The cancer painful patient stops pain the medication present situation to investigate

Cancer ache is a universal worldwide basis question, according to the World Health Organization (WHO) the statistics, 30%-50% cancer patients is accompanied by the varying degree the ache, because the entire society, even the medical personnel to this question understanding insufficiency, the cause around the world have 3,000,000 - 5,000,000 cancer patient long time to suffer the ache to suffer cannot obtain the effective treatment. In order to improve cancer patient's quality of life, WHO established the cancer pain in 1982 in Italy to treat the Expert board, after the discussion thought that the application existing and might relieve the majority cancer patient's ache for the number limited analgesia medicine, and proposed that “achieved to 2000 in the world scope causes cancer patient was not painful” goal [1]. Our country Medical department responded positively this summons and has taken a series of measures, like conducted the nationwide study group, the seminar; Provide guidance document and study material [1-3]; Adjustment narcotic supply policy; The organization develops develops some narcotic the new variety, if the morphine controls releases the piece. In order to enable the Foshan area to achieve WHO to set “the goal”, it is necessary to make an investigation to the Foshan area cancer pain medication present situation, in order to take further measure for the Department responsible for the work to provide the objective beneficial data information. 1 material and method Uses 1993-1995 year all previous years consumption stupefactive analgesic variety which, specification and schedule of quantities and about study and implementation independently designs “guiding principle” situation 10 question questionnaires, issues separately by the sanitation bureau medicine policy branch the Foshan area (including Foshan, the South China Sea, Shunde, three water, wise five cities) various hospitals medicament branch and the related medical personnel fills. The issue time was in February, 1996, received the table time is in April, 1996. 2 results 2.1 take back 76 hospital medicament branch the statistical data, but can list separately according to the request the tumor branch medication has 37 hospitals. Has counted these 37 hospital tumor branch 1993-1995 year all previous years use stupefactive analgesic variety and the total quantity, discovered that the injection pai for ding is the application most main analgesic, next has the morphine injection, the codein tablet, the dihydro etorphine tablet, in 1995 also used the morphine to control releases the piece and Ding Bingnuo fei. Looking from the 3a medication total quantity, seemed to be increases year by year tendency, but is not too remarkable. 2.2 approach Foshan area 28 hospital related administrative offices provide questionnaire 210, reclamation answer paper 208, the effective volume is 206. because 3 discussions medical department, in implemented WHO to set “the goal” to take a series of effective measures, this city medicine policy department has also carried on the corresponding work, thus the majority of medical personnel (64.1%) have studied earnestly or have looked at “the guiding principle” generally; 94.7% people can apply drugs according to three steps and ladders for the cancer painful patient; 79.1% people thought that eases the pain thoroughly for the cancer painful patient has the necessity very much, because they saw personally some cancer painful patient is in deep sorrow, because some patients cannot obtain the enough medicine from the regular way, but purchases the heroin pain-relieving secretly. Thought that is not unnecessary is mainly worries the patient to become addicted to, either the patient could not withstand the medicine untoward effect or the worry drugs cannot guarantee the supply. The Foshan area most medical personnel's ideological concept had the preliminary transformation, but is also very insufficient. Looking from the narcotic 3a consumption, seemed to be advances year by year tendency, but the scope is not big. in 1995 had the hospital to use the new variety - morphine to control releases the piece. The existence question and suggested: (1) medical affairs, the medicament, the administrative personnel study “the guiding principle” not to be very also common and thorough, various aspects personnel have not reached the mutual recognition, if got the card patient to go to the pharmacy to take the medicine, the pharmacy did not coordinate, still according to old rule management. The suggestion further conducts has the study group which, the seminar various medical unit administrative personnel, the medical care personnel, the medicament personnel participate; (2) ideological concept thorough transformation, “has not become addicted to the phobophobia” still to fetter the general medical personnel's hands and feet. According to recently to dependent explanation [4], only then spiritual dependence, and has the compulsion to abuse is accompanied by endangers the society the doer only then to call becoming addicted. The becoming addicted to medication is for the pursue euphoria experience, but the cancer painful patient applies drugs the goal relieves the ache. Some investigation material indicated that in the long-term cancer pain treatment's patient, doubts has the becoming addicted to proportion not to 0.2%[5]. In our investigation material has 32% related medical personnel to see 1-6 examples because of the long-term use pai for the patient who ding becomes addicted to, but they refer to most is the tolerance which or the bodily dependence produces to the medicine, this is the normal Pharmacology which the application stupefactive analgesic appears inevitably continuously responded, so long as stops the medicine not suddenly, will not have the problem. Therefore we should “becomes addicted to from the fear” in the fetter liberate thoroughly, according to the clinical ache treatment's need, uses the stupefactive analgesic reasonably, moreover must strengthen the propaganda dynamics through each form, the transformation society public's idea; (3) investigation indicated that still injected to the specific weight ache pai for ding primarily, this and world developed country medication tendency exactly opposite [5]. pai for ding the major object is the response time short (2.5-3.5 h); Injection spot partial irritant; Its metabolite in vivo half-life is long, the redundant medication has to the central nervous system annoys the toxicity violently, may send the spirit exceptionally, to tremble and to faint from fright [6]; Adds again pai is obvious for ding the blood medicine density valley phenomenon, has the untoward effect reason. Therefore the WHO expert promotes with great effort use persistent effect oral administration preparation [4], recent years produced the morphine controlled releases the piece is the ideal variety, Greece organizes these drugs the supply; (4) suggestion "Narcotic Special-purpose Card" sends the card power to release from the sanitation bureau to the hospital medical affairs imposes the convenience cancer painful patient to receive; The suggestion changes a beforehand annual report narcotic plan one quarter to report one time, moreover does not remove temporary urgently needed; Also the suggestion in guaranteed that prevents the narcotic inflow society to become narcotic under the premise, simplifies the cancer painful patient to lead the medicine the procedure.