J Leg Med. 2021 Jan-Jun;41(1-2):47-81. doi: 10.1080/01947648.2021.1929589.
As the opioid crisis in the United States evolved, so did the relationship between prescribers and pharmaceutical companies that manufacture prescription opioids, with policymakers at both the state and national levels focused on the issue of prescription opioid misuse. This article discusses the role of the prescriber-pharmaceutical company relationship with respect to opioid over- and underprescribing, the evolution of that relationship over time, and its contribution to what is now commonly known as the U.S. opioid crisis or overdose epidemic. The United States saw several "waves" of prescription opioid misuse, and this article characterizes the relationship between prescribers and pharmaceutical companies in similar waves. The article proposes several prescriber- and manufacturer-focused "solutions" that can be implemented to address and lessen the effects of the ongoing crisis. Changes directed at prescribers manufacturers must be implemented in tandem to ensure such solutions do not, in attempting to fill the existing cracks in the system, create even more.
随着美国阿片类药物危机的发展，开处方者与制造处方类阿片药物的制药公司之间的关系也发生了变化，州和国家各级的政策制定者都关注处方类阿片药物滥用问题。本文讨论了开处方者与制药公司关系在阿片类药物过度和不足处方方面的作用，以及随着时间的推移这种关系的演变，以及它对现在通常被称为美国阿片类药物危机或过量流行的贡献。美国出现了几波处方类阿片药物滥用，本文将开处方者和制药公司之间的关系描述为类似的波次。本文提出了一些以开处方者和制造商为重点的“解决方案”，可以实施这些方案来应对和减轻当前危机的影响。针对开处方者和制造商的变革必须同时实施，以确保这些解决方案在试图填补系统现有漏洞的同时，不会造成更多漏洞。
