ACMT Position Statement: Remove the Waiver Requirement for Prescribing Buprenorphine for Opioid Use Disorder
ACMT Position Statement: Remove the Waiver Requirement for Prescribing Buprenorphine for Opioid Use Disorder
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DOI：
10.1007/s13181-019-00728-9
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发表时间：
2019-10-01
影响因子：
2.9
通讯作者：
Stolbach, Andrew I.
中科院分区：
文献类型：
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作者：
Marino, Ryan;Perrone, Jeanmarie;Stolbach, Andrew I.
背景现行美国法律要求处方者获得丁丙诺啡门诊处方的豁免（“X 豁免”）[1]。北美持续流行的阿片类药物过量死亡现象构成了一场重大的公共卫生危机，据估计，仅 2017 年就有超过 48,000 名美国人死于阿片类药物过量[2]。阿片类药物使用障碍 (OUD) 是一种可以通过药物疗法治疗的慢性疾病。鉴于越来越多的证据，医疗保健界已达成共识，阿片类激动剂治疗 (OAT) 是 OUD 管理的最佳实践 [3]。丁丙诺啡（OAT 的一种形式）治疗可降低 OUD 患者的死亡风险 [4]，预防非致命性阿片类药物过量引起的并发症 [5]，预防注射相关感染，改善整体功能状态 [4, 6]，并且具有成本效益 [7]。
BackgroundCurrent US law requires prescribers to obtain a waiver (“X-waiver”) for outpatient prescription of buprenorphine [1]. The ongoing epidemic of opioid overdose deaths in North America represents a major public health crisis, with more than 48,000 Americans estimated to have died from opioid overdose in 2017 alone [2]. Opioid use disorder (OUD) is a chronic medical condition that can be treated with pharmacological therapies. In response to growing evidence, there is consensus within the healthcare community that opioid agonist therapy (OAT) is the best practice for the management of OUD [3]. Therapy with buprenorphine, a form of OAT, reduces the risk of death in patients with OUD [4], prevents complications from nonfatal opioid overdose [5], prevents injection-associated infections, improves overall functional status [4, 6], and is cost-effective [7].