Becomes addicted to the frightened - - cancer pain to treat the big bottleneck

In 1999 in the whole world narcotic medical service consumption place, China arranged at 102nd. Compares with neighboring country Japan, in 1999 the Japanese morphine medical service consumption amounted to more than 900 kilograms, our country is only more than 100 kilograms, but our country population was Japan's more than 10 times, actual morphine average per person consumption both countries differed nearly 100 times. What creates this kind of huge disparity the reason is? Reporter interviewed partial basic unit medical service unit's clinician on this question, and has consulted the related ache control expert, the generalized analysis indicated that affects the cancer pain treatment the reason is various, but the most important question is the general medical personnel and the patient exists generally “becomes addicted to the fear” to the meconium class medicine. This kind “becomes addicted to the fear”, is the meconium class medicine use chief obstacle, is also in the ache treatment biggest bottleneck. The production “becomes addicted to the fear” the primary cause is in doctor the universal existence some wrong traditional ideas, here, it is necessary to clarify. Body dependence ≠ spirit dependence To the meconium class pain-killer's fear is because widely exists the erroneous picture, thought that the body dependence (physiological dependence) equates in the spiritual dependence (becomes addicted to, medicine dependence). After the physiological dependence is refers to meconium class analgesic long-term usage period of time, forms endures. Its characteristic performance is, applies drugs after repeatedly, affects the potency to drop, the response time reduces, needs the incremental dose or the reduction can maintain the treatment result for the medicine time. The physiological dependence's production belongs to the normal physiological Pharmacology phenomenon. The spiritual dependence is one kind of reflection psychological abnormality the behavior performance, its characteristic is pure take pursues energetic enjoyment as the medication goal, resorts to all means with cannot help but to long for that obtains the medicine; After the medication, may obtain one kind specially well satisfied “the euphoria”, thus has formed ingrained in the psychology to the meconium class analgesic dependence. Has one kind of situation on clinical to be possible to be called the vacation “to become addicted to”, because uses for to describe one kind the ache not to be able to obtain the behavior change which the effective treatment causes, is called the medical source syndrome, this and sends the meconium class medicine spirit dependence behavior to be similar especially, but the nature is different. Therefore, should differentiate the physiological dependence correctly with the difference which becomes addicted. Cannot, because the constant pain patient uses the meconium class pain-killer to produce endures treats as them becoming addicted. If cannot differentiate the body dependence and the spiritual dependence, will cause the ache patient not to be able to obtain the enough analgetic treatment to suffer the nonessential pain. Narcotic ≠ narcotics The medical application ≠ abuses The so-called drugs, are refer to use for to treat or the prevention disease's material; But the narcotics are point out in the non-medical goal but the long-term usage can produce the dependent material repeatedly. Everything lists as the state regulation the medicine, the reasonable use is the drugs, the illegal use is narcotics. So-called abuses, is refers to using the medicine achieves the feeling of satisfaction, produces is no use to the treatment effect. All narcotics have the possibility to abuse, but the normal medical application is not abuses, must and illegal abuses the reasonable use distinguishes strictly. Specially cannot to seek relieves the ache to request to obtain the treatment patient to regard is the drug addict, also cannot increase the anaesthesia pain-killer dosage to take for is substance abuse, cannot delimits the narcotic and the narcotics the equal sign, but limits patient's right use. The ache patient has the spiritual dependence to be extremely rare The clinical research discovery, the meconium class medicine in the standardization service condition, the ache patient presents the phenomenon which becomes addicted to be extremely rare. The possible explanation is, when the ache vulnerability stimulation along in the transmission ache's neural pathway upward process, ache patient's in vivo has produced the special opium receptor. These acceptor dispersion in had among the meconium class material, dispersed entered in vivo the alleviation ache medicine. But does not have the ache individual not to have these special acceptors, this time, any enters in vivo majority of the meconium class material directly with brain's in acceptor union, caused in the brain the meconium class medicine density to advance suddenly, increased the possibility which became addicted. In addition, becomes addicted to the formation rate and the medicine for the formula type related, the direct intravenous injection make the blood medicine density to advance suddenly, easy to cause to become addicted. Uses the meconium class medicine in the constant pain treatment to control releases the preparation, the medicine slowly releases in the gastro-intestinal tract, causes the blood medicine density to a certain extent maintains constant. Therefore, in does not have in the substance abuse history patient's ache course of treatment, meconium class medicine's becoming addicted to is rare. An entire US's investigation showed: 10,000 examples with meconium class pharmacological treatment several Zhou Zhishu in the month patient, the only 22 examples have the spiritual dependence, these patients once had the substance abuse history. Other 11 882 examples with in the meconium class pharmacological treatment's in-patient, only some 4 examples have the spiritual dependence. Therefore may say that becomes addicted to does not occur nearly in the ache patient, including cancer patient. Expert appeal: Renewal medication idea, breakthrough treatment bottleneck The cancerous ache is a global scale serious public health question. Because exists generally so-called " addictive nature " the wrong traditional ideas, enables many patient's aches not to obtain the effective alleviation. The experts pointed out that because is afraid the patient to become addicted to or the worry anaesthetic inflow illegal channel, gives up eating for fear of choking, because in use frequently dosage insufficient influence pain-relieving effect, even evades does not use, this is to the ache patient not the humanity procedure. Thought that the ache treatment is “the headache medicine head, the foot painful medicine foot”, is also one wrong idea. If is only looking from the angle which stops pain temporarily, the ache treatment as if is only one expedient measure, namely so-called “takes stopgap measures”. But in fact, because has controlled the ache as well as the physiological function disorder which causes by the ache, if the improvement psychology function condition, the improvement sleep, reduces anxious, improved patient's quality of life, this is also an ache treatment important achievement. Proposed at the ninth world ache congress “the ache is one kind of disease, but is not only one symptom” the new idea, the medical worker must enhance the ache treatment to treats disease to treat same likely knew highly, the policy maker and even the populace must overcome the ache treatment barrier, enables the ache patient to obtain the full treatment. The WHO medicine dependent Expert board has published stated: The request “through to the medical worker, the health devices and all public's education promotes to use the meconium class pain-killer reasonably, guaranteed that has the reasonable medical needs patient to obtain the full treatment”. China's general medical workers must renew the medication idea, the breakthrough medication bottleneck, causes China's ache treatment level and the international trail connection.