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：（申请人的摘要） 人口越来越多地接受鸦片的长期接受阿片类药物， 用于治疗鸦片依赖性或治疗慢性疼痛。 管理鸦片维持的个体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导致疼痛改变 灵敏度和随后对其他阿片类药物的反应。许多临床医生 认为瘾君子无法从进一步的阿片类管理中受益，因为他们 对镇痛作用耐受。其他人则认为，如果瘾君子是 维持在鸦片激动剂上，该药物提供足够的镇痛 急性疼痛。患者不愿提供准确的历史，因为 临床医生经常扣留病史患者的阿片类镇痛药 吸毒。那些抱怨的人被怀疑地看着 被忽略。目前，很少有指导方针可以协助临床医生和 确实存在的是基于经验和共识，而不是基于证据的 研究。 这项研究建议检查：1）患者如何维持维护（要么 丁丙诺啡或美沙酮）经历疼痛（耐受性和阈值），以及如何 他们与非相关人不同，2）患者如何 维持在美沙酮和丁丙诺啡与正常对照不同 对添加的鸦片和非型镇痛药的反应以及3）如何治疗 镇痛的吗啡的血浆浓度水平在美沙酮和 与正常对照组相比，丁丙诺啡维持患者。 这项拟议的研究的结果将有助于制定系统准则 魔术师管理阿片类药物疼痛的个人。