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更安全的供应与医疗实践中的政治干预:艾伯塔省的麻醉品过渡服务。

Safer supply and political interference in medical practice: Alberta's Narcotics Transition Services.

机构信息

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; CUPS Medical Clinic, Calgary, Alberta, Canada.

Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

出版信息

Int J Drug Policy. 2024 Nov;133:104600. doi: 10.1016/j.drugpo.2024.104600. Epub 2024 Oct 2.

Abstract

Across much of Canada, opioid poisoning deaths have been increasing due to a toxic, contaminated, and unpredictable drug supply. Multiple prescribed safer supply pilot projects are being implemented and evaluated in an attempt to save lives. In the province of Alberta, however, new regulations introduced in 2022 significantly constrain safer supply prescribing by banning the prescription, dispensing, and administration of safer supply outside of a very limited number of clinics. In this commentary, we review prescribed safer supply programs in Canada and outline how the Alberta Government's change in regulations conflict with emerging evidence and efforts by other jurisdictions to address the rising opioid poisoning deaths. We examine the development of these regulations and analyze how the Alberta government shaped and justified this restrictive policy. We conclude by identifying important lessons learned from the experience in Alberta for researchers, healthcare providers, and decisionmakers in other jurisdictions.

摘要

在加拿大的大部分地区,由于有毒、受污染且不可预测的药物供应,阿片类药物中毒死亡人数一直在增加。正在实施和评估多个规定的更安全供应试点项目,以试图拯救生命。然而,在艾伯塔省,2022 年出台的新规定极大地限制了更安全供应的处方,禁止在非常有限数量的诊所之外开处方、配药和管理更安全供应,从而对更安全供应的处方产生了影响。在这篇评论中,我们审查了加拿大的规定更安全供应计划,并概述了艾伯塔省政府的法规变更如何与其他司法管辖区为应对不断上升的阿片类药物中毒死亡人数而提出的新证据和努力相冲突。我们研究了这些法规的制定过程,并分析了艾伯塔省政府如何制定和证明这项限制政策的合理性。最后,我们从艾伯塔省的经验中为其他司法管辖区的研究人员、医疗保健提供者和决策者确定了重要的经验教训。

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