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阿片类药物使用障碍培训对急诊医学提供者对待阿片类药物使用障碍治疗态度的影响。

Effect of opioid use disorder training on the attitudes of emergency medicine providers toward treatment of opioid use disorder.

作者信息

Creighton Ashley, Shecter Jonathan D, Kruse Maxwell, Wascak Kimberly, Murray Brian Patrick

机构信息

Wright Patterson Air Force Base, 4881 Sugar Maple Dr, Wright-Patterson AFB, OH 45433, United States of America; Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Fairborn, OH 45324, United States of America.

Wright Patterson Air Force Base, 4881 Sugar Maple Dr, Wright-Patterson AFB, OH 45433, United States of America; Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Fairborn, OH 45324, United States of America.

出版信息

Am J Emerg Med. 2025 Jul;93:48-56. doi: 10.1016/j.ajem.2025.03.018. Epub 2025 Mar 14.

Abstract

BACKGROUND

Opioid Use Disorder (OUD) remains a significant public health concern in the United States, claiming a staggering number of lives annually. Medication Assisted Treatment (MAT) with buprenorphine has emerged as an effective intervention. However, its utilization remains low, especially in Emergency Departments (EDs), due in part to bias against addiction. This study evaluated the impact of a grant to increase OUD treatment in the ED from the Ohio Department of Health on bias among ED providers.

METHODS

A longitudinal survey of emergency medicine providers was conducted before and after grant implementation to assess attitudes and prescribing behaviors.

RESULTS

While the grant increased the number of providers prescribing MAT and naloxone, it did not significantly alter attitudes toward OUD treatment in the ED. Providers overwhelmingly recognized addiction as a medical condition deserving empathy, but views on the appropriateness of EDs for addiction treatment remained unchanged.

DISCUSSION

Despite increased MAT prescriptions and naloxone distribution post-grant, the study suggests that broader cultural shifts are needed to integrate OUD treatment into ED practice fully. Efforts to destigmatize addiction and enhance provider education may be necessary to address underlying barriers to OUD treatment acceptance in the ED setting.

CONCLUSION

This study highlights a critical gap between favorable attitudes toward OUD treatment and actual practice. Although education and grant incentives led to increased MAT prescribing, most providers were hesitant to initiate ED treatment. Challenges included perceived lack of training, time constraints, and lingering stigma surrounding addiction.

摘要

背景

阿片类药物使用障碍(OUD)在美国仍然是一个重大的公共卫生问题,每年夺去惊人数量的生命。丁丙诺啡药物辅助治疗(MAT)已成为一种有效的干预措施。然而,其利用率仍然很低,尤其是在急诊科(ED),部分原因是对成瘾存在偏见。本研究评估了俄亥俄州卫生部提供的一项用于增加急诊科OUD治疗的拨款对急诊科医护人员偏见的影响。

方法

在拨款实施前后对急诊医学医护人员进行了纵向调查,以评估他们的态度和处方行为。

结果

虽然拨款增加了开具MAT和纳洛酮的医护人员数量,但并未显著改变急诊科对OUD治疗的态度。医护人员压倒性地认为成瘾是一种值得同情的疾病,但对急诊科进行成瘾治疗的适宜性的看法保持不变。

讨论

尽管拨款后MAT处方和纳洛酮分发有所增加,但该研究表明,需要更广泛的文化转变才能将OUD治疗完全融入急诊科实践。消除成瘾污名化和加强医护人员教育的努力可能是解决急诊科接受OUD治疗的潜在障碍所必需的。

结论

本研究凸显了对OUD治疗的积极态度与实际实践之间的关键差距。尽管教育和拨款激励措施导致MAT处方增加,但大多数医护人员对在急诊科启动治疗仍持犹豫态度。挑战包括感觉缺乏培训、时间限制以及围绕成瘾的持续污名化。

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