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Opioids Still Needed By Some Pain Patients 阿片类镇痛药仍有需求

“The opioid epidemic¹ is a national crisis that should not be underestimated.” That’s a quote from a June 1st New England Journal of Medicine perspective piece by Susan Glod. She’s a physician involved with hospice and palliative care and pain management. But the title of the piece reveals another issue related to the current situation. That title is The Other Victims of the Opioid Epidemic. Those other victims being people in desperate need of pain treatment who cannot now get it because of fears related to the prescribing and use of opioids.

“阿片类药物的盛行是一场不应被低估的全国性危机。”此话引用自6月1日苏珊·格洛德（Susan Glod）在《新英格兰医学期刊》中发表的观点。她是一名内科医生，从事临终关怀、姑息治疗和疼痛管理工作。但这篇文章的标题——《阿片类药物盛行的其他受害者》——揭示了另一个与当前形势有关的问题。她指的其他受害者即那些迫切需要疼痛治疗，却因为害怕阿片类药物相关的处方规定与用法而无法用到它的人。

\To try to help to avoid abuse, new forms of opioids have been created, called abuse-deterrent opioid medications. These can’t be crushed or dissolved, thus making them difficult to snort or inject. But “these formulations would have no impact on other opioid-related deaths such as unintentional overdose.”

为了避免滥用，人们创造了新型的阿片类药物——遏制滥用型阿片类药物。由于这些药物不能被压碎或溶解，所以导致它们难以被吸食或注射。但是，“这些制剂不会影响其他阿片类药物引起的死亡，例如非故意地配药过量。”

Glod in an audio interview related to her New England Journal piece.

格洛德在一个就其在新英格兰杂志上发表的文章接受的音频访谈中说道：

“I think that the downside to all of these formulations is that they have the potential to make needed medication more expensive and less accessible to patients who are having opioid responsive pain and who really do require these medications. What really worries me the most about all of this is that if the medical community, the public and policy makers² get too distracted by the promise of a solution to the opioid epidemic in the guise³ of a reformulation of known opioids, I’m worried that we’re going to lose focus on addressing all of the underlying⁴ systemic issues that have really led to the epidemic in the first place—such as lack of access to alternative evidence-based means of controlling pain, the lack of mental health and social services to address other components⁵ of suffering besides physical pain, and the lack of providers who are trained in managing drug addiction⁶ and dependence⁷.”

“我认为所有这些制剂的缺点是，它们有可能使有需求的药物变得更昂贵，且对那些患有阿片类反应性疼痛的病人、那些真正需要这些药物的病患来说变得更难以获取。真正最让我担心的一点是，如果医学界、公众和政策制定者们过于看重通过已知阿片类药物的重制来作为解决阿片类药物盛行问题的办法，那么我担心，我们会忘了解决问题的焦点所在，即真正导致阿片类药物盛行的问题的源头——潜在的制度问题。例如，缺乏可替代的以证据为基础的控制疼痛的方法，缺乏解决除了身体疼痛以外的其他痛苦因素的心理健康治疗和社会服务，以及缺乏接受过管理药物成瘾和过度依赖的培训的供应商。”

Glod’s full article and audio interview are available at the website of the New England Journal of Medicine.

格洛德的完整文章和音频采访可以在《新英格兰医学期刊》网站上查看。