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首页> 外文期刊>Journal of pain & palliative care pharmacotherapy >Characterization of Prescription Opioii Abuse in the United States: Focus on Route of Administration
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Characterization of Prescription Opioii Abuse in the United States: Focus on Route of Administration

机译：美国处方Opioii滥用的特征：关注给药途径

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Prescription opioids are prescribed increasingly for the management of chronic pain, and this has been accompanied by a dramatic rise in opioid-related abuse, addiction, and overdose deaths. Reports of abuse involving nonoral administration (e.g., snorting, injecting) of prescription opioids are increasing, although the epidemiology of oral versus nonoral abuse is not well understood. Available data indicate that oral abuse is far more common, with 72% to 97% of opioid abusers perferring oral administration. Factors associated with nonoral administration include longer duration of opioid abuse, male gender, and rural setting. Extended-release opioids, because of their relatively high drug load, may be attractive to experienced abusers seeking to manipulate the formulation to facilitate a rapid onset of effect. Putative abuse-deterrent formulations have been developed to decrease the likelihood or consequences of nonoral abuse. In addition, Risk Evaluation and Mitigation Strategies (REMS) are now required for prescribed extended-release/long-acting opioids by the US Food and Drug Administration, although their effectiveness in reducing the risk of abuse, addiction, and overdose has not been evaluated. Physicians should remain vigilant when prescribing opioids and should exercise appropriate patient selection, perform risk analysis and stratification, and maintain continuous patient monitoring to ensure the benefits outweigh these important risks.
机译：处方阿片类药物越来越多地用于治疗慢性疼痛，并伴随着与阿片类药物有关的滥用，成瘾和过量死亡的急剧增加。尽管对口服和非口服滥用的流行病学认识不多，但涉及非口服阿片类药物（例如，鼻吸，注射）的滥用报告正在增加。现有数据表明，口服滥用更为普遍，72％至97％的阿片类药物滥用者进行口服给药。与非口服给药有关的因素包括阿片类药物滥用时间较长，男性和农村环境。缓释阿片类药物由于其相对较高的载药量，可能对寻求操纵该制剂以促进其快速起效的经验丰富的滥用者具有吸引力。已经开发出假定的滥用威慑配方，以减少非口服滥用的可能性或后果。此外，美国食品药品监督管理局现在对处方的缓释/长效阿片类药物要求采用风险评估和缓解策略（REMS），尽管尚未评估其在降低滥用，成瘾和过量服用风险方面的有效性。 。处方阿片类药物时，医师应保持警惕，并应进行适当的患者选择，进行风险分析和分层，并持续进行患者监测，以确保收益超过这些重要风险。

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