在农村环境中实施阿片类药物使用障碍治疗：重点关注艾滋病毒和丙型肝炎的预防和治疗。
Implementing Treatment of Opioid-Use Disorder in Rural Settings: a Focus on HIV and Hepatitis C Prevention and Treatment.
机构信息
Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA.
Department of Medicine, Section of Addition Medicine, Oregon Health and Science University, Portland, OR, USA.
出版信息
Curr HIV/AIDS Rep. 2018 Aug;15(4):315-323. doi: 10.1007/s11904-018-0402-3.
Abstract
PURPOSE OF REVIEW
To describe the epidemiology of opioid-use disorder in the rural United States (U.S.) as it pertains to HIV and hepatitis C transmission and treatment resources.
RECENT FINDINGS
Heroin and fentanyl analogs have surpassed prescription opioids in their availability in rural opioid markets adding to HIV and hepatitis C (HCV) and overdose risks. Only 18% of rural individuals live in towns with inpatient services which are of limited quality and utility. Opioid treatment programs that provide methadone are not located in rural areas and only 3% of the primary care providers have the ability to prescribe buprenorphine. National models and resources have been established but lack implementation in rural areas leading to ongoing HIV and HCV transmission and overdose. Addressing the adverse impact of opioids in the rural U.S. will require a concerted effort to implement effective treatments according to national standards.
摘要
目的综述
描述美国农村地区阿片类药物使用障碍的流行病学，因为它与 HIV 和丙型肝炎的传播和治疗资源有关。
最近的发现
海洛因和芬太尼类似物在农村阿片类药物市场的供应中已经超过了处方类阿片类药物，这增加了 HIV 和丙型肝炎（HCV）以及过量用药的风险。只有 18%的农村居民生活在有住院服务的城镇，这些服务的质量和实用性有限。提供美沙酮的阿片类药物治疗方案不在农村地区，只有 3%的初级保健提供者有能力开出处方类丁丙诺啡。已经建立了国家模式和资源，但在农村地区缺乏实施，导致 HIV 和 HCV 的持续传播和过量用药。要解决美国农村地区阿片类药物的不良影响，需要根据国家标准共同努力实施有效的治疗。
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