Continuous Opioid Treatment for Chronic Noncancer Pain: A Time for Moderation in Prescribing
Continuous Opioid Treatment for Chronic Noncancer Pain: A Time for Moderation in Prescribing
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DOI：
10.3810/pgm.2009.07.2032
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发表时间：
2009-07-01
影响因子：
4.2
通讯作者：
Ciervo, Carman A.
中科院分区：
文献类型：
--
作者：
Colameco, Stephen;Coren, Joshua S.;Ciervo, Carman A.
医生已经接受了慢性非癌性疼痛（CNCP）长期阿片类药物治疗的概念，这一点可以通过增加处方来证明。许多患者受益于更自由的阿片类药物处方，但许多人没有，处方阿片类药物滥用与处方增加同时显着增加。由于阿片类药物的潜在严重不良反应，医生必须平衡潜在的利益与风险，特别是在阿片类药物滥用，滥用或依赖风险的个人。本文综述了长期持续阿片类药物治疗CNCP，目前的治疗指南，成瘾风险分层，阿片类药物诱导的痛觉过敏和内分泌功能障碍。
Physicians have embraced the concept of long-term opioid treatment for chronic noncancer pain (CNCP), as evidenced by increased prescribing. Many patients have benefited from more liberal opioid prescribing, but many have not, and prescription opioid abuse has risen significantly coincident with increased prescribing. Because of the potentially serious adverse effects of opioids, physicians must balance potential benefits against risks, especially in individuals at risk for opioid misuse, abuse, or dependence. This article reviews long-term, continuous opioid treatment of CNCP, current treatment guidelines, addiction risk stratification, opioid-induced hyperalgesia, and endocrine dysfunction.