Abuse risks and routes of administration of different prescription opioid compounds and formulations.
Abuse risks and routes of administration of different prescription opioid compounds and formulations.
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DOI：
10.1186/1477-7517-8-29
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发表时间：
2011-10-19
影响因子：
4.4
通讯作者：
Budman SH
中科院分区：
文献类型：
--
作者：
Butler SF;Black RA;Cassidy TA;Dailey TM;Budman SH
评估抗篡改配方（trf）和处方阿片类镇痛药的全类别风险评估和缓解战略（REMS）将需要对现有阿片类镇痛药的滥用模式进行基线描述，包括滥用现有处方阿片类镇痛药的相对风险和替代给药途径（roa）的典型滥用模式。本文介绍了处方阿片类药物滥用高危人群滥用氢可酮、立即释放（IR）和缓释（ER）羟考酮、美沙酮、IR和ER吗啡、氢吗啡酮、IR和ER芬太尼、IR和ER氧吗啡酮的未调整相对风险。当根据产品的处方量进行调整时，相对风险是如何变化的，同时通过产品的roa检查滥用模式。利用2009年成瘾严重程度指数多媒体版（ASI-MV®）Connect对34个州464个治疗机构的59,792名进入药物使用障碍治疗的患者的评估数据和SDI Health LLC的处方量数据，使用对数二项回归模型估计未经调整和调整的滥用风险。随机效应二元逻辑回归模型通过五个ROA之一来估计滥用产品的预测概率，预期ROA（即整个吞下），鼻吸，注射，咀嚼和其他。11种化合物/制剂的未经调整的相对滥用风险确定氢可酮和红外羟考酮的滥用程度最高，而红外羟吗啡酮和红外芬太尼的滥用频率最低。调整处方量表明氢可酮和IR羟考酮在处方基础上最不常被滥用。美沙酮和吗啡，尤其是IR吗啡，滥用的相对风险增加。对不含美沙酮的数据的检查显示，调整处方量后，ER羟考酮是风险最大的药物。确定了化合物/制剂的特定ROA模式，其中吗啡和氢吗啡酮最有可能被注射。这里观察到的未经调整的风险与其他人使用不同人群/方法获得的处方阿片类药物滥用排名一致。调整后的风险估计表明，一些不太广泛开处方的止痛药被滥用的情况比处方量预测的要多。所研究的化合物/配方证明了独特的ROA模式。基线滥用模式对今后评价信托基金和REMS十分重要。
Evaluation of tamper resistant formulations (TRFs) and classwide Risk Evaluation and Mitigation Strategies (REMS) for prescription opioid analgesics will require baseline descriptions of abuse patterns of existing opioid analgesics, including the relative risk of abuse of existing prescription opioids and characteristic patterns of abuse by alternate routes of administration (ROAs). This article presents, for one population at high risk for abuse of prescription opioids, the unadjusted relative risk of abuse of hydrocodone, immediate release (IR) and extended release (ER) oxycodone, methadone, IR and ER morphine, hydromorphone, IR and ER fentanyl, IR and ER oxymorphone. How relative risks change when adjusted for prescription volume of the products was examined along with patterns of abuse via ROAs for the products. Using data on prescription opioid abuse and ROAs used from 2009 Addiction Severity Index-Multimedia Version (ASI-MV®) Connect assessments of 59,792 patients entering treatment for substance use disorders at 464 treatment facilities in 34 states and prescription volume data from SDI Health LLC, unadjusted and adjusted risk for abuse were estimated using log-binomial regression models. A random effects binary logistic regression model estimated the predicted probabilities of abusing a product by one of five ROAs, intended ROA (i.e., swallowing whole), snorting, injection, chewing, and other. Unadjusted relative risk of abuse for the 11 compound/formulations determined hydrocodone and IR oxycodone to be most highly abused while IR oxymorphone and IR fentanyl were least often abused. Adjusting for prescription volume suggested hydrocodone and IR oxycodone were least often abused on a prescription-by-prescription basis. Methadone and morphine, especially IR morphine, showed increases in relative risk of abuse. Examination of the data without methadone revealed ER oxycodone as the drug with greatest risk after adjusting for prescription volume. Specific ROA patterns were identified for the compounds/formulations, with morphine and hydromorphone most likely to be injected. Unadjusted risks observed here were consistent with rankings of prescription opioid abuse obtained by others using different populations/methods. Adjusted risk estimates suggest that some, less widely prescribed analgesics are more often abused than prescription volume would predict. The compounds/formulations investigated evidenced unique ROA patterns. Baseline abuse patterns will be important for future evaluations of TRFs and REMS.
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DOI：
10.1016/j.jpain.2008.10.008
发表时间：
2009-02
期刊：
The journal of pain
影响因子：
--
作者：
Chou R;Fanciullo GJ;Fine PG;Adler JA;Ballantyne JC;Davies P;Donovan MI;Fishbain DA;Foley KM;Fudin J;Gilson AM;Kelter A;Mauskop A;O'Connor PG;Passik SD;Pasternak GW;Portenoy RK;Rich BA;Roberts RG;Todd KH;Miaskowski C;American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
通讯作者：
American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
影响因子：
4.2
作者：
Butler, Stephen F.;Redondo, Jose Pedro;Villaplano, Albert
通讯作者：
Villaplano, Albert
影响因子：
4.2
作者：
Comer, S. D.;Ashworth, J. B.;Walsh, S. L.
通讯作者：
Walsh, S. L.
影响因子：
3.9
作者：
HENDRIKS, VM;KAPLAN, CD;GEERLINGS, P
通讯作者：
GEERLINGS, P
影响因子：
4.4
作者：
Budman SH;Grimes Serrano JM;Butler SF
通讯作者：
Butler SF