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donde incluso pacientes que presentan trastornos por consumo de f&#225;rmacos opi&#225;ceos acaban consumiendo opi&#225;ceos ilegales&#44; como la hero&#237;na<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; Este fen&#243;meno es m&#225;s improbable en Espa&#241;a&#44; por las caracter&#237;sticas de nuestro sistema sanitario&#44; donde el acceso a los f&#225;rmacos es pr&#225;cticamente universal&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El equilibrio entre el uso adecuado de f&#225;rmacos opi&#225;ceos&#44; tanto para el tratamiento del dolor como de los distintos trastornos mentales&#44; y el mal uso o la dependencia&#44; pasa por la evaluaci&#243;n adecuada del paciente&#44; incluyendo las caracter&#237;sticas psicom&#233;dicas individuales<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a>&#44; los antecedentes y la valoraci&#243;n cuidadosa de los beneficios esperados del tratamiento o su combinaci&#243;n con otros f&#225;rmacos&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Tanto cl&#237;nicos&#44; como gestores y responsables de la educaci&#243;n m&#233;dica deben concienciarse de este problema&#44; a&#250;n emergente&#44; para evitar la epidemia de mal uso a que los f&#225;rmacos opi&#225;ceos pueden verse abocados en los pr&#243;ximos a&#241;os&#46; En este sentido&#44; una formaci&#243;n adecuada de los distintos profesionales implicados &#40;atenci&#243;n primaria&#44; internistas&#44; anestesi&#243;logos&#44; salud mental&#44; etc&#46;&#41; sobre el manejo de los analg&#233;sicos opi&#225;ceos ser&#225; determinante&#46;</p></span>"
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EDITORIAL
Buenos usos y riesgos de los fármacos opiáceos
Good use and risks of opioid drugs
C. Ronceroa,b,
Autor para correspondencia
croncero@vhebron.net

Autor para correspondencia.
, L. Grau-Lópeza,b
a Sección de Adicciones y Patología Dual, Servicio de Psiquiatría, Hospital Universitario Vall d’Hebron, CIBERSAM, Barcelona, España
b Departamento de Psiquiatría, Universidad Autónoma de Barcelona, Barcelona, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Los f&#225;rmacos opi&#225;ceos se pueden utilizar para el control de los s&#237;ntomas asociados al dolor&#44; sea o no de origen canceroso<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a>&#44; en el tratamiento de la dependencia de opi&#225;ceos legales e ilegales<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> e&#44; incluso&#44; se ha sugerido que podr&#237;an ser &#250;tiles en el tratamiento de trastornos mentales distintos a las adicciones<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">3</span></a>&#44; aunque se requieren estudios adicionales para confirmarlo&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El consumo de f&#225;rmacos opi&#225;ceos de prescripci&#243;n ha aumentado en los &#250;ltimos a&#241;os en la poblaci&#243;n europea y espa&#241;ola<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">4&#44;5</span></a>&#46; Este fen&#243;meno no es&#44; en s&#237; mismo&#44; peligroso<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a>&#46; Sin embargo&#44; el empleo de estos f&#225;rmacos sin control&#44; o durante periodos muy prolongados&#44; especialmente en poblaciones vulnerables&#44; se asocia con un incremento en el abuso&#44; o mal uso&#44; tal y como se describe en el art&#237;culo de Coloma-Carmona et al&#46; incluido en este n&#250;mero de <span class="elsevierStyleItalic">Revista Cl&#237;nica Espa&#241;ola</span><a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a>&#46; Adem&#225;s&#44; en este trabajo se plantean las diferencias de g&#233;nero existentes en los pacientes que abusan de f&#225;rmacos opi&#225;ceos&#44; aspecto ya conocido en aquellos que usan opi&#225;ceos ilegales como la hero&#237;na<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a>&#46; Sin embargo&#44; como describen los autores la planificaci&#243;n de los tratamientos y las medidas de protecci&#243;n para evitar el mal uso deber&#237;an ser independientes del g&#233;nero<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La caracterizaci&#243;n cl&#237;nica y psicopatol&#243;gica de los pacientes que reciben f&#225;rmacos opi&#225;ceos es fundamental para prevenir y detectar aquellas personas que han tenido problemas con los opi&#225;ceos ilegales o en los que utilizarlos supone un riesgo inasumible<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">9</span></a>&#59; o&#44; por el contrario&#44; en los que se deben usar dosis m&#225;s altas<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a>&#46; En los pacientes de alto riesgo se deber&#237;an implementar programas de prescripci&#243;n m&#225;s controlada&#44; usar opi&#225;ceos de vida media larga&#44; prescribir los de menor riesgo de mal uso y&#44; por supuesto&#44; potenciar y utilizar otras alternativas posibles para el tratamiento del dolor<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#44;10</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Si no se contemplan estos aspectos&#44; estaremos abocados a confirmar los problemas de mal uso y abuso de f&#225;rmacos opi&#225;ceos que se est&#225;n empezando a detectar en nuestro medio<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">4</span></a>&#46; Estas circunstancias ya est&#225;n acaeciendo plenamente en los Estados Unidos<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">11&#8211;13</span></a>&#44; donde incluso pacientes que presentan trastornos por consumo de f&#225;rmacos opi&#225;ceos acaban consumiendo opi&#225;ceos ilegales&#44; como la hero&#237;na<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; Este fen&#243;meno es m&#225;s improbable en Espa&#241;a&#44; por las caracter&#237;sticas de nuestro sistema sanitario&#44; donde el acceso a los f&#225;rmacos es pr&#225;cticamente universal&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El equilibrio entre el uso adecuado de f&#225;rmacos opi&#225;ceos&#44; tanto para el tratamiento del dolor como de los distintos trastornos mentales&#44; y el mal uso o la dependencia&#44; pasa por la evaluaci&#243;n adecuada del paciente&#44; incluyendo las caracter&#237;sticas psicom&#233;dicas individuales<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a>&#44; los antecedentes y la valoraci&#243;n cuidadosa de los beneficios esperados del tratamiento o su combinaci&#243;n con otros f&#225;rmacos&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Tanto cl&#237;nicos&#44; como gestores y responsables de la educaci&#243;n m&#233;dica deben concienciarse de este problema&#44; a&#250;n emergente&#44; para evitar la epidemia de mal uso a que los f&#225;rmacos opi&#225;ceos pueden verse abocados en los pr&#243;ximos a&#241;os&#46; En este sentido&#44; una formaci&#243;n adecuada de los distintos profesionales implicados &#40;atenci&#243;n primaria&#44; internistas&#44; anestesi&#243;logos&#44; salud mental&#44; etc&#46;&#41; sobre el manejo de los analg&#233;sicos opi&#225;ceos ser&#225; determinante&#46;</p></span>"
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Información del artículo
ISSN: 00142565
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2023 Marzo 7 5 12
2020 Junio 1 0 1
2018 Marzo 1 0 1
2017 Noviembre 1 0 1
2017 Octubre 4 3 7
2017 Septiembre 9 3 12
2017 Agosto 21 7 28
2017 Julio 5 11 16

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