癌症疼痛患者阿片类药物的滥用风险评估和管理

Risk Assessment and Management of Opioid Abuse in Patients with Cancer Pain

阿片类药物是癌症疼痛(简称癌痛)治疗的基础用药,因其安全性良好、给药途径多样、易于剂量滴定、对所有类型疼痛有效而广泛用于癌痛的治疗。随着癌症诊疗技术的提高和患者生存期的延长,癌痛患者接受阿片类药物治疗的时间可能更长,其滥用风险可能高于既往认知。该文旨在综述阿片类药物滥用的危险因素、风险评估工具和监测方法,以期更好地预测、识别和管理癌痛患者阿片类药物滥用行为,优化阿片类药物的可及性、有效性和安全性之间的平衡。

Opioids are the basic drugs for the treatment of cancer pain.They are widely used in the treatment of cancer pain due to their good safety,various ways of administration,easy dose-titration,and effective for all types of pain.As cancer treatments improve and patients live longer,cancer survivors receive opioid treatment for longer periods of time,often at higher risk of abuse than previously thought.The purpose of this review is to summarize the risk factors,risk assessment tools,and surveillance methods for opioid abuse in order to predict,identify,and manage opioid abuse in patients with cancer pain,and to optimize the balance between opioid access,efficacy,and safety.