使用加巴喷丁类药物者的滥用经历和依赖症状：定性系统综述。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2024-10-10 DOI:10.1016/j.drugpo.2024.104605

Amy G. McNeilage , Alison Sim , Suzanne Nielsen , Bridin Murnion , Claire E. Ashton-James

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引用次数: 0

摘要

背景：加巴喷丁类是全球处方最广的止痛药物之一。然而，越来越多的证据表明，使用这些药物会对人体造成伤害。本研究旨在对探讨加巴喷丁（普瑞巴林和/或加巴喷丁）滥用和依赖症状的生活经历的定性研究进行系统回顾和综合：检索了从开始到 2023 年 9 月的六个数据库（MEDLINE、Scopus、Web of Science、CINAHL、EMBASE、PsycINFO）和灰色文献来源。采用 "批判性评估技能计划 "定性检查表的 11 个项目修订版对纳入研究的方法学质量进行评估，并在专题综合中优先考虑质量较高的研究。采用 GRADE-CERQual 方法对综述总体结论的可信度进行了评估。该综述在 PROSPERO（CRD42023401832）上进行了前瞻性注册：共纳入 26 篇文章，代表 21 项原创研究。大部分研究采用访谈法，方法质量较高。滥用加巴喷丁类药物的动机包括获得快感、增强或抵消其他药物的作用、自我治疗疼痛、痛苦、失眠或戒断症状，以及替代其他药物。依赖性症状包括迅速产生耐受性和严重的戒断综合症，通常涉及精神症状。一般报告称，多种物质的使用会造成伤害，包括精神分裂、意识丧失和用药过量。大多数综述结果的可信度为中等，其中一项结果的可信度较低：本综述提供了有关滥用加巴喷丁类药物的潜在动机以及依赖症状的不同生活经历的丰富定性见解。考虑到这类药物在全球范围内的处方量不断增加，以及滥用可能带来的公共卫生挑战，本综述的研究结果可用于制定更有效的减低危害策略。

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Experiences of misuse and symptoms of dependence among people who use gabapentinoids: A qualitative systematic review

Background

Gabapentinoids are among the most widely prescribed pain medications worldwide. However, there is growing evidence of harms associated with their use. The aim of this study was to systematically review and synthesise qualitative research exploring lived experiences of gabapentinoid (pregabalin and/or gabapentin) misuse and symptoms of dependence.

Methods

Six databases (MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, PsycINFO) and grey literature sources were searched from inception to September 2023. The methodological quality of included studies was appraised using a modified 11-item version of the Critical Appraisal Skills Programme qualitative checklist, and higher quality studies were prioritised in the thematic synthesis. Confidence in the overall findings of the review was assessed using the GRADE-CERQual approach. The review was prospectively registered on PROSPERO (CRD42023401832).

Results

Twenty-six articles representing 21 original studies were included. The majority used interview methods and were of high methodological quality. Motives for gabapentinoid misuse included getting high, potentiating or offsetting the effects of other drugs, self-medicating for pain, distress, insomnia, or withdrawal symptoms, and substituting for another drug. Symptoms of dependence included the rapid development of tolerance and a severe withdrawal syndrome often involving psychiatric symptoms. Harms including dissociation, loss of consciousness, and overdose were generally reported as a consequence of polysubstance use. Confidence in most of the review findings was moderate with low confidence in one finding.

Conclusion

This review provides rich qualitative insights into the potential motives for gabapentinoid misuse as well as the diverse lived experiences of dependence symptomatology. Considering the increasing prescribing of these medications globally, and the potential for public health challenges resulting from misuse, the findings of this review can be used to develop more effective harm reduction strategies.

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.