Priest Kelsey C, McCarty Dennis, Lovejoy Travis I
School of Medicine, MD/PhD Program, Oregon Health & Science University, Portland, OR, USA.
School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA.
J Gen Intern Med. 2020 Dec;35(Suppl 3):886-890. doi: 10.1007/s11606-020-06266-3. Epub 2020 Nov 3.
To mitigate morbidity and mortality of the drug-related overdose crisis, the Veterans Health Administration (VHA) can increase access to treatments that save lives-medications for opioid use disorder (MOUD). Despite an increasing need, MOUD continues to be underutilized due to multifaceted barriers that exist within broader macro- and microenvironments. To promote MOUD utilization, policymakers and healthcare leaders should (1) identify and implement person-centered MOUD delivery systems (e.g., the Medication First Model, community-informed design); (2) recognize and address MOUD delivery gaps (e.g., the Best-Practice in Oral Opioid Agonist Collaborative); (3) broaden the definition of the MOUD delivery system (e.g., access to MOUD in non-clinical settings); and (4) expand MOUD options (e.g., injectable opioid agonist therapy). Increasing access to MOUD is not a singular fix to the overdose-related crisis. It is, however, a possible first step to mitigate harm, and save lives.
为降低与药物相关的过量用药危机的发病率和死亡率，退伍军人健康管理局（VHA）可增加获得挽救生命的治疗方法——阿片类药物使用障碍药物（MOUD）的机会。尽管需求不断增加，但由于更广泛的宏观和微观环境中存在多方面障碍，MOUD的使用仍未得到充分利用。为促进MOUD的使用，政策制定者和医疗保健领导者应：（1）确定并实施以患者为中心的MOUD给药系统（例如，药物优先模式、社区知情设计）；（2）认识并解决MOUD给药差距（例如，口服阿片类激动剂协作的最佳实践）；（3）拓宽MOUD给药系统的定义（例如，在非临床环境中获得MOUD）；以及（4）扩大MOUD选项（例如，注射用阿片类激动剂疗法）。增加获得MOUD的机会并非解决过量用药相关危机的唯一办法。然而，这可能是减轻伤害和挽救生命的第一步。
