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解决阿片类药物过量死亡率方面的种族和民族不平等问题:公平干预和结构变革策略

Addressing Racial and Ethnic Inequities in Opioid Overdose Mortality: Strategies for Equitable Interventions and Structural Change.

作者信息

Cruz Fabiola Arbelo, Jegede Oluwole

机构信息

Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, USA.

Connecticut Mental Health Center, 34 Park Street, New Haven, CT, USA.

出版信息

Curr Psychiatry Rep. 2024 Dec;26(12):852-858. doi: 10.1007/s11920-024-01556-7. Epub 2024 Nov 5.

Abstract

PURPOSE OF REVIEW

This review synthetizes findings reflecting the increasing racial and ethnic inequities in opioid overdose mortality and emphasizes the necessity for tailored interventions as well as other policy-level and structural strategies to stem this trend.

RECENT FINDINGS

Factors contributing to inequities in overdose mortality include changes in drug supply, persistent social-structural vulnerabilities stemming from structural racism, and inequities in access to medication for opioid use disorder and harm reduction services. Key strategies to address these inequities include the cultural adaptation of evidence-based interventions within an equity-based framework, integrating social determinants of health into addiction treatment, centering anti-racism praxis in addiction research, diversifying the addiction workforce, and integrating structural competency as a tool to restructure education and inform practice. Structural racism must be recognized as a key driver of inequities in substance use outcomes, and this understanding must be integrated into existing models of substance use disorder prevention, treatment, and research.

摘要

综述目的

本综述综合了反映阿片类药物过量死亡率方面日益加剧的种族和族裔不平等现象的研究结果,并强调了采取针对性干预措施以及其他政策层面和结构性策略以遏制这一趋势的必要性。

最新研究结果

导致过量死亡率不平等的因素包括药物供应的变化、结构性种族主义导致的持续社会结构脆弱性,以及在获得阿片类药物使用障碍治疗药物和减少伤害服务方面的不平等。解决这些不平等问题的关键策略包括在基于公平的框架内对循证干预措施进行文化调适、将健康的社会决定因素纳入成瘾治疗、在成瘾研究中以反种族主义实践为中心、使成瘾领域的劳动力多元化,以及将结构胜任力作为一种工具来重塑教育并指导实践。必须认识到结构性种族主义是物质使用结果不平等的关键驱动因素,并且这种认识必须融入现有的物质使用障碍预防、治疗和研究模式中。

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