Dr. Barry is the Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
Psychiatr Serv. 2018 Jan 1;69(1):100-103. doi: 10.1176/appi.ps.201700235. Epub 2017 Oct 2.
Major policy efforts are being aimed at combating the epidemic of opioid addiction and overdose deaths. In response to the epidemic, the medical community and policy makers have attempted to intervene; to date, these varied approaches have done little to reverse the increase in mortality related to opioid overdose. One factor that has complicated efforts to control overdose deaths has been the emergence of a public health crisis related to illicit fentanyl. The rise in fentanyl-related overdose deaths means that new approaches are needed to combat the opioid epidemic, including adoption of harm reduction strategies. Specific strategies that should be considered as part of efforts to combat the opioid crisis include safe drug consumption sites, anonymous drug-checking services, updated naloxone distribution policies, harm reduction-oriented policing, expansion of evidence-based pharmacological treatments in criminal justice and emergency department settings, and stigma-reduction messaging emphasizing the risks of fentanyl.
主要政策措施旨在应对阿片类药物成瘾和过量死亡的流行。为应对这一流行,医学界和政策制定者曾试图进行干预;但迄今为止,这些不同的方法收效甚微,无法扭转与阿片类药物过量相关的死亡率上升。使控制过量死亡的努力变得复杂的一个因素是与非法芬太尼有关的公共卫生危机的出现。芬太尼相关过量死亡人数的增加意味着需要采取新的方法来应对阿片类药物流行,包括采用减少伤害策略。作为应对阿片类药物危机的一部分,应考虑采取以下具体策略:安全药物使用场所、匿名药物检测服务、更新纳洛酮分发政策、以减少伤害为导向的警务、在刑事司法和急诊环境中扩大基于证据的药物治疗、减少强调芬太尼风险的污名化信息。