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揭开丁丙诺啡滥用的神秘面纱:对药物转移的恐惧是否阻碍了阿片类药物危机的解决?

Demystifying buprenorphine misuse: Has fear of diversion gotten in the way of addressing the opioid crisis?

机构信息

Yale University School of Public Health , New Haven , Connecticut , USA.

Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA.

出版信息

Subst Abus. 2019;40(2):148-153. doi: 10.1080/08897077.2019.1572052. Epub 2019 Apr 22.

Abstract

Buprenorphine is considered one of the most effective treatments for opioid use disorder and significantly reduces risk of overdose death. However, concerns about its diversion and misuse have often taken center stage in public discourse and in the design of practices and policies regarding its use. This has been to the detriment of many vulnerable patient populations, especially those involved in the criminal justice system. Policies that restrict access to buprenorphine in criminal justice and other settings due to concerns of diversion do not accurately reflect the relative risks and safety profile associated with it, creating unnecessary barriers that drive an illicit market of this much-needed medication. Although proper regulation of all controlled medications should be a priority, in most instances the benefits of buprenorphine highly outweigh its risks. In the midst of a national crisis, efforts should be focused on expanding, and not restricting, access to this lifesaving treatment.

摘要

丁丙诺啡被认为是治疗阿片类药物使用障碍最有效的方法之一,能显著降低过量死亡的风险。然而,其滥用和转移用途的问题经常成为公众讨论的焦点,也是制定相关使用实践和政策的关注重点。这对许多弱势群体造成了伤害,尤其是那些涉及刑事司法系统的群体。由于担心丁丙诺啡被转移用途,限制在刑事司法和其他环境中获取丁丙诺啡的政策并没有准确反映出其相关的风险和安全性,反而制造了不必要的障碍,推动了对这种急需药物的非法市场。虽然对所有管制药物进行适当监管应该是当务之急,但在大多数情况下,丁丙诺啡的益处远远超过其风险。在国家危机中,应该集中精力扩大而不是限制这种救命治疗的获取途径。

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