Stein Bradley D, Kilmer Beau, Taylor Jirka, Vaiana Mary E, Barnes-Proby Dionne, Caulkins Jonathan P, Davis Lois M, Dworsky Michael, Gates Susan M, Iguchi Martin Y, Osilla Karen Chan, Pacula Rosalie Liccardo, Pardo Bryce, Sherry Tisamarie B, Smucker Sierra
Rand Health Q. 2023 Sep 15;10(4):1. eCollection 2023 Sep.
Opioids play an outsized role in America's drug problems, but they also play a critically important role in medicine. Thus, they deserve special attention. Illegally manufactured opioids (such as fentanyl) are involved in a majority of U.S. drug overdoses, but the problems are broader and deeper than drug fatalities. Depending on the drugs involved, there can be myriad physical and mental health consequences associated with having a substance use disorder. And it is not just those using drugs who suffer. Substance use and related behaviors can significantly affect individuals' families, friends, employers, and wider communities. Efforts to address problems related to opioids are insufficient and sometimes contradictory. Researchers provide a nuanced assessment of America's opioid ecosystem, highlighting how leveraging system interactions can reduce addiction, overdose, suffering, and other harms. At the core of the opioid ecosystem are the individuals who use opioids and their families. Researchers also include detail on ten major components of the opioid ecosystem: substance use disorder treatment, harm reduction, medical care, the criminal legal system, illegal supply and supply control, first responders, the child welfare system, income support and homeless services, employment, and education. The primary audience for this study is policymakers, but it should also be useful for foundations looking for opportunities to create change that have often been overlooked. This study can help researchers better consider the full consequences of policy changes and help members of the media identify the dynamics of interactions that deserve more attention.
阿片类药物在美国的毒品问题中扮演着极为重要的角色，但它们在医学领域也发挥着至关重要的作用。因此，它们值得特别关注。非法制造的阿片类药物（如芬太尼）与美国大多数药物过量死亡事件有关，但问题比药物致死更为广泛和深刻。根据所涉及的药物不同，物质使用障碍可能会带来无数的身心健康后果。而且，不仅仅是吸毒者会遭受痛苦。物质使用及相关行为会对个人的家庭、朋友、雇主以及更广泛的社区产生重大影响。解决与阿片类药物相关问题的努力并不充分，有时甚至相互矛盾。研究人员对美国的阿片类药物生态系统进行了细致入微的评估，强调了如何利用系统间的相互作用来减少成瘾、过量用药、痛苦及其他危害。阿片类药物生态系统的核心是使用阿片类药物的个人及其家庭。研究人员还详细介绍了阿片类药物生态系统的十个主要组成部分：物质使用障碍治疗、减少伤害、医疗保健、刑事法律系统、非法供应与供应控制、急救人员、儿童福利系统、收入支持与无家可归者服务、就业和教育。本研究的主要受众是政策制定者，但对于那些寻求创造变革机会却常常被忽视的基金会来说也应具有参考价值。这项研究可以帮助研究人员更好地考虑政策变化的全面后果，并帮助媒体成员识别那些值得更多关注的相互作用动态。
