美国国家公共电台 NPR Is There A Way To Keep Using Opioid Painkillers And Reduce Risk?

 

STEVE INSKEEP, HOST:

In Your Health on this Monday, we report on the dilemma¹ at the heart of the opioid crisis. Many of the addictive² drugs that ruin or end lives are also helpful to people with severe pain, so doctors have to strike a balance. We have reporting from two members of NPR's Health team, starting with Allison Aubrey.

ALLISON AUBREY, BYLINE³: Imagine the kind of pain where even small movements are excruciating. Jon McHann knows how that feels. He's 56 and lives in Smithville, Tenn. We spoke⁴ to him by Skype.

JON MCHANN: I've laid in bed at times where my pain's at a nine or a 10, and I can't open my eyes because I know if I blink it's going to hurt.

AUBREY: McHann is a truck driver who operated heavy equipment, or at least that's what he used to do. But about 10 years ago, he took a bad fall.

MCHANN: I fell a few feet and I hit my tailbone just right. And I created a severe bulging⁵ disc that needed to be surgically⁶ corrected immediately.

AUBREY: McHann expected to make a full recovery and go back to work, but that didn't happen.

MCHANN: After the surgery, the pain was still like a nine or a 10, just excruciating to the point where you're just unable to really function.

AUBREY: His spinal⁷ problems turned out to be much more complicated and hard to treat. He went on to have several more surgeries but got no relief. So his doctors gave him a prescription⁸ for methadone, a powerful opioid drug, and he stayed on it for seven years.

MCHANN: It helped immensely. It brought my pain down to a five or a six where I could function fairly well throughout the day. I mean, I could go to church every weekend, I could help my wife shop, I could help around the house a little bit.

AUBREY: From McCann's perspective, the opioids were working. But then, as concerns about the epidemic⁹ grew, he started getting pushback from his doctors.

MCHANN: Every time I saw a clinician, my opioids were reduced.

AUBREY: His pain started to increase, and he worried that he'd be cut off the drug entirely¹⁰.

MCHANN: Basically, life wasn't going to be worth living if I couldn't get this pain under control.

AUBREY: McHann is not alone. Physician Stefan Kertesz says there are lots of patients with similar stories.

STEFAN KERTESZ: I have certainly met a good number of patients who have not found better options and they are now taking opioids for chronic¹¹ pain.

AUBREY: Kertesz is a professor at the University of Alabama at Birmingham School of Medicine. He says some doctors feel caught between a rock and a hard place. With the rise in opioid overdose deaths, there's a lot of pressure to limit prescriptions¹². CDC guidelines point to the serious risks of high dosages and long-term use. But Kertesz says some people who take opioids long term seem to benefit. So he says it's not always in the best interest of the patient to cut them off.

KERTESZ: Do I think we prescribed opioids too much over 20 years? Absolutely. We caused new addiction¹³ in some people by prescribing opioids too aggressively. But the idea that you can simply take them away, sometimes for people who need them, is mistaken.

AUBREY: Kertesz knows that his position is controversial. He pushes against the current thinking so much, I had to ask him if he ever worked for the pharmaceutical¹⁴ companies that market these drugs.

KERTESZ: I have never worked a day in my life for the pharmaceutical industry, and I have no interest in doing it in the future.

AUBREY: Kertesz says what he is an advocate for is helping¹⁵ people in pain.

KERTESZ: I do hope for better medications that have less potential for addiction. But I think human suffering's really complicated and doctors need to have room to make a professional decision together with their patient about what works best for them.

AUBREY: As for Jon McHann, just last month he had a procedure to ease the nerve compression in his back, and for now, he's optimistic.

MCHANN: So far I'm happier and I'm hoping to be opioid free. I don't know if I'll get there, but I want to try.

AUBREY: He's down to a daily Percocet, which is nowhere near the strength of the opioids he had been taking for so many years. Allison Aubrey, NPR News.

1 dilemma   

n.困境，进退两难的局面

参考例句：

• I am on the horns of a dilemma about the matter.这件事使我进退两难。
• He was thrown into a dilemma.他陷入困境。

2 addictive   

adj.(吸毒等)使成瘾的，成为习惯的

参考例句：

• The problem with video game is that they're addictive.电子游戏机的问题在于它们会使人上瘾。
• Cigarettes are highly addictive.香烟很容易使人上瘾。

3 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

4 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

5 bulging   

膨胀； 凸出（部）； 打气； 折皱

参考例句：

• Her pockets were bulging with presents. 她的口袋里装满了礼物。
• Conscious of the bulging red folder, Nim told her,"Ask if it's important." 尼姆想到那个鼓鼓囊囊的红色文件夹便告诉她：“问问是不是重要的事。”

6 surgically   

adv. 外科手术上, 外科手术一般地

参考例句：

• Unsightly moles can be removed surgically. 不雅观的痣可以手术去除。
• To bypass this impediment an almost mature egg cell is removed surgically. 为了克服这一障碍，通过手术，取出一个差不多成熟的卵细胞。

7 spinal   

adj.针的，尖刺的，尖刺状突起的；adj.脊骨的，脊髓的

参考例句：

• After three days in Japan,the spinal column becomes extraordinarily flexible.在日本三天，就已经使脊椎骨变得富有弹性了。
• Your spinal column is made up of 24 movable vertebrae.你的脊柱由24个活动的脊椎骨构成。

8 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

9 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

10 entirely   

ad.全部地，完整地；完全地，彻底地

参考例句：

• The fire was entirely caused by their neglect of duty. 那场火灾完全是由于他们失职而引起的。
• His life was entirely given up to the educational work. 他的一生统统献给了教育工作。

11 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

12 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

13 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

14 pharmaceutical   

adj.药学的，药物的；药用的，药剂师的

参考例句：

• She has donated money to establish a pharmaceutical laboratory.她捐款成立了一个药剂实验室。
• We are engaged in a legal tussle with a large pharmaceutical company.我们正同一家大制药公司闹法律纠纷。

15 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。