鸦片制剂, 华裔谈虎色变

鸦片制剂是含有具有强烈止疼功效的鸦片提取物的合成镇痛类药。在北美，随着包括吗啡奥施康定，芬太尼等鸦片制剂广泛遭滥用，因过量服用鸦片制剂而致死的人数正在迅速增加。在2011至2014年间，仅在安省就有近2,500人被此类药品夺去生命。

 

Opioid is a class of synthetic drugs made from opium – a power substance to suppress pain. In North America, the fatality of opioid – from Morphine to OxyContin to Fentanyl- overdose has risen rapidly, creating an epidemic of opioid abuse. In Ontario alone, these drugs have killed nearly 2,500 people between 2011 and 2014.

在加拿大，鸦片制剂滥用主要归咎于医生频繁开具处方止痛药。专家认为目前北美有数百万人在使用鸦片类止痛药，并称鸦片制剂滥用已成加拿大最大的药品安全问题。根据CAMH提供的信息，在2010至2013年间，两种新型鸦片制剂——Hydromorphone和Fentanyl的处方率分别上升了56%及15%，从而导致过量服用鸦片制剂的致死率增加了24%。

The abuse was caused by the widespread prescription of painkillers in Canada. Experts believe that there are millions of people in North America currently on these painkillers, calling it Canada’s biggest drug safety problem. According to information from CAMH, between 2010 and 2013, the prescription of two new opioids, Hydromorphone and Fentanyl have climbed by 56% and 15% respectively, leading to 24% rise in fatality of opioids overdose. 

但是，中国的鸦片制剂滥用现象却远不及西方国家普遍。尽管西方国家早就开始使用吗啡减轻术后剧烈疼痛，或是帮助晚期癌症患者缓解病痛，但鸦片制剂在癌症病患人数急剧上升的中国仍鲜有使用。

But opioid abuse is far less prevalent in China than in Western countries. While morphine have long been used in Western medicine to manage severe pain following surgery or to ease the suffering of advanced cancer patients, opioids remain rarely used in China – despite its rapid rise of cancer patients.

据彭博社报道，中国的鸦片制剂消耗量远远低于美国，预计中国今年将会使用7686万克麻醉药品，与美国高达13.6亿克的预计消耗量相比这显然是小巫见大巫。此外，虽然澳洲人口只有近2500万，还不到中国的七十分之一，但澳洲所消耗的鸦片制剂总量却比中国高出近50%。

In China, the use of opioids is falling far behind that of the U.S.  According to Bloomberg News, 76.86 million grams of opioids will be used in China this year, a mere fraction of the 1.36 billion grams Americans will take. The total consumption of opioids in Australia, a country with just under 25 million people, is almost 50% more than China.

对于疼痛，许多中国人宁愿咬牙硬抗，也不会求助于止痛药。香港麻醉科学会会长Cheung Chi-wai医生称：“中国人会说‘我不需要吃止痛药，我可以扛过去’，甚至连一些刚做完手术的患者都拒绝使用止痛药，因为他们认为咬咬牙就可以挺过去。”

When it comes to pain, many Chinese people prefer to tough it out than resort to painkillers. Chinese people say, 'I don't need to take pain medication; I'm a strong person," says Dr Cheung Chi-wai, president of the Society of Anaesthetists in Hong Kong. "Even post-surgery patients are refusing pain medication because they think that is the way to act."

中国人对鸦片制剂的回避在很大程度上是源于鸦片战争留下的刻骨铭心的历史记忆。在19世纪，中国曾两次与英国开战，企图将鸦片拒之于国门外，但最终都以失败告终。结果，有数百万中国人迷恋上毒品，逾四分之一中国男性沦为不可自拔的瘾君子。

Sensitive historical memories of the opium wars may play a big role in Chinese people’s aversion to opioids. In the 19th century, China lost two wars to the British in a futile attempt to keep opium out of the country. As a result, millions of people became addicted to the drug, and over 25% of Chinese men used the drug regularly. 

中国清除鸦片的历程艰辛且漫长。在中国共产党掌权后，当局立即发起了一系列以根除鸦片毒害之运动，包括禁止农民种植鸦片作物；勒令居民参加鸦片危害教育活动；让家庭成员鼓励瘾君子求医等。彻底清除“鸦片荼毒”是中国政府最引以为傲的政绩之一。

China has come a long way since the drug ridden days of the Opium Wars. After the Chinese communist party took power, it immediately took a slew of actions to eradicate opium. Peasants were no longer allowed to plough opium crops, residents were ordered to attend education programs on the harms of opioids, and addicts were encouraged by the family members to seek help. Wiping out “the scourge of opium” was one of the Chinese government’s proudest achievements. 

中国政府限制鸦片制剂使用的管制措施远比西方国家严格。当局对鸦片严打导致民众对之谈虎色变，并深恶痛绝。

The Chinese government has also imposed restrictions on opioid use that are far more stringent than Western countries. Its fierce crackdown on opium has aroused public fear and condemnation towards the drug. 

但是，当今社会已置身于一场新的现代鸦片战争之中。一方面，慢性疼痛或癌症垂死患者需要鸦片制剂镇痛，而另一方面，滥用鸦片制剂又给社会带来严重挑战，使医生在不同道德职责上难以取舍，也令病患面临两难选择。

But contemporary society has engaged in a modern-day opium war. On one hand, patients suffering from chronic pain or dying from cancer need opioid prescription to suppress pain, while on the other hand, opioid addiction presents a serious challenge, leaving doctors’ struggling with moral obligations and forcing patients into a dilemma. 

毫不为奇，许多经历过中国政府触目惊心的反鸦片运动影响的华裔人士在这场两难抉择的现代战争中立场果断并作出明确选择，即他们宁愿忍受剧痛而拒鸦片于不沾。

Unsurprisingly in this war, many of those affected by the Chinese government’s fear mongering campaign against opium choose to avoid this struggle altogether. They prefer to succumb to the pain and to stay away from opioid.