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鴉片類止痛藥成癮之評估與預防

摘要


鴉片類止痛藥為臨床上廣泛使用的藥物,主要與中樞神經中的μ受器接合,於酬賞系統(reward system)、情緒調節和呼吸功用之腦區作用。因鴉片類藥物的藥理特性,易產生生理性依賴;以及容易有濫用及成癮的問題。鴉片成癮疾患亦常見有下列共病:精神疾患、疼痛問題、藥物過量和自殺相關問題。於初次使用鴉片類止痛劑的病患中,若其具有心理疾患共病、一次拿取劑量大(120 mg/day morphine)或天數長(>30天)的藥物;其有較高的風險發展成鴉片成癮疾患。目前的成癮風險評估工具中,以Pain Medication Questionnaire score ≥ 30有較佳的預測性。針對高風險族群,若能以個別化方式增進其保護因子、減少危險因子,可預防其產生鴉片成癮疾患。

參考文獻


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