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过量用药接收中心——一个时机已到的想法?

Overdose Receiving Centers - An Idea Whose Time Has Come?

作者信息

Hern H Gene, Goldstein David, Tzvieli Ori, Mercer Mary, Sporer Karl, Herring Andrew A

出版信息

Prehosp Emerg Care. 2022 Jan-Feb;26(1):3-5. doi: 10.1080/10903127.2020.1864073. Epub 2021 Feb 2.

Abstract

Drug overdose deaths have been the leading cause of accidental death in the United States with two thirds involving opioids. Strong evidence supports the efficacy of medications for addiction treatment such as buprenorphine and harm reduction strategies such as naloxone distribution. While emergency medical service (EMS) systems have defined specialty centers for the treatment of many significant life threatening disease (trauma, stroke, myocardial infarction) implementation of opioid use disorder systems of care that integrate EMS are uncommon. As fentanyl drives the third wave of the opioid epidemic, EMS systems are uniquely positioned to direct patients to hospitals that can provide the best care for patients with Opiate Use Disorder (OUD.) Emergency Departments which have established systems for early intervention and treatment for patients with opioid use disorders have shown higher engagement in treatment programs. This, in turn, leads to lower mortality. EMS systems which designate specialty centers for overdose patients may show a public health mortality benefit.

摘要

药物过量致死一直是美国意外死亡的主要原因,其中三分之二涉及阿片类药物。有力证据支持药物成瘾治疗药物(如丁丙诺啡)的疗效以及减少伤害策略(如分发纳洛酮)。虽然紧急医疗服务(EMS)系统为许多严重危及生命的疾病(创伤、中风、心肌梗死)设立了专科治疗中心,但整合EMS的阿片类药物使用障碍护理系统并不常见。随着芬太尼引发阿片类药物流行的第三波高峰,EMS系统处于独特地位,能够将患者引导至可为阿片类药物使用障碍(OUD)患者提供最佳护理的医院。为阿片类药物使用障碍患者建立早期干预和治疗系统的急诊科,在治疗项目中的参与度更高。这进而导致死亡率降低。为过量用药患者指定专科中心的EMS系统可能会带来公共卫生方面的死亡率益处。

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