마약류 진통제 안전관리 방안 마련을 위한 설문연구

Abstract

Background : Prescriptions of opioids have rapidly increased worldwide for controlling various types of pain such as neuropathic, musculoskeletal, and cancer pain. Abuse of prescription opioids is increasing in Korea. The purpose of this study was to investigate causes of prescription opioid abuse and propose strategies for safety managements of prescription opioids through a survey of experts. Methods : The survey was conducted to investigate causes of opioid abuse and ask experts’ opinions about promoting opioid safety. We enrolled a total of 22 panelists who had clinical practice experience in pain or addiction medicine and opioid safety related work. A questionnaire was drafted based on a literature review. It was then revised through a pilot test and consultation with external experts. A Likert nine-point scale was introduced as a response method. Results : The leading cause of prescription opioid abuse was an institutional factor. The consensus was achieved on the lack of education for health and medical services personnel, the absence of a special opioid prescription process, and the limited authority to refuse prescription to suspected abusers. Fentanyl patch had the highest risk of prescription opioid abuse, followed by oxycodone oral agent and rapid onset fentanyl products. Among proposed safety management strategies, consensus was achieved for 14 of 21 strategies. Strategies with the highest level of agreement were authorization to refuse opioid prescription to suspected abusers, mandatory inquiry of patients’ narcotics prescription history, education for students majoring in healthcare, and development of guidelines to deal with withdrawal symptoms. Conclusion : As various social problems related to substances are reported, the need for substance management is gradually emerging. Responding to social demands, medical practitioners should be alert to prescription opioids and develop their functions in order for patients to receive safe treatment from addiction and abuse.