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处方药滥用:为应对这一新的毒品泛滥问题正在采取哪些措施?向刑事司法、毒品政策和人力资源小组委员会提供的证词。

Prescription drug abuse: what is being done to address this new drug epidemic? Testimony before the Subcommittee on Criminal Justice, Drug Policy and Human Resources.

作者信息

Manchikanti Laxmaiah

机构信息

American Society of Interventional Pain Physicians, Paducah, KY, USA.

出版信息

Pain Physician. 2006 Oct;9(4):287-321.

Abstract

This comprehensive health policy review of the prescription drug abuse epidemic is based on the written and oral testimony of witnesses at a July 26, 2006 Congressional Hearing, including that of Laxmaiah Manchikanti, MD, the chief executive officer of the American Society of Interventional Pain Physicians and additions from review of the literature. Honorable Mark E. Souder, chairman of the Subcommittee on Criminal Justice, Drug Policy, and Human Resources, introduced the issue as follows: "Prescription drug abuse today is second only to marijuana abuse. In the most recent household survey, initiates to drug abuse started with prescription drugs (especially pain medications) more often than with marijuana. The abuse of prescription drugs is facilitated by easy access (via physicians, the Internet, and the medicine cabinet) and a perception of safety (since the drugs are FDA approved). In addition to the personal toll of drug abuse using prescription drugs, indirect costs associated with prescription drug abuse and diversion include product theft, commission of other crimes to support addiction, law enforcement costs, and encouraging the practice of defensive medicine." The Administration witnesses, Bertha Madras, Nora D. Volkow, MD, Sandra Kweder, MD, and Joe Rannazzisi reviewed the problem of drug abuse and discussed what is being done at the present time as well as future strategies to combat drug abuse, including prescription drug monitoring programs, reducing malprescriptions, public education, eliminating Internet drug pharmacies, and the development of future drugs which are not only tamper-resistant but also non-addictive. The second panel, consisting of consumers and advocates, included Misty Fetco, Linda Surks, and Barbara van Rooyan, all of whom lost their children to drugs, presented their stories and strategies to prevent drug abuse, focusing on education at all levels, development of resistant drugs, and non-opioid treatment of chronic pain. Mathea Falco, JD, and Stephen E. Johnson presented issues related to drug abuse and measures to curb drug abuse by various means. Stephen J. Pasierb presented startling statistics on teen drug abuse and various educational programs to deter abuse. Laxmaiah Manchikanti, MD presented an overview of prescription drug abuse, strategies to prevent drug abuse, including immediate funding and rapid implementation of NASPER, education at all levels and improving relations with the DEA and the provider community.

摘要

这份关于处方药滥用流行情况的全面健康政策审查报告,基于2006年7月26日国会听证会上证人的书面和口头证词,包括美国介入性疼痛医师协会首席执行官拉克马亚·曼奇坎蒂医生的证词,以及文献综述的补充内容。刑事司法、毒品政策和人力资源小组委员会主席马克·E·苏德议员阁下对该问题的介绍如下:“如今,处方药滥用仅次于大麻滥用。在最近的家庭调查中,开始滥用药物的人更多是从处方药(尤其是止痛药)开始,而非大麻。容易获取(通过医生、互联网和药柜)以及对安全性的认知(因为这些药物已获美国食品药品监督管理局批准)助长了处方药的滥用。除了使用处方药进行药物滥用带来的个人代价外,与处方药滥用和转移相关的间接成本包括产品盗窃、为支持成瘾而实施的其他犯罪、执法成本,以及助长了防御性医疗行为。”政府证人伯莎·马德拉斯、诺拉·D·沃尔科夫医生、桑德拉·克韦德医生和乔·兰纳齐西审查了药物滥用问题,并讨论了目前正在采取的措施以及打击药物滥用的未来策略,包括处方药监测项目、减少不当处方、公众教育、取缔互联网药店,以及研发不仅具有防篡改功能而且无成瘾性的未来药物。第二个小组由消费者和倡导者组成,包括米斯蒂·费特科、琳达·瑟克斯和芭芭拉·范罗扬,他们的孩子都因毒品丧生,他们讲述了自己的故事以及预防药物滥用的策略,重点是各级教育、研发抗成瘾药物,以及对慢性疼痛进行非阿片类治疗。法学博士马西娅·法尔科和斯蒂芬·E·约翰逊提出了与药物滥用相关的问题以及通过各种手段遏制药物滥用的措施。斯蒂芬·J·帕西埃布展示了关于青少年药物滥用的惊人统计数据以及各种防止滥用的教育项目。拉克马亚·曼奇坎蒂医生概述了处方药滥用情况、预防药物滥用的策略,包括立即资助并迅速实施全国阿片类药物滥用监测项目、各级教育,以及改善与美国缉毒局和医疗服务提供者群体的关系。

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