Department of Anesthesiology, LSUHSC, 1542 Tulane Avenue, Suite 659, New Orleans, LA, 70112, USA.
Department of Pharmacology, LSUHSC, New Orleans, LA, USA.
Curr Pain Headache Rep. 2018 Apr 4;22(5):32. doi: 10.1007/s11916-018-0685-5.
In the USA, there has been a sharp increase in heroin, prescription opiate, and illicitly manufactured fentanyl abuse with overdoses tripling since the 1990s. Several states have been deemed as "high-burden" abuse states where there is a greater proportion of synthetic opiate use. During the same period that prescription limitations were initially implemented throughout the country, the fentanyl epidemic started nationwide.
In the setting of data demonstrating an almost fourfold increase in overdose deaths from 1999 to 2008, states began restricting access to Food and Drug Agency (FDA) approved opioid medications. Another factor further exacerbating the opioid crises is that the cost of all formulations of naloxone has increased significantly over the past several years. In order to combat the opioid epidemic, stricter prescribing practices and prescription-monitoring programs have been instituted. Also, improvements in abuse-deterrent strategies for all opioid preparations can play an important role by increasing the safety of these medications and is a major focus of the FDA.
综述目的：在美国，自 20 世纪 90 年代以来，海洛因、处方类鸦片和非法制造的芬太尼滥用现象急剧增加，过量用药的情况增加了两倍。有几个州被认为是“高负担”滥用州，这些州中合成类鸦片的使用比例更高。在全国范围内最初实施处方限制的同期，芬太尼泛滥开始在全国范围内蔓延。
最新发现：在数据表明 1999 年至 2008 年因过量用药而导致的死亡人数几乎增加了四倍的情况下，各州开始限制获得美国食品和药物管理局（FDA）批准的阿片类药物。另一个进一步加剧阿片类药物危机的因素是，过去几年中，所有纳洛酮配方的成本都大幅上升。为了应对阿片类药物泛滥，已经制定了更严格的处方实践和处方监测计划。此外，提高所有阿片类药物制剂的防滥用策略也可以通过提高这些药物的安全性发挥重要作用，这是 FDA 的一个主要重点。
