PAIN ANALGESIC RESPONSE IN OPIATE DEPENDENCE

阿片依赖的疼痛镇痛反应

• 批准号: 6515826
• 负责人: WALTER NMN LING
• 金额: $ 53.04万
• 依托单位: FRIENDS RESEARCH INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-06-01 至 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6515826
• 关键词: analgesia; analgesics; buprenorphine; clinical trials; drug addiction; drug interactions; drug tolerance; human subject; human therapy evaluation; ketamine; methadone; morphine; pain; patient oriented research; psychopharmacology

DESCRIPTION: (Applicant's Abstract) There is an increasingly large population receiving opiates on a chronic basis, either for treatment of opiate dependence or for treatment of chronic pain. Managing pain in opiate maintained individuals is a challenging problem. The development of opioid tolerance and dependence may result in altered pain sensitivity and subsequent response to additional opioids. Many clinicians believe addicts cannot benefit from further opiate administration because they are tolerant to the analgesic effects. Others believe that if an addict is maintained on an opiate agonist, that medication provides adequate analgesia for acute pain. Patients are reluctant to give accurate histories because clinicians often withhold opioid analgesics from patients with a history of drug abuse. Those who do complain are viewed suspiciously and their complaints ignored. Currently there are few guidelines to assist clinicians and those that do exist are based on experience and consensus rather than evidence-based research. This study proposes to examine: 1) how patients on opiate maintenance (either buprenorphine or methadone) experience pain (tolerance and threshold) and how they are different from non-opiate dependent individuals, 2) how patients maintained on methadone and buprenorphine differ from normal controls in response to added opiate and non-opiate analgesics and 3) how therapeutic plasma concentration levels of morphine for analgesia differ in methadone and buprenorphine maintained patients compared to normal controls. The results of this proposed study will help develop systematic guidelines for clinicians in the management of pain in opiate maintained individuals.

描述：（申请人摘要） 越来越多的人长期接受阿片类药物， 用于治疗阿片依赖或治疗慢性疼痛。 管理阿片类药物维持者的疼痛是一个具有挑战性的问题。这 阿片类药物耐受性和依赖性的发展可能会导致疼痛改变 对其他阿片类药物的敏感性和随后的反应。许多临床医生 相信成瘾者无法从进一步的阿片类药物管理中受益，因为他们 对镇痛作用具有耐受性。其他人则认为，如果一个瘾君子 维持阿片激动剂，药物提供足够的镇痛作用 用于急性疼痛。患者不愿意提供准确的病史，因为 临床医生经常不对有阿片类镇痛病史的患者使用阿片类镇痛药。 药物滥用。那些确实抱怨的人会受到怀疑，他们的抱怨 被忽略。目前，很少有指南可以帮助临床医生和那些 确实存在基于经验和共识，而不是基于证据 研究。 本研究旨在检查：1）患者如何维持阿片类药物（无论是 丁丙诺啡或美沙酮）经历疼痛（耐受性和阈值）以及如何 他们与非阿片类药物依赖者不同，2) 患者如何 维持美沙酮和丁丙诺啡与正常对照不同 对添加阿片类和非阿片类镇痛药的反应以及 3) 治疗效果如何 用于镇痛的吗啡血浆浓度水平在美沙酮和 丁丙诺啡维持患者与正常对照相比。 这项拟议研究的结果将有助于制定系统的指导方针 临床医生对阿片类药物维持个体的疼痛进行管理。