From the Harvard Medical School, Boston, MA (JCM, AC, WB); Baylor College of Medicine, Houston, TX (WB).
J Am Board Fam Med. 2022 Mar-Apr;35(2):394-397. doi: 10.3122/jabfm.2022.02.210308.
The rate of overdose deaths has increased dramatically over the past 2 decades. Recently, efforts have been made to expand access to medications for opioid use disorder, such as buprenorphine, by removing X-waiver training requirements. However, relieving such barriers has also raised concern about increasing diversion rates for buprenorphine use, defined as the use of buprenorphine for some purpose or by someone other than it was originally intended. Historically, diversion has been addressed through the criminalization of buprenorphine possession without a prescription. We argue that while buprenorphine diversion is not to be condoned, the benefits of such actions greatly outweigh the harms. Thus, criminalization of diverted buprenorphine represents a dangerous and wasteful response that threatens the progress made through expanded access to this lifesaving medication.
在过去的 20 年里，药物过量死亡的比率急剧上升。最近，人们努力扩大阿片类药物使用障碍药物（如丁丙诺啡）的获取途径，取消 X 豁免培训要求。然而，消除这些障碍也引起了人们对丁丙诺啡转用率（定义为丁丙诺啡被用于某种目的或被非预期的人使用）增加的担忧。从历史上看，丁丙诺啡的转用是通过将未经处方持有丁丙诺啡定为刑事犯罪来解决的。我们认为，虽然不应纵容丁丙诺啡的转用，但这些行为的好处远远大于危害。因此，将转用的丁丙诺啡定罪代表了一种危险和浪费的反应，威胁到通过扩大获取这种救命药物所取得的进展。
