What You Should Know About Opioids and Painkillers | Body Stuff with Dr. Jen Gunter | TED

Opioids are one of the most commonly prescribed painkillers.

翻译人员: Winston Chung 校对人员: JENNY SUN

阿片类（鸦片类）药物是最常见的 处方止痛药之一。

From broken ribs to back pain to treating pain after surgery.

从肋骨骨折到背痛， 再到手术后的疼痛治疗。

But there's a lot of misconceptions around them,

但是围绕它们存在很多误解，

so it's important to take the time to understand them better.

所以花时间更好地理解它们很重要。

[Body Stuff with Dr. Jen Gunter]

[詹∙冈特博士的《身体的知识》]

The first misconception is that opioids are the best,

第一个误解是阿片类药物是最好、

strongest form of pain medication.

最强的止痛药物。

But in almost every well-designed study

但在几乎所有精心设计的研究中，

comparing opioids to anti-inflammatory drugs such as ibuprofen,

将阿片类药物与布洛芬等消炎药进行比较，

the anti-inflammatories come out on top.

消炎药的效果都是最好的。

From a safety or effectiveness perspective, or both.

从安全性或有效性的角度， 或两者兼而有之。

Let's talk about the effectiveness first.

我们先来说说功效吧。

How do opioids work?

阿片类药物如何起作用？

To understand that, we have to first know a little bit about how pain works.

要理解这一点，我们必须先了解一点 疼痛是如何起作用的。

Pain is our body's way of telling us that something's wrong.

疼痛是我们身体告诉我们有问题的方式。

You stubbed your toe, you burned your hand.

你踢到脚趾头，或烫到手。

Pain gives us the message that it's time for us to rest,

疼痛给我们讯息是，是时候休息、

recover and treat the damage.

恢复和治疗损伤了。

In the body, pain is created by multiple chemical signals and receptors,

在体内，疼痛是由多种化学信号 和神经末梢产生的，

and different medications can target different parts of that pain pathway.

而不同的药物会针对 疼痛神经的不同部分。

Medications like acetaminophen, such as Tylenol,

像扑热息痛等药物，如泰诺

or nonsteroidal anti-inflammatory drugs,

或抗炎镇痛药物

also known as NSAIDs, like ibuprofen, aspirin and naproxen,

也称NSAIDs，像布洛芬， 阿司匹林，萘普生，

all treat pain in different ways from opioids.

都和阿片类药物治疼痛的方法不同。

Opioids work by binding to and activating the opioid receptors

阿片类药物通过结合并激活 遍布全身的阿片样物质受体

来发挥作用，从而阻断疼痛信号。

located throughout the body, blocking pain signals.

This activation also triggers the release of dopamine,

这种激活也会触发多巴胺的释放，

a hormone associated with pleasure.

一种关联快感的荷尔蒙。

So in addition to pain relief,

因此，除了缓解疼痛之外，

some people can feel relaxed or even euphoric.

有些人还会感到轻松甚至是兴奋。

In higher doses, opioids can affect cognition and even breathing.

在较高剂量下，阿片类药物 会影响认知甚至呼吸。

But here's a really important point that people often don't know.

但这是人们通常不知道的 非常重要的一点。

Opioid receptors can adapt, often in a short amount of time,

阿片类药物受体往往可以在很短的时间内 适应，并对阿片类药物产生依赖。

to expect opioids.

And when a patient doesn’t take them,

当患者不服用这些药物时，

they experience symptoms of withdrawal.

他们会出现脱瘾症状。

And withdrawal is very uncomfortable.

而脱瘾期间是非常不舒服的。

People can mistake that discomfort

人们可能会误认为这种不适是

for thinking the opioids were actually working.

阿片类药物确实有效果。

And what people don't know is this can happen after just a few doses.

而人们不知道的是这种情况 只需服用几剂就会发生。

When you're a patient needing relief from pain,

当你是一个需要缓解疼痛的病人时，

it can be confusing to know the difference.

要知道其中的区别可能会很迷惑。

All you want is to feel normal again.

你想要的只是再次感觉正常。

In this way, opioids, if not used very carefully and intentionally,

这样一来，阿片类药物，如果 不是非常小心和有意地使用，

can create physical dependence.

就会造成身体对药物的依赖。

They can also paradoxically worsen pain.

它们也可能会反常地加重疼痛。

And there's a risk of developing addiction.

并且有发展成瘾的风险。

There's nuance here.

这里有细微差别。

People who have become physically dependent

已经产生身体依赖的人

often don't even know they are.

常常还不知道他们在依赖药物。

They just know that the opioids seem to be offering relief

他们只知道阿片类药物 似乎可以缓解疼痛，

without realizing that they could actually be contributing to the pain.

却没有意识到它们实际上 可能会加剧疼痛。

I want to be clear here.

我想在这里说清楚。

Opioids can be effective, appropriate therapy,

阿片类药物可能是有效的、恰当的疗法，

but they should be prescribed with great care.

但是开这种处方要很谨慎。

This is the doctor's responsibility.

这是医生的责任。

Here's some advice so you can be an educated patient.

这里有一些建议，这样你就可以 成为一个受过教育的病人。

If you or a loved one experience acute pain,

如果你或你所爱的人经历急性疼痛，

ask to explore alternatives to opioids like Tylenol,

请考虑阿片类药物的替代品，如泰诺，

NSAIDs, muscle relaxants and physical therapy.

消炎药，肌肉松弛药和物理疗法。

If your doctor doesn’t bring those up first,

如果你的医生没有首先提出这些，

and if you or a loved one are prescribed opioids,

如果你或你的亲人的处方 开的是阿片类药物，

make sure your doctor has a plan to taper you off,

要确认你的医生有打算让你逐渐减少，

accounting for the risk of dependence.

考虑到药物依赖的风险。

And finally, ask for naloxone.

最后，索要纳洛酮。

This is a drug that can reverse opioid overdose.

这是一种可以逆转阿片类药物过量的药物。

It can be easy to forget if you’ve taken a dose,

你可能很容易忘记你是否服用了一剂药物，

and you never know who in your household could take your medication.

而且你永远不知道你家里的谁 会服用你的药物。

Naloxone can literally save a life.

纳洛酮确实可以挽救生命。

Remember, when it comes to pain,

请记住，当涉及到疼痛时，

opioids are not always the most effective way to safely offer relief.

阿片类药物并不总是安全 缓解疼痛的最有效方法。

And when they are prescribed,

当它们被开成处方药时，

they should always be prescribed with a plan.

它们应该总是在有一个服用 计划的情况下被开出来。