Opioid Use, Misuse, and Abuse in Patients Labeled as Fibromyalgia
Opioid Use, Misuse, and Abuse in Patients Labeled as Fibromyalgia
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DOI：
10.1016/j.amjmed.2011.05.031
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发表时间：
2011-10-01
影响因子：
5.9
通讯作者：
Shir, Yoram
中科院分区：
文献类型：
--
作者：
Fitzcharles, Mary-Ann;Ste-Marie, Peter A.;Shir, Yoram
背景：由于疼痛是纤维肌痛的主要症状，因此通常使用针对疼痛缓解的治疗是合乎逻辑的。镇痛药物治疗仍然是大多数慢性疼痛疾病的传统治疗干预，在过去20年中阿片类药物的使用逐渐增加。对慢性阿片类药物治疗的疗效、风险-获益比和可能的长期影响的担忧已经提出。目前关于阿片类药物治疗纤维肌痛的信息有限，所有现行指南均不鼓励使用阿片类药物。方法：对所有转诊至三级护理疼痛中心诊所并诊断为纤维肌痛的患者进行图表审查，以评估阿片类药物的使用。结果：我们记录了457名患者中32%的阿片类药物使用情况，其中超过三分之二的患者使用强效阿片类药物。阿片类药物的使用更常见的是与较低的教育，失业，残疾支付，目前不稳定的精神疾病，药物滥用的历史，和以前的自杀attempts.CONCLUSION：我们已经观察到负面的健康和心理社会状态的患者使用阿片类药物和标记为纤维肌痛。长期使用阿片类药物治疗纤维肌痛需要评估。(C)2011 Elsevier Inc. All rights reserved.美国医学杂志（2011）124，955-960
BACKGROUND: As pain is the cardinal symptom of fibromyalgia, it is logical that treatments directed toward pain relief will be commonly used. Analgesic drug therapy remains the traditional treatment intervention for most chronic pain conditions, with a progressive increased use of opioids in the past 20 years. Concerns about efficacy, risk-benefit ratio, and possible long-term effects of chronic opioid therapy have been raised. There is limited information about opioid treatment in fibromyalgia, with all current guidelines discouraging opioid use.METHODS: A chart review of all patients referred to a tertiary care pain center clinic with a referring diagnosis of fibromyalgia was conducted to evaluate use of opioid medications.RESULTS: We have recorded opioid use by 32% of 457 patients referred to a multidisciplinary fibromyalgia clinic, with over two thirds using strong opioids. Opioid use was more commonly associated with lower education, unemployment, disability payments, current unstable psychiatric disorder, a history of substance abuse, and previous suicide attempts.CONCLUSION: We have observed negative health and psychosocial status in patients using opioids and labeled as fibromyalgia. Prolonged use of opioids in fibromyalgia requires evaluation. (C) 2011 Elsevier Inc. All rights reserved. The American Journal of Medicine (2011) 124, 955-960