs were used to analyze rates of abuse, misuse, and diversion using the Drug Diversion, Key Informant, Poison Center and Opioid Treatment Programs, 2003-2007. National rate and rate ratios were calculated using population and person-time exposed denominators. Detailed data are presented on severity of medical outcome and drug formulations.Results.Between 2003 and 2007, there were steady increases in the rates of abuse, misuse, and diversion of both methadone and buprenorphine. Rate ratios (per 100,000 population per quarter) of abuse, misuse, and diversion were consistently higher for methadone than buprenorphine. RADARS System poison centers received 7,476 calls for methadone and 1,117 calls for buprenorphine. After accounting for availability, there were higher rates of calls for methadone misuse, abuse, and diversion than buprenorphine in three of the four programs. The numbers of exposures requiring medical attention correspond to 46.8% and 25.8% of all calls, for methadone and buprenorphine, respectively. The most commonly diverted form of methadone was solid oral tablets (which are typically dispensed at pharmacies, not at opioid treatment programs), comprising 73% of cases.Conclusions.Buprenorphine appears to have a better safety profile than methadone during routine outpatient medical use. However, both medications have roles in the treatment of pain and opioid addiction, and further research into their respective benefits and risks should be conducted.