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阿片类药物流行:促成因素、负面后果及最佳实践综述

The Opioid Epidemic: A Review of the Contributing Factors, Negative Consequences, and Best Practices.

作者信息

Judd Dallin, King Connor R, Galke Curtis

机构信息

Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, USA.

Marriott School of Business, Brigham Young University, Provo, USA.

出版信息

Cureus. 2023 Jul 10;15(7):e41621. doi: 10.7759/cureus.41621. eCollection 2023 Jul.

Abstract

The opioid epidemic is a significant public health crisis that has caused extensive harm and devastation in the United States. This literature review aimed to identify the contributing factors and negative consequences of the epidemic, as well as best practices for healthcare providers in managing the epidemic. Overprescribing opiates and opioids, lack of education and opportunity, and being unmarried or divorced were some of the identified contributing factors to dependence on opioids. The epidemic's negative consequences are substantial, leading to increased access to opioids for vulnerable populations, which consequently cause accidental death among men and the degradation of rural community health services. As part of the literature review, we also analyzed the best practices for healthcare providers, including implementing prescription drug monitoring programs (PDMPs). However, we found that while PDMPs resulted in a decrease in opioid overprescription and an increase in provider confidence when prescribing medication, the evidence for their effectiveness in improving rural community health services or reducing opioid overdoses and opioid-related deaths was inconclusive. Our review highlights that the greatest challenge to overcome is a lack of legal mandates and proper education for healthcare providers on best practices for addressing the epidemic. To regulate and control opioids effectively, tracking and standardizing prescription models by federal agencies and medical institutions is necessary but not enough. Legal action is vital for the successful containment of the opioid crisis.

摘要

阿片类药物泛滥是一场重大的公共卫生危机,在美国造成了广泛的危害和破坏。这篇文献综述旨在确定该泛滥的促成因素和负面后果,以及医疗保健提供者应对该泛滥的最佳做法。阿片类药物和鸦片制剂的过度开方、缺乏教育和机会,以及未婚或离异是确定的导致阿片类药物依赖的一些促成因素。该泛滥的负面后果相当严重,导致弱势群体更容易获得阿片类药物,进而导致男性意外死亡以及农村社区卫生服务质量下降。作为文献综述的一部分,我们还分析了医疗保健提供者的最佳做法,包括实施处方药监测计划(PDMPs)。然而,我们发现,虽然PDMPs导致阿片类药物过度开方减少,且医疗保健提供者在开药时信心增强,但关于其在改善农村社区卫生服务或减少阿片类药物过量使用及与阿片类药物相关的死亡方面有效性的证据尚无定论。我们的综述强调,要克服的最大挑战是缺乏针对医疗保健提供者应对该泛滥最佳做法的法律规定和适当教育。为了有效监管和控制阿片类药物,联邦机构和医疗机构对处方模式进行跟踪和标准化是必要的,但还不够。法律行动对于成功遏制阿片类药物危机至关重要。

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